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| 1 | Rebalancing Growth in China:A Three-Handed Approach显示文摘The present paper is an attempt to define the contours of the right macroeconomic strategy for China. In a nutshell, we believe that the package includes a decrease in saving, with a focus on private saving, an increase in the supply of services, in particular health services, and an appreciation of the RMB. This is why we refer to this strategy as a “three-handed approach”: action on the fiscal and budgetary front, accompanied by currency revaluation. We start by asking how the Chinese economy got to where it is, what the strategy has been since the beginning of the reforms, and what the main characteristics of the economy are today. We then ask what is the desirable path for the future, and which are the main policy trade-offs implied by such a path. Finally, we put the various pieces together to describe what we believe is a consistent policy package. | Olivier Blanchard Francesco Giavazzi | 2006 | China & World Economy2006,14,4: | 42 |
| 2 | Current guidelines for the management of non-alcoholic fatty liver disease:A systematic review with comparative analysis显示文摘The current epidemic of non-alcoholic fatty liver disease(NAFLD) is reshaping the field of hepatology all around the world.The widespread diffusion of metabolic risk factors such as obesity,type2-diabetes mellitus,and dyslipidemia has led to a worldwide diffusion of NAFLD.In parallel to the increased availability of effective anti-viral agents,NAFLD is rapidly becoming the most common cause of chronic liver disease in Western Countries,and a similar trend is expected in Eastern Countries in the next years.This epidemic and its consequences have prompted experts from all over the word in identifying effective strategies for the diagnosis,management,and treatment of NAFLD.Different scientific societies from Europe,America,and Asia-Pacific regions have proposed guidelines based on the most recent evidence about NAFLD.These guidelines are consistent with the key elements in the management of NAFLD,but still,show significant difference about some critical points.We reviewed the current literature in English language to identify the most recent scientific guidelines about NAFLD with the aim to find and critically analyse the main differences.We distinguished guidelines from 5 different scientific societies whose reputation is worldwide recognised and who are representative of the clinical practice in different geographical regions.Differences were noted in: the definition of NAFLD,the opportunity of NAFLD screening in high-risk patients,the noninvasive test proposed for the diagnosis of NAFLD and the identification of NAFLD patients with advanced fibrosis,in the follow-up protocols and,finally,in the treatment strategy(especially in the proposed pharmacological management).These difference have been discussed in the light of the possible evolution of the scenario ofNAFLD in the next years. | Simona Leoni Francesco Tovoli Lucia Napoli Ilaria Serio Silvia Ferri Luigi Bolondi | 2018 | World Journal of Gastroenterology2018,24,30: | 42 |
| 3 | Diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy显示文摘Biliary lithiasis is an endemic condition in both Western and Eastern countries, in some studies affecting 20% of the general population. In up to 20% of cases, gallbladder stones are associated with common bile duct stones(CBDS), which are asymptomatic in up to one half of cases. Despite the wide variety of examinations and techniques available nowadays, two main open issues remain without a clear answer: how to cost-effectively diagnose CBDS and, when they are finally found, how to deal with them. CBDS diagnosis and management has radically changed over the last 30 years, following the dramatic diffusion of imaging, including endoscopic ultrasound(EUS) and magnetic resonance cholangiography(MRC), endoscopy and laparoscopy. Since accuracy, invasiveness, potential therapeutic use and costeffectiveness of imaging techniques used to identifyCBDS increase together in a parallel way, the concept of 'risk of carrying CBDS' has become pivotal to identifying the most appropriate management of a specific patient in order to avoid the risk of 'under-studying' by poor diagnostic work up or 'over-studying' by excessively invasive examinations. The risk of carrying CBDS is deduced by symptoms, liver/pancreas serology and ultrasound. 