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| 1 | Normal aspects of colorectal motility and abnormalities in slow transit constipation显示文摘Human colonic motility is a relatively difficult topic to investigate. However, the refinement of manometric techniques in recent years enabled us to study both the proximal and distal segments of the viscus. The present paper reviews our knowledge about normal aspects of colorectal motility in man and the abnormalities found in slow transit constipation (STC), one of the most frequent and difficult to treat subtypes of constipation. An internetbased search strategy of the Medline and Science Citation Index was performed using the keywords colon, colonic,colorectal, constipation, slow transit, motility, recal, rectum in various combinations with the Boolean operators AND, OR and NOT. Only articles related to human studies were used, and manual cross-referencing was also performed.Most of colonic motor activity is represented by single nonpropagated contractions, rarely organized in bursts; this activity is maximal during the day, especially after waking and following meals. In addition, a specialized propagated activity with propulsive features is detectable, represented by high- and low-amplitude propagated contractions. In the severe form of constipation represented by the slow transit type, the above motor activity is completely deranged. In fact, both basal segmental activity (especially in response to meals) and propagated activity (especially that of high amplitude) are usually decreased, and this may represent a physiologic marker of this disorder. Human colonic motor activity is quite a complex issue, still only partly understood and investigated, due to anatomic and physiological difficulties. In recent years, however, some more data have been obtained, even in proximal segments. These data have helped in elucidating, althoughonly in part, some pathophysiological mechanisms of chronic constipation, and especially of the STC subtype. | Gabrio Bassotti Giuseppe de Roberto Danilo Castellani Luca Sediari Antonio Morelli | 2005 | World Journal of Gastroenterology2005,11,18: | 21 |
| 2 | A randomized double-blind trial on perioperative administration of probiotics in colorectal cancer patients显示文摘AIM:To investigate whether probiotic bacteria,given perioperatively,might adhere to the colonic mucosa, reduce concentration of pathogens in stools,and modulate the local immune function. METHODS:A randomized,double-blind clinical trial was carried out in 31 subjects undergoing elective colorectal resection for cancer.Patients were allocated to receive either a placebo(group A,n=10),or a dose of 10 7 of a mixture of Bifidobacterium longum(BB536) and Lactobacillus johnsonii(La1)(group B,n=11),or the same mixture at a concentration of 10 9 (group C,n=10).Probiotics,or a placebo,were given orally 2 doses/d for 3 d before operation.The same treatment continued postoperatively from day two to day four. Stools were collected before treatment,during surgery (day 0)and 5 d after operation.During the operation, colonic mucosa samples were harvested to evaluate bacterial adherence and to assess the phenotype of dendritic cells(DCs)and lymphocyte subsets by surface antigen expression(flow cytometry).The presence of BB536 and La1 was evaluated by the random amplified polymorphism DNA method with specific polymerase chain reaction probes. RESULTS:The three groups were balanced for baseline and surgical parameters.BB536 was never found at any time-points studied.At day 0,La1 was present in 6/10(60%)patients in either stools or by biopsy in group C,in 3/11(27.2%)in group B,and none in the placebo group(P=0.02,C vs A).There was a linear correlation between dose given and number of adher- ent La1(P=0.01).The rate of mucosal colonization by enterobacteriacae was 30%(3/10)in C,81.8%(9/11) in B and 70%(7/10)in A(P=0.03,C vs B).The Enterobacteriacae count in stools was 2.4(log10 scale) in C,4.6 in B,and 4.5 in A(P=0.07,C vs A and B). The same trend was observed for colonizing enterococ- ci.La1 was not found at day+5.We observed greater expression of CD3,CD4,CD8,and naive and memory lymphocyte subsets in group C than in group A with a dose response trend(C>B>A).Treatment didnot affect DC phenotype or activation,but after ex vivo stimulation with lipopolysaccharides,groups C and B had a lower proliferation rate compared to group A (P=0.04).Moreover,dendritic phenotypes CD83-123, CD83-HLADR,and CD83-11c(markers of activation) were significantly less expressed in patients colonized with La1(P=0.03 vs not colonized). CONCLUSION:La1,but not BB536,adheres to the colonic mucosa,and affects intestinal microbiota byreducing the concentration of pathogens and modulates local immunity. | Luca Gianotti Lorenzo Morelli Francesca Galbiati Simona Rocchetti Sara Coppola Aldo Beneduce Cristina Gilardini Daniela Zonenschain Angelo Nespoli Marco Braga | 2010 | World Journal of Gastroenterology2010,16,2: | 18 |
