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1Endoscopic submucosal dissection vs endoscopic mucosal resection for early gastric cancer: A meta-analysis显示文摘AIM: To compare endoscopic submucosal dissection(ESD) and endoscopic mucosal resection(EMR) for early gastric cancer(EGC).METHODS: Computerized bibliographic search was performed on PubMed/Medline, Embase, Google Schol-ar and Cochrane library databases. Quality of each included study was assessed according to current Co-chrane guidelines. Primary endpoints were en bloc re-section rate and histologically complete resection rate. Secondary endpoints were length of procedure, post-treatment bleeding, post-procedural perforation and re-currence rate. Comparisons between the two treatment groups across all the included studies were performed by using Mantel-Haenszel test for fixed-effects mod-els(in case of low heterogeneity) or DerSimonian and Laird test for random-effects models(in case of high heterogeneity).RESULTS: Ten retrospective studies(8 full text and 2 abstracts) were included in the meta-analysis. Overall data on 4328 lesions, 1916 in the ESD and 2412 in the EMR group were pooled and analyzed. The mean operation time was longer for ESD than for EMR(stan-dardized mean difference 1.73, 95%CI: 0.52-2.95, P =0.005) and the 'en bloc ' and histological complete re-section rates were significantly higher in the ESD group [OR = 9.69(95%CI: 7.74-12.13), P < 0.001 and OR = 5.66,(95%CI: 2.92-10.96), P < 0.001, respectively]. As a consequence of its greater radicality, ESD provided lower recurrence rate [OR = 0.09,(95%CI: 0.05-0.17), P < 0.001]. Among complications, perforation rate was significantly higher after ESD [OR = 4.67,(95%CI, 2.77-7.87), P < 0.001] whereas the bleeding incidences did not differ between the two techniques [OR = 1.49(0.6-3.71), P = 0.39].CONCLUSION: In the endoscopic therapy of EGC, ESD showed a superior efficacy but higher complication rate with respect to EMR.Antonio Facciorusso Matteo Antonino Marianna Di Maso Nicola Muscatiello 2014World Journal of Gastrointestinal Endoscopy2014,6,11:50
2Systematic review of surgical resection vs radiofrequency ablation for hepatocellular carcinoma显示文摘Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation can not be offered or is not immediately accessible. Hepatic resection (HR) is currently considered the most curative strategy, but in the last decade local ablative therapies have started to obtain satisfactory results in term of efficacy and, of them, radiofrequency ablation (RFA) is considered the reference standard. An extensive literature review, from the year 2000, was performed, focusing on results coming from studies that directly compared HR and RFA. Qualities of the studies, characteristics of patients included, and patient survival and recurrence rates were analyzed. Except for three randomized controlled trials (RCT), most studies are affected by uncertain methodological approaches since surgical and ablated patients represent different populations as regards clinical and tumor features that are known to affect prognosis. Unfortunately, even the available RCTs report conflicting results. Until further evidences become available, it seems reasonable to offer RFA to very small HCC (< 2 cm) with no technical contraindications, since in this instance complete necrosis is most likely to be achieved. In larger nodules, namely > 2 cm and especially if > 3 cm, and/or in tumor locations in which ablation is not expected to be effective or safe, surgical removal is to be preferred.Alessandro Cucchetti Fabio Piscaglia Matteo Cescon Giorgio Ercolani Antonio Daniele Pinna 2013World Journal of Gastroenterology2013,19,26:40
3Drug-induced liver injury:Is it somehow foreseeable?显示文摘The classic view on the pathogenesis of drug-induced liver injury is that the so-called parent compounds are made hepatotoxic by metabolism (formation of neosubstances that react abnormally), mainly by cytochromes P-450 (CYP), with further pathways, such as mitochondrial dysfunction and apoptosis, also playing a role. Risk factors for drug-induced liver injury include concomitant hepatic diseases, age and genetic polymorphisms of CYP. However, some susceptibility can today be predicted before drug administration, working on the common substrate, by phenotyping and genotyping studies and by taking in consideration patients' health status. Physicians should always think of this adverse effect in the absence of other clear hepatic disease. Ethical and legal problems towards operators in the health care system are always matters to consider.Giovanni Tarantino Matteo Nicola Dario Di Minno Domenico Capone 2009World Journal of Gastroenterology2009,15,23:30