'Low risk' patients do not require further examination before laparoscopic cholecystectomy. Two main 'philosophical approaches' face each other for patients with an 'intermediate to high risk' of carrying CBDS: on one hand, the 'laparoscopy-first' approach, which mainly relies on intraoperative cholangiography for diagnosis and laparoscopic common bile duct exploration for treatment, and, on the other hand, the 'endoscopy-first' attitude, variously referring to MRC, EUS and/or endoscopic retrograde cholangiography for diagnosis and endoscopic sphincterotomy for management. Concerning CBDS diagnosis, intraoperative cholangiography, EUS and MRC are reported to have similar results. Regarding management, the recent literature seems to show better short and long term outcome of surgery in terms of retained stones and need for further procedures. Nevertheless, open surgery is invasive, whereas the laparoscopic common bile duct clearance is time consuming, technically demanding and involves dedicated instruments. Thus, although no consensus has been achieved and CBDS management seems more conditioned by the availability of instrumentation, personnel and skills than cost-effectiveness, endoscopic treatment is largely preferred worldwide. | Renato Costi Alessandro Gnocchi Francesco Di Mario Leopoldo Sarli | 2014 | World Journal of Gastroenterology2014,20,37: | 48 |
| 4 | 儿童家具设计研究及创新方法显示文摘文章以我国儿童家具设计行业的设计现状与困境为切入点,分析儿童家具设计行业存在着忽视设计活动中的设计研究以及缺乏对其创新方法的梳理等设计创新力不足的问题。在此基础上,阐述应从'制造思维'转变为'用户思维'、再进行调焦式设计灵感采集、基于儿童家具设计潮流建立数据采集卡等方面进行设计研究创新,为后期的设计方案概念的生成打下基础。并试图通过设计研究的创新来优化儿童家具设计方法,从而帮助企业提升创新力与可持续竞争力。 | 张楠 关惠元 Francesco Zurlo | 2018 | 南京艺术学院学报(美术与设计)2018,,2: | 38 |
| 5 | Major osteoporotic fragility fractures: Risk factor updates and societal impact显示文摘Osteoporosis is a silent disease without any evidence of disease until a fracture occurs. Approximately 200 million people in the world are affected by osteoporosis and 8.9 million fractures occur each year worldwide. Fractures of the hip are a major public health burden, by means of both social cost and health condition of the elderly because these fractures are one of the main causes of morbidity, impairment, decreased quality of life and mortality in women and men. The aim of this review is to analyze the most important factors related to the enormous impact of osteoporotic fractures on population. Among the most common risk factors, low body mass index; history of fragility fracture, environmental risk, early menopause, smoking, lack of vitamin D, endocrine disorders(for example insulin-dependent diabetes mellitus), use of glucocorticoids, excessive alcohol intake, immobility and others represented the main clinical risk factors associated with augmented risk of fragility fracture. The increasing trend of osteoporosis is accompanied by an underutilization of the available preventive strategies and only a small number of patients at high fracture risk are recognized and successively referred for therapy. This report provides analytic evidences to assess the best practices in osteoporosis management and indications for the adoption of a correct healthcare strategy to significantly reduce the osteoporosis burden. Early diagnosis is the key to resize the impact of osteoporosis on healthcare system. In this context, attention must be focused on the identification of high fracture risk among osteoporotic patients. It is necessary to increase national awareness campaigns across countries in order to reduce the osteoporotic fractures incidence. | Paola Pisani Maria Daniela Renna Francesco Conversano Ernesto Casciaro Marco Di Paola Eugenio Quarta Maurizio Muratore Sergio Casciaro | 2016 | World Journal of Orthopedics2016,7,3: | 39 |