| 3 | Toward a definition of colonic inertia显示文摘Chronic constipation is a relatively frequent symptom; among its subtypes, the so called-colonic inertia represents a disease condition that is often considered for surgery. However, to date, there has been no agreement on definition of colonic inertia, and a literature review showed that this definition was given to numerous entities that differ from each other.In this paper these concepts are reviewed and a more stringent definition of colonic inertia is proposed. | Gabrio Bassotti Giuseppede Roberto Luca Sediari Antonio Morelli | 2004 | World Journal of Gastroenterology2004,10,17: | 4 |
| 4 | Deep endometriosis with pericolic lymph node involvement: A case report and literature review显示文摘Deep infiltrating endometriosis is an often-painful disorder affecting women during their reproductive years that usually involves the structures of the pelvis and frequently the gastrointestinal tract.We present the case of a 37-year-old female patient with an endometrial growth on the sigmoid colon wall causing pain,diarrhea and the presence of blood in the feces.The histology of the removed specimen also revealed the involvement of the utero-vesical fold,the recto-vaginal septum and a pericolic lymph node,which are all quite uncommon findings.To identify the endometrial cells,we performed immunohistochemical staining for CD10and the estrogen and progesterone receptors. | Andrea Cacciato Insilla Monnalisa Granai Grazia Gallippi Patrizia Giusti Sabina Giusti Simone Guadagni Luca Morelli Daniela Campani | 2014 | World Journal of Gastroenterology2014,20,21: | 4 |
| 5 | Effects of levosi mendan on systemic and regional hemodynamics in septic myo cardial depression 显示文摘 | Morelli A De Castro S De Luca L | 2005 | Intensive Care Medicine2005,31,5: | 1 |
| 6 | Tissue microarray-chip featuring computerized immunophenotypical characterization more accurately subtypes ampullary adenocarcinoma than routine histology显示文摘BACKGROUND Ampullary adenocarcinomas(AACs)are heterogeneous tumors currently classified into three important sub-classes(SC):Intestinal(INT),Pancreato-Biliary(PB)and Mixed-Type(MT).The different subgroups have similar clinical presentation and are treated by pancreatoduodenectomy with curative intent.However,they respond differently to chemotherapy and have different prognostic outcomes.The SC are often difficult to identify with conventional histology alone.The clinical outcome of all three remains unclear,particularly for MT.AIM To identify two main subtypes of AACs,using an immunohistochemical(IHC)score based on CDX2,CK7 and CK20.METHODS Tissue samples from 21 patients who had undergone resection of AAC were classified by HE histology and IHC expression of CDX2,CK7 and CK 20.An IHC score was obtained for each marker by counting the number of positive cells(0=no stained cells;1<25%;2<50%and 3>50%)and their intensity(1=weak;2=moderate and 3=strong).A global score(GS)was then obtained by summation of the IHC scores of each marker.The MT tumors were grouped either with the INT or PB group based on the predominant immuno-molecular phenotype,obtaining only two AACs subtypes.The overall survival in INT and PB patients was obtained by Kaplan-Meier methods.RESULTS Histological parameters defined the AACs subtypes as follows:15%INT,45%PB and 40%MT.Using IHC expression and the GS,75%and 25%of MT samples were assigned to either the INT or the PB group.The mean value of the GS was 9.5(range 4-16).All INT samples had a GS above the average,distinct from the PB samples which had a GS score significantly below the average(P=0.0011).The INT samples were identified by high expression of CDX2 and CK20,whereas PB samples exhibited high expression of CK7 and no expression of CK20(P=0.0008).The INT group had a statistically significant higher overall survival than in the PB group(85.7 mo vs 20.3 mo,HR:8.39;95%CI:1.38 to 18.90;P=0.0152).CONCLUSION The combination of histopathological and molecular criteria enables the classification of AACs into two clinically relevant histo-molecular phenotypes,which appear to represent distinct disorders with potentially significant changes to the current therapeutic strategies. | Matteo Palmeri Niccola Funel Gregorio Di Franco Niccolo Furbetta Desiree Gianardi Simone Guadagni Matteo Bianchini Luca E Pollina Claudio Ricci Marco Del Chiaro Giulio Di Candio Luca Morelli | 2020 | World Journal of Gastroenterology2020,26,43: | 1 |