4Prognostic factors for hepatocellular carcinoma recurrence显示文摘The recurrence of hepatocellular carcinoma,the sixth most common neoplasm and the third leading cause of cancer-related mortality worldwide,represents an important clinical problem,since it may occur after both surgical and medical treatment.The recurrence rate involves 2 phases:an early phase and a late phase.The early phase usually occurs within 2 years after resection;it is mainly related to local invasion and intrahepatic metastases and,therefore,to the intrinsic biology of the tumor.On the other hand,the late phase occurs more than 2 years after surgery and is mainly related to de novo tumor formation as a consequence of the carcinogenic cirrhotic environment.Since recent studies have reported that early and late recurrences may have different risk factors,it is clinically important to recognize these factors in the individual patient as soon as possible.The aim of this review was,therefore,to identify predicting factors for the recurrence of hepatocellularcarcinoma,by means of invasive and non-invasive methods,according to the different therapeutic strategies available.In particular the role of emerging techniques(e.g.,transient elastography)and biological features of hepatocellular carcinoma in predicting recurrence have been discussed.In particular,invasive methods were differentiated from non-invasive ones for research purposes,taking into consideration the emerging role of the genetic signature of hepatocellular carcinoma in order to better allocate treatment strategies and surveillance follow-up in patients with this type of tumor.Antonio Colecchia Ramona Schiumerini Alessandro Cucchetti Matteo Cescon Martina Taddia Giovanni Marasco Davide Festi 2014World Journal of Gastroenterology2014,20,20:28
5Sarcopenia 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 2016Journal of Geriatric Cardiology2016,13,7:25
6MicroRNAs as possible biomarkers for diagnosis and prognosis of hepatitis b- and c-related-hepatocellularcarcinoma显示文摘Aim of the present review is to summarize the current knowledge about the potential relationship between mi RNAs and hepatitis B virus(HBV)-hepatitis C virus(HCV) related liver diseases. A systematic computerbased search of published articles, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis Statement, was performed to identify relevant studies on usefulness of serum/plasma/urine mi RNAs, as noninvasive biomarkers for early detection of HBV and HCV-induced hepatocellular carcinoma(HCC) development, as well as for its prognostic evaluation. The used Medical Subject Headings terms and keywords were: 'HBV', 'HCV', 'hepatocellular carcinoma', 'micro RNAs', 'mi RNAs', 'diagnosis', 'prognosis', 'therapy', 'treatment'. Some serum/plasma mi RNAs, including mi R-21, mi R-122, mi-125a/b, mi R-199a/b, mi R-221, mi R-222, mi R-223, mi R-224 might serve as biomarkers for early diagnosis/prognosis of HCC, but, to date, not definitive results or well-defined panels of mi RNAs have been obtained. More well-designed studies, focusing on populations of different geographical areas and involving larger series of patients, should be carried out to improve our knowledge on the potential role of mi RNAs for HCC early detection and prognosis.Sirio Fiorino Maria Letizia Bacchi-Reggiani Michela Visani Giorgia Acquaviva Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Luca Di Tommaso Arrigo Bondi Sergio Sabbatani Andrea Domanico Carlo Fabbri Paolo Leandri Annalisa Pession Elio Jovine Dario de Biase 2016World Journal of Gastroenterology2016,22,15:25
7What we should know about portal vein thrombosis in cirrhotic patients:A changing perspective显示文摘Portal vein thrombosis(PVT) is one of the most common complications occurring during the natural course of liver cirrhosis.Even though PVT is often asymptomatic,the worsening of liver function,an unexpected episode of gastrointestinal bleeding or ascitic decompensation may be landmarks of PVT development.Beyond these clinical manifestations,it is debated whether PVT really has an impact on liver cirrhosis natural history or rather represents only one of its consequences.Probably PVT development should not only be considered as a matter of impaired blood flow or pro-coagulation tendency.On one hand,PVT seems a consequence of the worsening in portal vein outflow due to the increased hepatic resistance in cirrhotic livers.On the other hand,vascular microthrombosis secondary to necroinflammation may cause liver ischemia and infarction,with loss of hepatic tissue(parenchymal extinction) which is replaced by fibrotic tissue.Therefore,PVT might