| 6 | 基于Google Earth Engine的长三角城市群生态环境变化与城市化特征分析显示文摘作为城市发展的最高空间组织形式,城市群在高速城市化进程中将不可避免的对地区生态环境产生胁迫影响。如何平衡生态环境和城市化发展已经成为了值得关注的问题。以长三角城市群为例,基于Google Earth Engine云平台,通过整合日间光学遥感和夜间灯光遥感数据对生态环境状况、城市化强度以及二者在发展过程中的耦合协调特征开展了长时间序列的对比分析。结果表明:1)长三角城市群在过去近20年间的遥感生态环境指数(Remote Sensing-based Ecological Index,RSEI)稳定上升,生态环境呈现出好转的态势,但地区间的差异依旧显著;2)综合灯光指数(Comprehensive Nighttime Light Index,CNLI)能够较为准确的刻画城市群的城市化水平,研究期间内长三角城市群形成了'层次分明'、'由东向西'逐步推进的多层次的城市化格局,其中高强度城市化城市集中在上海市及其周边的无锡、苏州和嘉兴,低强度城市化城市则分布在城市群西部;3)基于CNLI和RSEI指数构建的耦合协调距离模型能够有效的识别出城市群内部城市化与生态环境的耦合协调程度,并根据象限特征将城市群城市划分为良好协调类型、初级协调类型、城市化滞后型和生态环境滞后型城市。 | 郑子豪 吴志峰 陈颖彪 杨智威 Francesco Marinello | 2021 | 生态学报2021,41,2: | 36 |
| 7 | Proton pump inhibitor treatment of patients with gastroesophageal reflux-related chronic cough:A comparison between two different daily doses of lansoprazole显示文摘瞄准:为了比较 lansoprazole 的二不同一日量,给 12 个星期并且到估计角色胃肠(官方补给) 是的调查为选择病人的标准。方法:从 45 ,病人们为 unexplained 提交了长期的坚持的咳嗽, 36 有至少一官方补给的调查(内视镜检查法,食道的 pH-metry 和质子的4星期的试用抽的 24-h 禁止者( PPI )治疗)积极并且随机被分配收到 30 mg lansoprazole o.d 或 30 mg 为 12 个星期的 lansoprazole b.i.d 。症状在 PPI 测试(访问 2 ) 以后并且在 12 星期的 lansoprazole 治疗经期(访问 3 ) 以后在基线(访问 1 ) 被评估。结果:35 个病人完成了学习协议。报导的 21 个病人(60.0%) 没有二个治疗组之间的差别从他们的咳嗽完成地势(58.8% 和 61.1% 没在 30 mg lansoprazole 和 60 个 mg lansoprazole 组有咳嗽,分别地) 。在治疗的结束从他们的咳嗽有完全的地势的超过 80% 病人显示出积极回答到 PPI 测试。结论:12 星期甚至在标准一日量的 lansoprazole 治疗,在有长期的坚持的咳嗽的病人是有效的。对起始的 PPI 测试的积极回答似乎是为选择对治疗作出回应的病人的最好的标准。 | Fabio Baldi Roberta Cappiello Carlotta Cavoli Stefania Ghersi Francesco Torresan Enrico Roda | 2006 | World Journal of Gastroenterology2006,12,1: | 31 |
| 8 | Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation(Part Ⅱ:Treatment)显示文摘The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation.There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation.Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre.Osmotic laxatives may be effective in patients who do not respond to fibre supplements.Stimulant laxatives should be reserved for patients who do not respond to osmotic laxatives.Controlled trials have shown that serotoninergic enterokinetic agents,such as prucalopride,and prosecretory agents,such as lubiprostone,are effective in the treatment of patients with chronic constipation.Surgery is sometimes necessary.Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coli who are resistant to medical therapy and who do not have defecatory disorders,generalised motility disorders or psychological disorders.Randomised controlled trials have established the efficacy of rehabilitative treatment in dys-synergic defecation.Many surgical procedures may be used to treat obstructed defecation in patients with acquired anatomical defects,but none is considered to be the gold standard.Surgery should be reserved for selected patients with an impaired quality of life.Obstructed defecation is often associated with pelvic organ prolapse.Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse,but the efficacy and safety of such procedures have not yet been established. | Antonio Bove Massimo Bellini Edda Battaglia Renato Bocchini Dario Gambaccini Vincenzo Bove Filippo Pucciani Donato Francesco Altomare Giuseppe Dodi Guido Sciaudone Ezio Falletto Vittorio Piloni | 2012 | World Journal of Gastroenterology2012,18,36: | 33 |
| 9 | Black soldier fly defatted meal as a dietary protein source for broiler chickens:Effects on growth performance,blood traits,gut morphology and histological features显示文摘Background: The present study has evaluated the effects of different inclusion levels of a partially defatted black soldier fly(Hermetia illucens L.; HI) larva meal on the growth performance, blood parameters and gut morphology of broiler chickens. A total of 256 male broiler chickens(Ross 308) were reared from d 1 to d 35 and assigned to4 dietary treatments(8 replicates/treatment and 8 birds/replicate). HI larva meal was included at increasing levels(0, 5%, 10% and 15%; HI0, HI5, HI10 and HI15, respectively) in isonitrogenous and isoenergetic diets formulated for 3 feeding