| 7 | Different Sensitivity of Lamina Propria T-Cell Subsets to Nitric Oxide-Induced Apoptosis Explains Immunomodulatory Activity of a Nitric Oxide--Releasing Derivative of Mesalamine in Rodent Colitis显示文摘 | Luca Santucci John Wallace Andrea Mencarelli Silvana Farneti Antonio Morelli Stefano Fiorucci | 2005 | Gastroenterology2005,,5: | 1 |
| 8 | Orbital chronology of Early Eocene hyperthermals from the Contessa Road section, central Italy显示文摘 | Simone Galeotti Srinath Krishnan Mark Pagani Luca Lanci Alberto Gaudio James C. Zachos Simonetta Monechi Guia Morelli Lucas Lourens | 2010 | Earth and Planetary Science Letters2010,,1: | 1 |
| 9 | Long-Term Study on the Effects of Visual Biofeedback and Muscle Training as a Therapeutic Modality in Pelvic Floor Dyssynergia and Slow-Transit Constipation显示文摘 | Edda Battaglia M.D. Anna Maria Serra M.D. Giuseppina Buonafede M.D. Luca Dughera M.D. Fabio Chistolini M.D. Antonio Morelli M.D. Giorgio Emanuelli M.D. Gabrio Bassotti M.D. Ph.D. F.A.C.G | 2004 | Diseases of the Colon & Rectum2004,,1: | 1 |
| 10 | Impact of Very Advanced Donor Age on Hepatic Artery Thrombosis After Liver Transplantation显示文摘 | Matteo Cescon Matteo Zanello Gian Luca Grazi Alessandro Cucchetti Matteo Ravaioli Giorgio Ercolani Massimo Del Gaudio Augusto Lauro Maria Cristina Morelli Antonio Daniele Pinna | 2011 | Transplantation2011,,4: | 1 |
| 11 | Impact of Very Advanced Donor Age on Hepatic Artery Thrombosis After Liver Transplantation显示文摘 | Matteo Cescon Matteo Zanello Gian Luca Grazi Alessandro Cucchetti Matteo Ravaioli Giorgio Ercolani Massimo Del Gaudio Augusto Lauro Maria Cristina Morelli Antonio Daniele Pinna | 2011 | Transplantation2011,,4: | 1 |
| 12 | Expanding Indications for TIPSS: Portal Decompression Before Elective Oncologic Gastric Surgery in Cirrhotic Patients显示文摘 | Gabriele Catalano Lucio Urbani Paolo De Simone Luca Morelli Laura Coletti Roberto Cioni Giancarlo Matocci Franco Mosca Franco Filipponi | 2005 | Journal of Clinical Gastroenterology2005,,10: | 1 |
| 13 | Standardization of seismic tomographic models and earthquake focalmechanisms data sets based on web technologies,visualization withkeyhole markup language显示文摘 | Luca Postpischln Peter Danecek Andrea Morelli Silvia Pondrelli | 2011 | Computers&Geosciences2011,37,: | 1 |
| 14 | Role of abdominal ultrasound for the surveillance follow-up of pancreatic cystic neoplasms: a cost-effective safe alternative to the routine use of magnetic resonance imaging显示文摘BACKGROUND Patients with pancreatic cystic neoplasms(PCN), without surgical indication at the time of diagnosis according to current guidelines, require lifetime imagebased surveillance follow-up. In these patients, the current European evidencedbased guidelines advise magnetic resonance imaging(MRI) scanning every 6 mo in the first year, then annually for the next five years, without reference to any role for trans-abdominal ultrasound(US). In this study, we report on our clinical experience of a follow-up strategy of image-based surveillance with US, and restricted use of MRI every two years and for urgent evaluation whenever suspicious changes are detected by US.AIM To report the results and cost-efficacy of a US-based surveillance follow-up for known PCNs, with restricted use of MRI.METHODS We retrospectively evaluated the records of all the patients treated in our institution with non-surgical PCN who received follow-up abdominal US and restricted MRI from the time of diagnosis, between January 2012 and January 2017. After US diagnosis and MRI confirmation, all patients underwent US surveillance every 6 mo for the first year, and then annually. A MRI scan was routinely performed every 2 years, or at any stage for all suspicious US findings.In this communication, we reported the clinical results of this alternative followup, and the results of a comparative cost-analysis between our surveillance protocol(abdominal US and restricted MRI) and the same patient cohort that has been followed-up in strict accordance with the European