also be considered as the overt manifestation of the liver fibrosing process evolution and anticoagulant therapy may thus have microscopic indirect effects also on the progression of liver disease.At present,a connection between PVT development and the progression of liver fibrosis/cirrhosis has not yet been demonstrated.Nevertheless,it is not clear if PVT development may worsen cirrhotic patients' outcome by itself.Some authors tried to assess liver transplant benefit in PVT cirrhotic patients but data are contrasting.In this review,we will try to answer these questions,providing a critical analysis of data reported in literature.Francesca Romana Ponziani Maria Assunta Zocco Matteo Garcovich Francesca D'Aversa Davide Roccarina Antonio Gasbarrini 2012World Journal of Gastroenterology2012,18,36:24
8Current concepts in hepatic resection for hepatocellular carcinoma in cirrhotic patients显示文摘Hepatocellular carcinoma(HCC) is one of the most frequent neoplasms worldwide and in most cases it is associated with liver cirrhosis.Liver resection is considered the most potentially curative therapy for HCC patients when liver transplantation is not an option or is not immediately accessible.This review is aimed at investigating the current concepts that drive the surgical choice in the treatment of HCC in cirrhotic patients;Eastern and Western perspectives are highlighted.An extensive literature review of the last two decades was performed,on topics covering various aspects of hepatic resection.Early post-operative and long-term outcome measures adopted were firstly analyzed in an attempt to define an optimal standardization useful for research comparison.The need to avoid the development of post-hepatectomy liver failure represents the 'conditio sine qua non' of surgical choice and the role of the current tools available for the assessment of liver function reserve were investigated.Results of hepatic resection in relationship with tumor burden were compared with those of available competing strategies,namely,radiofrequency ablation for early stages,and trans-arterial chemoembolization for intermediate and advanced stages.Finally,the choice for anatomical versus non-anatomical,as well as the role of laparoscopic approach,was overviewed.The literature review suggests that partial hepatectomy for HCC should be considered in the context of multi-disciplinary evaluation of cirrhotic patients.Scientific research on HCC has moved,in recent years,from surgical therapy toward non-surgical approaches and most of the literature regarding topics debated in the present review is represented by observational studies,whereas very few well-designed randomized controlled trials are currently available;thus,no robust recommendations can be derived.Alessandro Cucchetti Matteo Cescon Franco Trevisani Antonio Daniele Pinna 2012World Journal of Gastroenterology2012,18,44:22
9Portal vein thrombosis in cirrhosis: Why a well-known complication is still matter of debate显示文摘Portal vein thrombosis(PVT)represents a well-known complication during the natural course of liver cirrhosis(LC),ranging from asymptomatic cases to lifethreating conditions related to portal hypertension and hepatic decompensation.Portal flow stasis,complex acquired hypercoagulable disorders and exogenous factors leading to endothelial dysfunction have emerged as key factors for PVT development.However,PVT occurrence remains unpredictable and many issues regarding its natural history,prognostic significance and treatment are still elusive.In particular although spontaneous resolution or disease stability occur in most cases of PVT,factors predisposing to disease progression or recurrence after spontaneous recanalization are not clarified as yet.Moreover,PVT impact on LC outcome is still debated,as PVT may represent itself a consequence of liver fibrosis and hepatic dysfunction progression.Anticoagulation and transjugular intrahepatic portosystemic shunt are considered safe and effective in this setting and are recommended in selected cases,even if the safer therapeutic option and the optimal therapy duration are still unknown.Nevertheless,their impact on mortality rates should be addressed more extensively.In this review we present the most debated questions regarding PVT,whose answers should come from prospective cohort studies and large sample-size randomized trials.Mariella Faccia Maria Elena Ainora Francesca Romana Ponziani Laura Riccardi Matteo Garcovich Antonio Gasbarrini Maurizio Pompili Maria Assunta Zocco 2019World Journal of Gastroenterology2019,25,31:23