phases: starter(1–10 d), growing(10–24 d) and finisher(24–35 d). Two birds per pen were slaughtered at d 35 and morphometric investigations and histopathological alterations were performed.Results: The live weight(LW) showed linear and quadratic responses to increasing HI larva meal(maximum for HI10 group). Average daily gain(ADG) showed a linear and quadratic responses to HI meal(maximum for HI10 group) during starter and growing periods. A linear decrease was observed for ADG during the finisher period. The daily feed intake(DFI) showed a linear and quadratic effect during the starter period(maximum for HI10 group).Linear and quadratic responses were observed for the feed conversion ratio(FCR) in the growing period and for the whole period of the experiment. The FCR showed a linear response in the finisher period(maximum for HI15).No significant effects were observed for the blood and serum parameters, except for the phosphorus concentration,which showed linear and quadratic responses as well as glutathione peroxidase(GPx) activity, the latter of which showed a linear response. The HI15 birds showed a lower villus height, a higher crypt depth and a lower villus height-to-crypt depth ratio than the other groups.Conclusions: Increasing levels of dietary HI meal inclusion in male broiler chickens may improve the LW and DFI during the starter period, but may also negatively affect the FCR and gut morphology, thus suggesting that low levels may be more suitable. However, no significant effects on the haematochemical parameters or histological findings were observed in relation to HI meal utilization. | Sihem Dabbou Francesco Gai Ilaria Biasato Maria Teresa Capucchio Elena Biasibetti Daniela Dezzutto Marco Meneguz Iveta Plachà Laura Gasco Achille Schiavone | 2018 | Journal of Animal Science and Biotechnology2018,9,4: | 34 |
| 10 | Short-term clinical outcomes of laparoscopic vs open rectal excision for rectal cancer: A systematic review and metaanalysis显示文摘AIM To review evidence on the short-term clinical outcomes of laparoscopic(LRR) vs open rectal resection(ORR) for rectal cancer.METHODS A systematic literature search was performed using Cochrane Central Register, MEDLINE, EMBASE, Scopus, Open Grey and Clinical Trials.gov register for randomized clinical trials(RCTs) comparing LRR vs ORR for rectal cancer and reporting short-term clinical outcomes. Articles published in English from January 1, 1995 to June, 30 2016 that met the selection criteria were retrieved and reviewed. The Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) statements checklist for reporting a systematic review was followed. Random-effect models were used to estimate mean differences and risk ratios. The robustness and heterogeneity of the results were explored by performing sensitivity analyses. The pooledeffect was considered significant when P < 0.05.RESULTS Overall, 14 RCTs were included. No differences were found in postoperative mortality(P = 0.19) and morbidity(P = 0.75) rates. The mean operative time was 36.67 min longer(95%CI: 27.22-46.11, P < 0.00001), the mean estimated blood loss was 88.80 ml lower(95%CI:-117.25 to-60.34, P < 0.00001), and the mean incision length was 11.17 cm smaller(95%CI:-13.88 to-8.47, P < 0.00001) for LRR than ORR. These results were confirmed by sensitivity analyses that focused on the four major RCTs. The mean length of hospital stay was 1.71 d shorter(95%CI:-2.84 to-0.58, P < 0.003) for LRR than ORR. Similarly, bowel recovery(i.e., day of the first bowel movement) was 0.68 d shorter(95%CI:-1.00 to-0.36, P < 0.00001) for LRR. The sensitivity analysis did not confirm a significant difference between LRR and ORR for these latter two parameters. The overall quality of the evidence was rated as high. CONCLUSION LRR is associated with lesser blood loss, smaller incision length, and longer operative times compared to ORR. No differences are observed for postoperative morbidity and mortality. | Aleix Martínez-Pérez Maria Clotilde Carra Francesco Brunetti Nicola de'Angelis | 2017 | World Journal of Gastroenterology2017,23,44: | 33 |