guidelines recommended for an exclusive MRI-based surveillance protocol.RESULTS In the 5-year period, 200 patients entered the prescribed US-restricted MRI surveillance follow-up. Mean follow-up period was 25.1 ± 18.2 mo. Surgery was required in two patients(1%) because of the appearance of suspicious features at imaging(with complete concordance between the US scan and the on-demand MRI). During the follow-up, US revealed changes in PCN appearance in 28 patients(14%). These comprised main pancreatic duct dilatation(n = 1), increased size of the main cyst(n = 14) and increased number of PNC(n = 13). In all of these patients, MRI confirmed US findings, without adding more information.The bi-annual MRI identified evolution of the lesions not identified by US in only11 patients with intraductal papillary mucinous neoplasms(5.5%), largely consisting of an increased number of very small PCN(P = 0.14). The overall mean cost of surveillance, based on a theoretical use of the European evidenced-based exclusive MRI surveillance in the same group of patients, would have been 1158.9± 798.6 € per patient, in contrast with a significantly lower cost of 366.4 ± 348.7 €(P < 0.0001) incurred by the US-restricted MRI surveillance used at our institution.CONCLUSION In patients with non-surgical PCN at the time of diagnosis, US surveillance could be a safe complementary approach to MRI, delaying and reducing the numbers of second level examinations and therefore reducing the costs. | Luca Morelli Simone Guadagni Valerio Borrelli Roberta Pisano Gregorio Di Franco Matteo Palmeri Niccolò Furbetta Dario Gambaccini Santino Marchi Piero Boraschi Luca Bastiani Alessandro Campatelli Franco Mosca Giulio Di Candio | 2019 | World Journal of Gastroenterology2019,25,18: | 0 |
| 15 | Open avenues for carotenoid biofortification of plant tissues显示文摘Plant carotenoids are plastidial isoprenoids that function as photoprotectants,pigments,and precursors of apocarotenoids such as the hormones abscisic acid and strigolactones.Humans do not produce carotenoids but need to obtain them from their diet as precursors of retinoids,including vitamin A.Carotenoids also provide numerous other health benefits.Multiple attempts to improve the carotenoid profile of different crops have been carried out by manipulating carotenoid biosynthesis,degradation,and/or storage.Here,we will focus on open questions and emerging subjects related to the use of biotechnology for carotenoid biofortification.After impressive achievements,new efforts should be directed to extend the use of genome-editing technologies to overcome regulatory constraints and improve consumer acceptance of the carotenoid-enriched products.Another challenge is to prevent off-target effects like those resulting from altered hormone levels and metabolic homeostasis.Research on biofortification of green tissues should also look for new ways to deal with the negative impact that altered carotenoid contents may have on photosynthesis.Once a carotenoid-enriched product has been obtained,additional effort should be devoted to confirming that carotenoid intake from the engineered food is also improved.Thiswork involves ensuring post-harvest stability and assessing bioaccessibility of the biofortified product to confirm that release of carotenoids from the food matrix has not been negatively affected.Successfully addressing these challenges will ensure new milestones in carotenoid biotechnology and biofortification. | Luca Morelli Manuel Rodriguez-Concepcion | 2023 | Plant Communications2023,4,1: | 0 |
| 16 | Use of zebrafish embryos as avatar of patients with pancreatic cancer:A new xenotransplantation model towards personalized medicine显示文摘BACKGROUND The response to chemotherapy treatment of patients with pancreatic ductal adenocarcinoma(PDAC)is difficult to predict and the identification of patients who most likely will benefit from aggressive chemotherapy approaches is crucial.The concept of personalized medicine has emerged in the last years with the objective to tailor the medical treatment to the individual characteristics of each patient,and particularly to the tumor biology of each patient.The need for invivo xenotransplantation models for cancer patients has increased exponentially,and for this reason zebrafish avatars have gained popularity.Preliminary studies were conducted also with PDAC tissue.AIM To develop a simple,not expensive,diffusible zebrafish embryo model as avatar for patients affected by