10Non-polypoid colorectal neoplasms:Classification,therapy and follow-up显示文摘In the last years,an increasing interest has been raised on non-polypoid colorectal tumors(NPT) and in particular on large flat neoplastic lesions beyond 10 mm tending to grow laterally,called laterally spreading tumors(LST).LSTs and large sessile polyps have a greater frequency of high-grade dysplasia and local invasiveness as compared to pedunculated lesions of the same size and usually represent a technical challenge for the endoscopist in terms of either diagnosis and resection.According to the Paris classification,NPTs are distinguished in slightly elevated(0-Ⅱa,less than 2.5 mm),flat(0-Ⅱb) or slightly depressed(0-Ⅱc).NPTs are usually flat or slightly elevated and tend to spread laterally while in case of depressed lesions,cell proliferation growth progresses in depth in the colonic wall,thus leading to an increased risk of submucosal invasion(SMI) even for smaller neoplasms.NPTs may be frequently missed by inexperienced endoscopists,thus a careful training and precise assessment of all suspected mucosal areas should be performed.Chromoendoscopy or,if possible,narrow-band imaging technique should be considered for the estimation of SMI risk of NPTs,and the characterization of pit pattern and vascular pattern may be useful to predict the risk of SMI and,therefore,to guide the therapeutic decision.Lesions suitable to endoscopic resection are those confined to the mucosa(or superficial layer of submucosa in selected cases) whereas deeper invasion makes endoscopic therapy infeasible.Endoscopic mucosal resection(EMR,piecemeal for LSTs > 20 mm,en bloc for smaller neoplasms) remains the first-line therapy for NPTs,whereas endoscopic submucosal dissection in high-volume centers or surgery should be considered for large LSTs for which en bloc resection is mandatory and cannot be achieved by means of EMR.After piecemeal EMR,follow-up colonoscopy should be performed at 3 mo to assess resection completeness.In case of en bloc resection,surveillance colonoscopy should be scheduled at 3 years for adenomatous lesions ≥ 1 cm,or in presence of villous features or high-grade dysplasia patients(regardless of the size),while less intensive surveillance(colonoscopy at 5-10 years) is needed in case of single(or two) NPT < 1 cm presenting tubular features or low-grade dysplasia at histology.Antonio Facciorusso Matteo Antonino Marianna Di Maso Michele Barone Nicola Muscatiello 2015World Journal of Gastroenterology2015,21,17:20
11Operative link for gastritis assessment vs operative link on intestinal metaplasia assessment显示文摘AIM:To compare the reliability of gastritis staging sys-tems in ranking gastritis-associated cancer risk in a large series of consecutive patients.METHODS:Gastric mucosal atrophy is the precancer-ous condition in which intestinal-type gastric cancer(GC)most frequently develops.The operative link for gas-tritis assessment(OLGA)staging system ranks the GC risk according to both the topography and the severity of gastric atrophy(as assessed histologically on the ba-sis of the Sydney protocol for gastric mucosal biopsy).Both cross-sectional and long-term follow-up trials have consistently associated OLGA stages Ⅲ-Ⅳ with a higher risk of GC.A recently-proposed modification of the OLGA staging system(OLGIM)basically incorporates the OLGA frame,but replaces the atrophy score with an assessment of intestinal metaplasia(IM)alone.A series of 4552 consecutive biopsy sets(2007-2009)was re-trieved and reassessed according to both the OLGA and the OLGIM staging systems.A set of at least 5 biopsy samples was available for all the cases considered.RESULTS:In 4460 of 4552 cases(98.0%),both the high-risk stages(Ⅲ + Ⅳ)and the low-risk stages(0 +Ⅰ + Ⅱ)were assessed applying the OLGA and OL-GIM criteria.Among the 243 OLGA high-risk stages,14(5.8%)were down-staged to a low risk using OLGIM.The 67(1.5%)incidentally-found neoplastic lesions(intraepithelial or invasive)were consistently associated with high-risk stages,as assessed by both OLGA and OLGIM(P < 0.001 for both).Two of 34 intestinal-type GCs coexisting with a high-risk OLGA stage(stage Ⅲ)were associated with a low-risk OLGIM stage(stage Ⅱ).CONCLUSION:Gastritis staging systems(both OLGA and OLGIM)convey prognostically important informa-tion on the gastritis-associated cancer risk.Because of its clinical impact,the stage of gastritis should be included as a conclusive message in the gastritis histol-ogy report.Since it focuses on IM alone,OLGIM staging is less sensitive than OLGA staging in the identif ication of patients at high risk of gastric cancer.Massimo Rugge Matteo Fassan Marco Pizzi Fabio Farinati Giacomo Carlo Sturniolo Mario Plebani David Y Graham 2011World Journal of Gastroenterology2011,17,41:19