| 11 | Percutaneous assist devices in acute myocardial infarction with cardiogenic shock: Review, meta-analysis显示文摘AIM: To assess the impact of percutaneous cardiac support in cardiogenic shock(CS) complicating acute myocardial infarction(AMI), treated with percutaneous coronary intervention. METHODS: We selected all of the studies published from January 1st, 1997 to May 15 st, 2015 that compared the following percutaneous mechanical support in patients with CS due to AMI undergoing myocardial revascularization:(1) intra-aortic balloon pump(IABP) vs Medical therapy;(2) percutaneous left ventricular assist devices(PLVADs) vs IABP;(3) complete extracorporeal life support with extracorporeal membrane oxygenation(ECMO) plus IABP vs IABP alone; and(4) ECMO plus IABP vs ECMO alone, in patients with AMI and CS undergoing myocardial revascularization. We evaluated the impact of the support devices on primary and secondary endpoints. Primary endpoint was the inhospital mortality due to any cause during the same hospital stay and secondary endpoint late mortality at 6-12 moof follow-up. RESULTS: One thousand two hundred and seventytwo studies met the initial screening criteria. After detailed review, only 30 were selected. There were 6 eligible randomized controlled trials and 24 eligible observational studies totaling 15799 patients. We found that the inhospital mortality was:(1) significantly higher with IABP support vs medical therapy(RR = +15%, P = 0.0002);(2) was higher, although not significantly, with PLVADs compared to IABP(RR = +14%, P = 0.21); and(3) significantly lower in patients treated with ECMO plus IABP vs IABP(RR =-44%, P = 0.0008) or ECMO(RR =-20%, P = 0.006) alone. In addition, Trial Sequential Analysis showed that in the comparison of IABP vs medical therapy, the sample size was adequate to demonstrate a significant increase in risk due to IABP. CONCLUSION: Inhospital mortality was significantly higher with IABP vs medical therapy. PLVADs did not reduce early mortality. ECMO plus IABP significantly reduced inhospital mortality compared to IABP. | Francesco Romeo Maria Cristina Acconcia Domenico Sergi Alessia Romeo Simona Francioni Flavia Chiarotti Quintilio Caretta | 2016 | World Journal of Cardiology2016,8,1: | 29 |
| 12 | Gastric cancer: Current status of lymph node dissection显示文摘D2 procedure has been accepted in Far East as the standard treatment for both early(EGC) and advanced gastric cancer(AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials(RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique. In case of AGC the debate on the extent of nodal dissection has been open for many decades. While D2 gastrectomy was performed as the standard procedure in eastern countries, mostly based on observational and retrospective studies, in the west the Medical Research Council(MRC), Dutch and Italian RCTs have been conducted to show a survival benefit of D2 over D1 with evidence based medicine. Unfortunately both the MRC and the Dutch trials failed to show a survival benefit after the D2 procedure, mostly due to the significant increase of postoperative morbidity and mortality, which was referred to splenopancreatectomy. Only 15 years after the conclusion of its accrual, the Dutch trial could report a significant decrease of recur-rence after D2 procedure. Recently the long term survival analysis of the Italian RCT could demonstrate a benefit for patients with positive nodes treated with D2 gastrectomy without splenopancreatectomy. As nowadays also in western countries D2 procedure can be done safely with pancreas preserving technique and without preventive splenectomy, it has been suggested in several national guidelines as the recommended procedure for patients with AGC. | Maurizio Degiuli Giovanni De Manzoni Alberto Di Leo Domenico D'Ugo Erica Galasso Daniele Marrelli Roberto Petrioli Karol Polom Franco Roviello Francesco Santullo Mario Morino | 2016 | World Journal of Gastroenterology2016,22,10: | 29 |