PDAC.METHODS Tumor tissue was taken from the surgical specimen by the histopathologist.After its fragmentation into small pieces,they are stained with CM-Dil.Small pieces of stained tissue were transplanted into the yolk of wt AB zebrafish embryos with a glass capillary needle.Embryos were incubated at 35°C in E3 medium supplemented with 1%Pen/Strep in the presence or absence of drugs for the following days in respect of the treatment plan(Gemcitabine;Gemcitabine and Oxaliplatin;Gemcitabine and nab-Paclitaxel;5-Fluorouracil and Folinic acid and Oxaliplatin and Irinotecan).The response of zebrafish xenografts to the chemotherapy options has been analyzed by monitoring the fluorescent stained area at 2 h post injection(hpi),1 d and 2 d post injection(dpi).In each time point,the mean size of the stained area was measured by ImageJ and it was normalized with respect to the 1 dpi time point mean relative tumor area(RTA).We evaluated the effect of the chemotherapy exposition comparing the mean RTA of each treated subgroup and the control group and evaluating the percentage reduction of the mean RTA by comparing each treated subgroup with the control group.RESULTS Between July 2018 and October 2019,a total of 15 patients with pancreatic cancer were prospectively enrolled.In all cases,it was possible to take a fragment of the tumor from the surgical specimen for the xenotransplantation in the zebrafish embryos.The histological examination confirmed the presence of a PDAC in all cases.In absence of chemotherapy(control group),over time the Dil-stained area showed a statistically significant increase in all cases.A statistically significant reduction of the mean RTA in the treated subgroups for at least one chemotherapy scheme was reported in 6/15(40%)cases.The analysis of the percentage reduction of the RTA in treated subgroups in comparison to the control group revealed the presence of a linear relationship in each subgroup between the percentage reduction of the RTA and the number of cases reporting each percentage threshold considered for the analysis.CONCLUSION Our model seems to be effective for the xenotransplantation of PDAC tissue and evaluation of the effect of each chemotherapy scheme on the xenotransplanted tumor tissue. | Gregorio Di Franco Alice Usai Niccola Funel Matteo Palmeri Ida Elena Rosamaria Montesanti Matteo Bianchini Desirée Gianardi NiccolòFurbetta Simone Guadagni Enrico Vasile Alfredo Falcone Luca Emanuele Pollina Vittoria Raffa Luca Morelli | 2020 | World Journal of Gastroenterology2020,26,21: | 0 |
| 17 | Detailing the ultrastructure’s increase of prion protein in pancreatic adenocarcinoma显示文摘BACKGROUND Recent evidences have shown a relationship between prion protein(PrPc)expression and pancreatic ductal adenocarcinoma(PDAC).Indeed,PrPc could be one of the markers explaining the aggressiveness of this tumor.However,studies investigating the specific compartmentalization of increased PrPc expression within PDAC cells are lacking,as well as a correlation between ultrastructural evidence,ultrastructural morphometry of PrPc protein and clinical data.These data,as well as the quantitative stoichiometry of this protein detected by immuno-gold,provide a significant advancement in understanding the biology of disease and the outcome of surgical resection.AIM To analyze quantitative stoichiometry and compartmentalization of PrPc in PDAC cells and to correlate its presence with prognostic data METHODS Between June 2018 and December 2020,samples from pancreatic tissues of 45 patients treated with pancreatic resection for a preoperative suspicion of PDAC at our Institution were collected.When the frozen section excluded a PDAC diagnosis,or the nodules were too small for adequate sampling,patients were ruled out from the present study.Western blotting was used to detect,quantify and compare the expression of PrPc in PDAC and control tissues,such as those of non-affected neighboring pancreatic tissue of the same patient.To quantify the increase of PrPc and to detect the subcellular compartmentalization of PrPc within PDAC cells,immuno-gold stoichiometry within specific cell compartments was analyzed with electron microscopy.Finally,an analysis of quantitative PrPc expression according to prognostic data,such as cancer stage,recurrence of the disease at 12 mo after surgery and recurrence during adjuvant chemotherapy was made.RESULTS The amount of PrPc within specimen from 38 out of 45 patients was determined by