12Coronary thrombus in patients undergoing primary PCI for STEMI:Prognostic significance and management显示文摘Acute ST-elevation myocardial infarction(STEMI) usually results from coronary atherosclerotic plaque disruption with superimposed thrombus formation. Detection of coronary thrombi is a poor prognostic indicator,which is mostly proportional to their size and composition. Particularly,intracoronary thrombi impair both epicardial blood flow and myocardial perfusion,by occluding major coronary arteries and causing distal embolization,respectively. Thus,although primary percutaneous coronary intervention is the preferred treatement strategy in STEMI setting,the associated use of adjunctive antithrombotic drugs and/or percutaneous thrombectomy is crucial to optimize therapy of STEMI patients,by improving either angiographical and clinical outcomes. This review article will focus on the prognostic significance of intracoronary thrombi and on current antithrombotic pharmacological and interventional strategies used inthe setting of STEMI to manage thrombotic lesions.Sabine Vecchio Elisabetta Varani Tania Chechi Marco Balducelli Giuseppe Vecchi Matteo Aquilina Giulia Ricci Lucchi Alessro Dal Monte Massimo Margheri 2014World Journal of Cardiology2014,6,6:18
13Contrast-enhanced ultrasound in differentiating malignant from benign portal vein thrombosis in hepatocellular carcinoma显示文摘Portal vein thrombosis(PVT) may occur in liver cirrhosis patients. Malignant PVT is a common complication in cirrhotic patients with concomitant hepatocellular carcinoma(HCC) and, in some cases, it may be even the initial sign of an undetected HCC. Detection of malignant PVT in a patient with liver cirrhosis heavily affects the therapeutic strategy. Gray-scale ultrasound(US) is widely unreliable for differentiating benign and malignant thrombi. Although effective for this differential diagnosis, fine-needle biopsy remains an invasive technique. Sensitivity of color-doppler US in detection of malignant thrombi is highly dependent on the size of the thrombus. Contrast-enhanced computed tomography(CT) and contrast-enhanced magnetic resonance(MRI) can be useful to assess the nature of portal thrombus, while limited data are currently available about the role of positron emission tomography(PET) and PET-CT. In contrast with CT, MRI, PET, and PET-CT, contrast-enhanced ultrasound(CEUS) is a fast, effective, well tolerated and cheap technique, that can be performed even in the same session in which the thrombus has been detected. CEUS can be performed bedside and can be available also in transplanted patients. Moreover, CT and MRI only yield a snapshot analysis during contrast diffusion, while CEUS allows for a continuous real-time imaging of the microcirculation that lasts several minutes, so that the whole arterial phase and the late parenchymal phase of the contrast diffusion can be analyzed continuously by real-time US scanning. Continuous real-time monitoring of contrast diffusion entails an easy detection of thrombus maximum enhancement. Moreover, continuous quantitative analyses of enhancement(wash in- wash out studies) by CEUS during contrast diffusion is nowadays available in most CEUS machines, thus giving a more sophisticated and accurate evaluation of the contrast distribution and an increased confidence in diagnosis in difficult cases. In conclusion, CEUS is avery reliable technique with a high intrinsic sensitivity for portal vein patency assessment. More expensive and sophisticated techniques(i.e., CT, MRI, PET, and PET-CT) should only be indicated in undetermined cases at CEUS.Luciano Tarantino Pasquale Ambrosino Matteo Nicola Dario Di Minno 2015World Journal of Gastroenterology2015,21,32:18
14Prevention and treatment of hepatic encephalopathy: Focusing on gut microbiota显示文摘The gut flora plays an important role in the pathogenesis of the complications of cirrhosis. Hepatic encephalopathy (HE) represents a broad continuum of neuropsychological dysfunction in patients with acute or chronic liver disease and/or porto-systemic shunting of blood flow and it manifests with progressive deterioration of the superior neurological functions. The pathophysiology of this disease is complex, as it involves overproduction and reduced metabolism of various neurotoxins, particularly ammonia. Management of HE is diversified and requires several steps: elimination of precipitating factors, removal of toxins, proper nutritional support, modulation of resident fecal flora and downregulation of systemic and gut-derived inflammation. This review will provide an overview of gut barrier function and the influence of gut-derived factors on HE, focusing on the role of gut microbiota in the pathogenesis of HE and the recent literature findings on its therapeutic manipulation.Matteo Garcovich Maria Assunta Zocco Davide Roccarina Francesca Romana Ponziani Antonio Gasbarrini 2012World Journal of Gastroenterology2012,18,46:16