| 13 | Nutritional value of a partially defatted and a highly defatted black soldier fly larvae (Hermetia illucens L.) meal for broiler chickens: apparent nutrient digestibility,apparent metabolizable energy and apparent ileal amino acid digestibility显示文摘Background: The study aimed to determine the apparent total tract digestibility coefficients(ATTDC) of nutrients, the apparent metabolizable energy(AME and AMEn) and the amino acid(AA) apparent ileal digestibility coefficients(AIDC)of a partially defatted(BSFp) and a highly defatted(BSFh) black soldier fly larvae meal. The experimental diets were: a basal diet and two diets prepared by substituting 250 g/kg(w/w) of the basal diet with BSFp or BSFh, respectively.Results: Significant differences were found between BSFp and BSFh meals for ATTDC of the nutrients: BSFp resulted more digestible than BSFh, except for ATTDC of CP which did not differed between meals, while a statistical trend was observed for ATTDC of DM and EE. The AME and AMEn values were significantly(P < 0.05) different between the two BSF meals, with higher levels for BSFp(16.25 and 14.87 MJ/kg DM, respectively). The AIDC of the AA in BSFp ranged from 0.44 to 0.92, while in BSFh they ranged from 0.45 to 0.99. No significant differences were observed for the AA digestibility(0.77 and 0.80 for BSFp and BSFh, respectively), except for glutamic acid, proline and serine that were more digestible in the BSFh meal(P < 0.05).Conclusions: Defatted BSF meals can be considered as an excellent source of AME and digestible AA for broilers with a better efficient nutrient digestion. These considerations suggested the effective utilization of defatted BSF larvae meal in poultry feed formulation. | Achille Schiavone Michele De Marco Silvia Martínez Sihem Dabbou Manuela Renna Josefa Madrid Fuensanta Hernandez Luca Rotolo Pierluca Costa Francesco Gai Laura Gasco | 2017 | Journal of Animal Science and Biotechnology2017,8,4: | 27 |
| 14 | Intestinal inflammation and colorectal cancer:A doubleedged sword?显示文摘Chronic inflammation is thought to be the leading cause of many human cancers including colorectal cancer(CRC).Accordingly,epidemiologic and clinical studies indicate that patients affected by ulcerative colitis and Crohn's disease,the two major forms of inflammatory bowel disease,have an increased risk of developing CRC.In recent years,the role of immune cells and their products have been shown to be pivotal in initiation and progression of colitis-associated CRC.On the other hand,activation of the immune system has been shown to cause dysplastic cell elimination and cancer suppression in other settings.Clinical and experimental data herein reviewed,while confirming chronic inflammation as a risk factor for colon carcinogenesis,do not completely rule out the possibility that under certain conditions the chronic activation of the mucosal immune system might protect from colonic dysplasia. | Angelamaria Rizzo Francesco Pallone Giovanni Monteleone Massimo Claudio Fantini | 2011 | World Journal of Gastroenterology2011,17,26: | 25 |
| 15 | Sarcopenia in heart failure: mechanisms and therapeutic strategies显示文摘长期的心失败(CHF ) 是一个高度流行的条件在之中老并且与可观的病态, institutionalization 和死亡被联系。在它的先进阶段, CHF 被肌肉质量和力量的损失经常伴随。Sarcopenia 是活跃地与大量不利健康结果由于它的协会在最近的年里被学习了的衰老老人症候群。这评论的目标是讨论在 CHF 和 sarcopenia 之间的关系,与分享的 pathophysiological 小径和处理的一个焦点。营养不良,全身的发炎,内分泌的不平衡,和氧化应力看起来连接 sarcopenia 和 CHF。在肌肉发达的水平, ubiquitin proteasome 系统,发信号的 myostatin,和 apoptosis 的改变在 sarcopenia 和 CHF 被描述了并且能在肌肉质量和功能的损失起一个作用。阻碍肌肉在 CHF 病人浪费的前进的可能的治疗学的策略包括变换血管收缩素的酶禁止者和 β 的蛋白质和维生素 D 补充,结构化的物理锻练,和管理; -blockers。有生长荷尔蒙,睾丸激素,和 ghrelin 的神经质的补充也作为潜在的治疗被讨论。 | Agnese Collamati Emanuele Marzetti Riccardo Calvani Matteo Tosato Emanuela D'Angelo Alex N Sisto Francesco Landi | 2016 | Journal of Geriatric Cardiology2016,13,7: | 25 |