semi-quantitative analysis by using Western blotting,which indicates that PrPc increases almost three-fold in tumor pancreatic tissue compared with healthy pancreatic regions[242.41±28.36 optical density(OD)vs 95±17.40 OD,P<0.0001].Quantitative morphometry carried out by using immuno-gold detection at transmission electron microscopy confirms an increased PrPc expression in PDAC ductal cells of all patients and allows to detect a specific compartmentalization of PrPc within tumor cells.In particular,the number of immuno-gold particles of PrPc was significantly higher in PDAC cells respect to controls,when considering the whole cell(19.8±0.79 particles vs 9.44±0.45,P<0.0001).Remarkably,considering PDAC cells,the increase of PrPc was higher in the nucleus than cytosol of tumor cells,which indicates a shift in PrPc compartmentalization within tumor cells.In fact,the increase of immuno-gold within nuclear compartment exceeds at large the augment of PrPc which was detected in the cytosol(nucleus:12.88±0.59 particles vs 5.12±0.32,P<0.0001;cytosol:7.74.±0.44 particles vs 4.3±0.24,P<0.0001).RESULTS In order to analyze the prognostic impact of PrPc,we found a correlation between PrPc expression and cancer stage according to pathology results,with a significantly higher expression of PrPc for advanced stages.Moreover,24 patients with a mean follow-up of 16.8 mo were considered.Immuno-blot analysis revealed a significantly higher expression of PrPc in patients with disease recurrence at 12 mo after radical surgery(360.71±69.01 OD vs 170.23±23.06 OD,P=0.023),also in the subgroup of patients treated with adjuvant CT(368.36±79.26 OD in the recurrence group vs 162.86±24.16 OD,P=0.028),which indicates a correlation with a higher chemo-resistance.CONCLUSION Expression of PrPc is significantly higher in PDAC cells compared with control,with the protein mainly placed in the nucleus.Preliminary clinical data confirm the correlation with a poorer prognosis. | Matteo Bianchini Maria Anita Giambelluca Maria Concetta Scavuzzo Gregorio Di Franco Simone Guadagni Matteo Palmeri NiccolòFurbetta Desirée Gianardi Niccola Funel Claudio Ricci Raffaele Gaeta Luca Emanuele Pollina Alfredo Falcone Caterina Vivaldi Giulio Di Candio Francesca Biagioni Carla Letizia Busceti Luca Morelli Francesco Fornai | 2021 | World Journal of Gastroenterology2021,27,42: | 0 |
| 18 | Robot-assisted trans-gastric drainage and debridement of walled-off pancreatic necrosis using the EndoWrist stapler for the da Vinci Xi:A case report显示文摘BACKGROUND Walled-off pancreatic necrosis (WOPN) is a late complication of acute pancreatitis. The management of a WOPN depends on its location and on patient's symptoms. Trans-gastric drainage and debridement of WOPN represents an important surgical treatment option for selected patients. The da Vinci surgical System has been developed to allow an easy, minimally invasive and fast surgery, also in challenging abdominal procedures. We present here a case of a WOPN treated with a robotic trans-gastric drainage using the da Vinci Xi. CASE SUMMARY A 63-year-old man with an episode of acute necrotizing pancreatitis was referred to our center. Six wk after the acute episode the patient developed a walled massive fluid collection, with an extensive pancreatic necrosis, causing obstruction of the gastrointestinal tract. The patient underwent a robotic transgastric drainage and debridement of the WOPN performed with the da Vinci Xi platform. Firstly, an anterior ideal gastrotomy was carried out, guided by intraoperative ultrasound (US)-scan using the TilePro? function. Then, through the gastrotomy, the best location for drainage on the posterior gastric wall was again US-guided identified. The anastomosis between the posterior gastric wall and the walled-off necrosis wall was carried out with the new EndoWrist stapler with vascular cartridge. Debridement and washing of the cavity through the anastomosis were performed. Finally, the anterior gastrotomy was closed and the cholecystectomy was performed. The postoperative course was uneventful and a post-operative computed tomography-scan showed the collapse of the fluid collection. CONCLUSION In selected cases of WOPN the da Vinci Surgical System can be safely used as a valid surgical treatment option. | Luca Morelli Niccolò Furbetta Desirée Gianardi Matteo Palmeri Gregorio Di Franco Matteo Bianchini Gianni Stefanini Simone Guadagni Giulio Di Candio | 2019 | World Journal of Clinical Cases2019,7,12: | 0 |