15Computed tomography findings of pneumatosis and portomesenteric venous gas in acute bowel ischemia显示文摘AIM:To use more representative sample size to evaluate whether computed tomography(CT)scan evidence of the concomitant presence of pneumatosis and portomesenteric venous gas is a predictor of transmural bowel necrosis.METHODS:Data from 208 patients who were referred for a diagnosis of bowel ischemia were retrospectively reviewed.Only patients who underwent a surgical intervention following a diagnosis of bowel ischemia who also had a post-operative histological confirmation of such a diagnosis were included.Patients were split into two groups according to the presence of histological evidence of transmural bowel ischemia(case group)or partial bowel ischemia(control group).CT images were reviewed for findings of ischemia,including mural thickening,pneumatosis,bowel distension,portomesenteric venous gas and arterial or venous thrombi.RESULTS:A total of 248 subjects who underwent surgery for bowel ischemia were identified.Among the208 subjects enrolled in our study,transmural bowel necrosis was identified in 121 subjects(case group),and partial bowel necrosis was identified in 87 subjects(control group).Based on CT findings,including mural thickening,bowel distension,pneumatosis,pneumatosis plus portomesenteric venous gas and presence of thrombi or emboli,there were no significant differences between the case and control groups.The concomitant presence of pneumatosis and porto-mesenteric venous gas showed an odds ratio of 1.95(95%CI:0.491-7.775,P=0.342)for the presence of transmural necrosis.The presence of pneumatosis plus porto-mesenteric venous gas exhibited good specificity(83%)but low sensitivity(17%)in the identification of transmural bowel infarction.Accordingly,the positive and negative predictive values were 60% and 17%,respectively.CONCLUSION:Although pneumatosis plus porto-mesenteric venous gas is associated with bowel ischemia,we have demonstrated that their co-occurrence cannot be used as diagnostic signs of transmural necrosis.Marco Milone Matteo Nicola Dario Di Minno Mario Musella Paola Maietta Vittorio Iaccarino Giovanni Barone Francesco Milone 2013World Journal of Gastroenterology2013,19,39:15
16Systematic review of health-related quality of life after esophagectomy for esophageal cancer显示文摘This study is aimed to assess the long-term health-related quality of life(HRQL) of patients after esopha-gectomy for esophageal cancer in comparison with es-tablished norms,and to evaluate changes in HRQL during the different stages of follow-up after esopha-geal resection. A systematic review was performed bysearching medical databases(Medline,Embase andthe Cochrane Library) for potentially relevant studiesthat appeared between January 1975 and March 2011.Studies were included if they addressed the questionof HRQL after esophageal resection for esophage alcancer. Two researchers independently performed the study selection,data extraction and analysis processes.Twenty-one observational studies were included witha total of 1282(12-355) patients. Five studies were performed with short form-36(SF-36) and 16 with European Organization for Research and Treatment of Cancer(EORTC) QLQ C30(14 of them also utilized the disease-specific OES18 or its previous version OES24) .The analysis of long-term generic HRQL with SF-36showed pooled scores for physical,role and socialfunction after esophagectomy similar to United Statesnorms,but lower pooled scores for physical function,vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 globalscale during a 6-mo follow-up showed that global scaleand physical function were better at the baseline. The symptom scales indicated worsened fatigue,dyspneaand diarrhea 6 mo after esophagectomy. In contrast,however,emotional function had significantly improved after 6 mo. In conclusion,short- and long-term HRQLis deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-termconsequence of esophagectomy involving either the respiratory system or the alimentary tract. The short-and long-term improvement in the emotional function of patients who have undergone successful operationsmay be attributed to the impression that they have survived a near-death experience.Marco Scarpa Stefano Valente Rita Alfieri Matteo Cagol Giorgio Diamantis Ermanno Ancona Carlo Castoro 2011World Journal of Gastroenterology2011,17,42:15