| 16 | Locally advanced nasopharyngeal carcinoma:Current and emerging treatment strategies显示文摘Although nasopharyngeal carcinoma(NPC)is a widespread malignant tumor,it is particularly frequent in Southeast Asia.Although T1 tumors can be effectively controlled with exclusive radiotherapy,this treatment modality is insufficient for most NPC patients,who present with locally advanced disease at diagnosis.In fact,for stages ranging from T2b N0 to T4 N3,definitive scientific evidence supports the use of concurrent platinum-based chemotherapy with standard external beam radiotherapy.This treatment approach has shown a statistically significant advantage in terms of overall survival,with respect to radiotherapy alone.Several trials have also investigated the use of neoadjuvant and adjuvant chemotherapy in combination with radiotherapy or chemo-radiotherapy.Platinum compounds,anthracyclines and taxanes are among the chemotherapy agents employed.This review focuses on the clinical results obtained in the field of adjuvant/concurrent/neoadjuvant chemotherapy for locally advanced NPC,for which exclusive concurrent chemo-radiotherapy currently represents the standard treatment approach. | Francesco Perri Davide Bosso Carlo Buonerba Giuseppe Di Lorenzo Giuseppina Della Vittoria Scarpati | 2011 | World Journal of Clinical Oncology2011,2,12: | 24 |
| 17 | Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis显示文摘AIM: To evaluate acute cholecystitis, complicated by peritonitis, acute phase response and immunological status in patients treated by laparoscopic or open approach. METHODS: From January 2002 to May 2012, we conducted a prospective randomized study on 45 consecutive patients (27 women, 18 men; mean age 58 years). These subjects were taken from a total of 681 patients who were hospitalised presenting similar preoperative findings: acute upper abdominal pain with tenderness, involuntary guarding under the right hypochondrium and/or in the flank; fever higher than 38 ℃, leukocytosis greater than 10 × 10 9 /L or both, and ultrasonographic evidence of calculous cholecystitis possibly complicated by peritonitis. These patients had undergone cholecystectomy for acute calculous cholecystitis,complicated by bile peritonitis. Randomly, 23 patients were assigned to laparoscopic cholecystectomy (LC), and 22 patients to open cholecystectomy (OC). Blood samples were collected from all patients before operation and at days 1, 3 and 6 after surgery. Serum bacteraemia, endotoxaemia, white blood cells (WBCs), WBC subpopulations, human leukocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin-1 (IL-1) and IL-6, and C-reactive protein (CRP) were measured at 0, 30, 60, 90, 120 and 180 min, at 4, 6, 12, 24 h, and then daily (8 A.M.) until post-operative day 6.RESULTS: The two groups were comparable in the severity of peritoneal contamination as indicated by the viable bacterial count (open group = 90% of positive cultures vs laparoscopic group = 87%) and endotoxin level (open group = 33.21 ± 6.32 pg/mL vs laparoscopic group = 35.02 ± 7.23 pg/mL). Four subjects in the OC group (18.1%) and 1 subject (4.3%) in the LC group (P < 0.05) developed intra-abdominal abscess. Severe leukocytosis (range 15.8-19.6/mL) was observed only after OC but not after LC, mostly due to an increase in neutrophils (days 1 and 3, P < 0.05). This value returned to the normal range within 3-4 d after LC and 5-7 d after OC. Other WBC types and lymphocyte subpopulations showed no significant variation. On the first day after surgery, a statistically significant difference was observed in HLA-DR expression between LC (13.0 ± 5.2) and OC (6.0 ± 4.2) (P < 0.05). A statistically significant change in plasma elastase concentration was recorded post-operatively at days 1, 3, and 6 in patients from the OC group when compared to the LC group (P < 0.05). In the OC group, the serum levels of IL-1 and IL-6 began to increase considerably from the first to the sixth hour after surgery. In the LC group, the increase of serum IL-1 and IL-6 levels was delayed and the peak values were notably lower than those in the OC group. Significant differences between the groups, for these two cytokines, were observed from the second to the twenty-fourth hour (P < 0.05) after surgery. The mean values of serum CRP in the LC group on post-operative