17Ten years of sorafenib in hepatocellular carcinoma: Are there any predictive and/or prognostic markers?显示文摘Sorafenib has been considered the standard of care for patients with advanced unresectable hepatocellular carcinoma(HCC) since 2007 and numerous studieshave investigated the role of markers involved in the angiogenesis process at both the expression and genetic level and clinical aspect. What results have ten years of research produced? Several clinical and biological markers are associated with prognosis. The most interesting clinical parameters are adverse events, Barcelona Clinic Liver Cancer stage, and macroscopic vascular invasion, while several single nucleotide polymorphisms and plasma angiopoietin-2 levels represent the most promising biological biomarkers. A recent pooled analysis of two phase III randomized trials showed that the neutrophil-to-lymphocyte ratio, etiology and extra-hepatic spread are predictive factors of response to sorafenib, but did not identify any predictive biological markers. After 10 years of research into sorafenib there are still no validated prognostic or predictive factors of response to the drug in HCC. The aim of the present review was to summarize 10 years of research into sorafenib, looking in particular at the potential of associated clinical and biological markers to predict its efficacy in patients with advanced HCC.Giorgia Marisi Alessandro Cucchetti Paola Ulivi Matteo Canale Giuseppe Cabibbo Leonardo Solaini Francesco G Foschi Serena De Matteis Giorgio Ercolani Martina Valgiusti Giovanni L Frassineti Mario Scartozzi Andrea Casadei Gardini 2018World Journal of Gastroenterology2018,24,36:14
18Nasogastric or nasointestinal feeding in severe acute pancreatitis显示文摘AIM:To assess the rate of spontaneous tube migration and to compare the effects of naso-gastric and nasointestinal(NI)(beyond the ligament of Treitz) feeding in severe acute pancreatitis(SAP).METHODS:After bedside intragastric insertion,tube position was assessed,and enteral nutrition(EN) started at day 4,irrespective of tube localization.Patients were monitored daily and clinical and laboratory parameters evaluated to compare the outcome of patients with nasogastric(NG) or NI tube.RESULTS:Spontaneous tube migration to a NI site occurred in 10/25(40%) prospectively enrolled SAP patients,while in 15(60%) nutrition was started with a NG tube.Groups were similar for demographics and pancreatitis aetiology but computed tomography(CT) severity index was higher in NG tube patients than in NI(mean 6.2 vs 4.7,P=0.04).The CT index seemed a risk factor for failed obtainment of spontaneous distal migration.EN trough NG or NI tube were similar in terms of tolerability,safety,clinical goals,complications and hospital stay.CONCLUSION:Spontaneous distal tube migration is successful in 40% of SAP patients,with higher CT severity index predicting intragastric retention;in such cases EN by NG tubes seems to provide a pragmatic alternative opportunity with similar outcomes.Matteo Piciucchi Elettra Merola Massimo Marignani Mari-anna Signoretti Roberto Valente Lucia Cocomello Flavia Baccini Francesco Panzuto Gabriele Capurso Gianfranco Delle Fave 2010World Journal of Gastroenterology2010,16,29:13
19Simultaneous intraductal papillary neoplasms of the bile duct and pancreas treated with chemoradiotherapy显示文摘Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological features.These include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous carcinoma.To date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated surgically.We hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct IPMN-P.Since surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and radio-therapy.This was effective in decreasing the mass size and in resolving subsequent jaundice.This is also the f irst reported case of IPMN-B successfully treated with chemoradiotherapy.Clinicians should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery.Roberto Valente Gabriele Capurso Paola Pierantognetti Elsa Iannicelli Matteo Piciucchi Adriana Romiti Paolo Mercantini Alberto Larghi Giulia Francesca Federici Viola Barucca Maria Falchetto Osti Emilio Di Giulio Vincenzo Ziparo Gianfranco Delle Fave 2012World Journal of Gastrointestinal Oncology2012,4,2:13
20基于方格网法的树冠体积测算方法显示文摘提出了一种基于方格网法测算树冠体积的方法。研究利用免棱镜全站仪获取树冠点云数据,建立树冠表面特征点的坐标方格网,根据方格网法计算土方量的原理来求算树冠体积,通过传统经典模型人工方法、三维激光量测法与本文算法,分别计算实验区域研究对象的体积,将结果进行对比分析,本研究提出的算法平均相对误差为4.13%,平均准确度为95.97%,且在置信度0.05下树冠体积的计算值与实测值之间的差异性为不显著,结果完全满足计算精度,其计算耗时只有传统人工量测法的1/3,成本为三维激光扫描的2%,降低了成本且提高了效率。何诚 张思玉 Matteo Convertino 周爱民 洪芳霞 2014农业机械学报2014,45,12:13
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