days (1 and 3) were also lower than those in the OC group (P < 0.05). Systemic concentration of endotoxin was higher in the OC group at all intra-operative sampling times, but reached significance only when the gallbladder was removed (OC group = 36.81 ± 6.4 ρg/mLvs LC group = 16.74 ± 4.1 ρg/mL, P < 0.05). One hour after surgery, microbiological analysis of blood cultures detected 7 different bacterial species after laparotomy, and 4 species after laparoscopy (P < 0.05). CONCLUSION: OC increased the incidence of bacteraemia, endotoxaemia and systemic inflammation compared with LC and caused lower transient immunological defense, leading to enhanced sepsis in the patients examined. | Federico Sista Mario Schietroma Giuseppe De Santis Antonella Mattei Emanuela Marina Cecilia Federica Piccione Sergio Leardi Francesco Carlei Gianfranco Amicucci | 2013 | World Journal of Gastrointestinal Surgery2013,5,4: | 23 |
| 18 | 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 |
| 19 | Surgical treatment of anal stenosis显示文摘Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classifi cation of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed. Ninety percent of anal stenosis is caused by overzealous hemorrhoidectomy. Treatment, both medical and surgical, should be modulated based on stenosis severity. Mild stenosis can be managed conservatively with stool softeners or fiber supplements. Sphincterotomy may be quite adequate for a patient with a mild degree of narrowing. For more severe stenosis, a formal anoplasty should be performed to treat the loss of anal canal tissue. Anal stenosis may be anatomic or functional. Anal stricture is most often a preventable complication. Many techniques have been used for the treatment of anal stenosis with variable healing rates. It is extremely diffi cult to interpret the results of the various anaplastic procedures de in the literature as prospective trials have not been performed. However, almost any approach will at least improve patient symptoms. | Giuseppe Brisinda Serafino Vanella Federica Cadeddu Gaia Marniga Pasquale Mazzeo Francesco Brandara Giorgio Maria | 2009 | World Journal of Gastroenterology2009,15,16: | 22 |
| 20 | Oxidative stress:New insights on the association of nonalcoholic fatty liver disease and atherosclerosis显示文摘Non-alcoholic fatty liver disease(NAFLD) represents the most common and emerging chronic liver disease worldwide. It includes a wide spectrum of liver diseasesranging from simple fatty liver to non-alcoholic steatohepatitis(NASH),which may progress to fibrosis and more severe liver complications such as cirrhosis,hepatocellular carcinoma and liver mortality. NAFLD is strongly associated with obesity,insulin resistance,hypertension,and dyslipidaemia,and is now regarded as the liver manifestation of the metabolic syndrome. The increased mortality of patients with NAFLD is primarily a result of cardiovascular disease and,to a lesser extent,to liver related diseases. Increased oxidative stress has been reported in both patients with NAFLD and patient with cardiovascular risk factors. Thus,oxidative stress represents a shared pathophysiological disorder between the two conditions. Several therapeutic strategies targeting oxidative stress reduction in patients with NAFLD have been proposed,with conflicting results. In particular,vitamin E supplementation has been suggested for the treatment of non-diabetic,non-cirrhotic adults with active NASH,although this recommendation is based only on the results of a single randomized controlled trial. Other antioxidant treatments suggested are resveratrol,silybin,L-carnitine and pentoxiphylline. No trial so far,has evaluated the cardiovascular effects of antioxidant treatment in patients with NAFLD. New,large-scale studies including as end-point also the assessment of the atherosclerosis markers are needed. | Licia Polimeni Maria Del Ben Francesco Baratta Ludovica Perri Fabiana Albanese Daniele Pastori Francesco Violi Francesco Angelico | 2015 | World Journal of Hepatology2015,7,10: | 23 |