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| 1 | Helicobacter pylori and extragastric diseases: A review显示文摘Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract. | Antonietta Gerarda Gravina Rocco Maurizio Zagari Cristiana De Musis Lorenzo Romano Carmelina Loguercio Marco Romano | 2018 | World Journal of Gastroenterology2018，24，29： | 90 |
| 2 | Portal vein thrombosis:Insight into physiopathology,diagnosis,and treatment显示文摘Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but might also occur in absence of an overt liver disease. Several causes, either local or systemic, might play an important role in PVT pathogenesis. Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Clinical examination, laboratory investigations, and imaging are helpful to provide a quick diagnosis, as prompt treatment might greatly affect a patient's outcome. In this review, we analyze the physiopathological mechanisms of PVT development, together with the hemodynamic and functional alterations related to this condition. Moreover, we describe the principal factors most frequently involved in PVT development and the recent knowledge concerning diagnostic and therapeutic procedures. Finally, we analyze the implications of PVT in the setting of liver transplantation and its possible influence on patients' future prognoses. | Francesca R Ponziani Maria A Zocco Chiara Campanale Emanuele Rinninella Annalisa Tortora Luca Di Maurizio Giuseppe Bombardieri Raimondo De Cristofaro Anna M De Gaetano Raffaele Landolfi Antonio Gasbarrini | 2010 | World Journal of Gastroenterology2010，16，2： | 75 |
| 3 | Predictive factors for anastomotic leakage after laparoscopic colorectal surgery显示文摘Every colorectal surgeon during his or her career is faced with anastomotic leakage(AL); one of the most dreaded complications following any type of gastrointestinal anastomosis due to increased risk of morbidity, mortality, overall impact on functional and oncologic outcome and drainage on hospital resources. In order to understand and give an overview of the AL risk factors in laparoscopic colorectal surgery, we carried out a careful review of the existing literature on this topic and found several different definitions of AL which leads us to believe that the lack of a consensual, standard definition can partly explain the considerable variations in reported rates of AL in clinical studies. Colorectal leak rates have been found to vary depending on the anatomic location of the anastomosis with reported incidence rates ranging from 0 to 20%, while the laparoscopic approach to colorectal resections has not yet been associated with a significant reduction in AL incidence. As well, numerous risk factors, though identified, lack unanimous recognition amongst researchers. For example, the majority of papers describe the risk factors for left-sided anastomosis, the principal risk being male sex and lower anastomosis, while little data exists defining AL risk factors in a right colectomy. Also, gut microbioma is gaining an emerging role as potential risk factor for leakage. | Antonio Sciuto Giovanni Merola Giovanni D De Palma Maurizio Sodo Felice Pirozzi Umberto M Bracale Umberto Bracale | 2018 | World Journal of Gastroenterology2018，24，21： | 48 |
| 4 | Update on ischemia-reperfusion injury in kidney transplantation: Pathogenesis and treatment显示文摘Ischemia/reperfusion injury is an unavoidable relevant consequence after kidney transplantation and influences short term as well as long-term graft outcome. Clinically ischemia/reperfusion injury is associated with delayed graft function, graft rejection, chronic rejection and chronic graft dysfunction. Ischemia/reperfusion affects many regulatory systems at the cellular level as well as in the renal tissue that result in a distinct inflammatory reaction of the kidney graft. Underlying factors of ischemia reperfusion include energy metabolism, cellular changes of the mitochondria and cellular membranes, initiation of different forms of cell death-like apoptosis and necrosis together with a recently discovered mixed form termed necroptosis. Chemokines and cytokines together with other factors promote the inflammatory response leading to activation of the innate immune system as well as the adaptive immune system. If the inflammatory reaction continues within the graft tissue, a progressive interstitial fibrosis develops that impacts long-term graft outcome. It is of particular importance in kidney transplantation to understand the underlying mechanisms and effects of ischemia/reperfusion on the graft as this knowledge also opens strategies to prevent or treat ischemia/reperfusion injury after transplantation in order to improve graft outcome. | Maurizio Salvadori Giuseppina Rosso Elisabetta Bertoni | 2015 | World Journal of Transplantation2015，5，2： | 43 |
| 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 | 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 |
| 7 | Interleukin-6 and its soluble receptor in patients with liver cirrhosis and hepatocellular carcinoma显示文摘瞄准:为了评估免疫, interleukin-6 ( IL-6 )和从有肝细胞癌( HCC )和浆液的病人的肿瘤组织标本上的 IL-6 受体( IL-6R )的组织化学的本地化与 HCC 以及肝肝硬化( LC )在一组病人 IL-6 和 sIL-6R 铺平在一组有独自一个的 LC 并且在一个控制组的病人。方法:三组题目被学习:组我(n = 83 ) 受不了 HCC 和 LC,组 II (n = 72 ) 受不了独自一个的 LC 和组 III (n = 42 ) 同样健康的控制。所有病人有丙肝病毒感染。浆液 IL-6 和 IL-6R 层次用一个商业地可得到的 ELISA 工具包被决定。Immunohistochemistry 对 IL-6 和 IL-6R 用 streptavidin-biotin 建筑群和兔子 polyclonal 抗体被执行。结果:Immunohistochemistry 分析显示出媒介到强壮细胞质并且为 IL-6 和 IL-6R 的膜反应分别地在 HCC 的至少 40% 盒子,而肝肝硬化病人和控制为 IL-6 是否定的或为 IL-6R 显示出很温和、焦点的像点的细胞质的反应。在 HCC 组的浆液 IL-6 层次比在 LC 和控制组的那些显著地高(P <
0.0001 ) 。在在 3 个组之中的 sIL-6R 集中没有有效差量。当有 HCC 的病人根据 Okuda 的分类被划分成组时, IL-6 和 sIL-6R 水平的重要浆液增加从舞台被观察我上演 III (P <
0.02, P <
0.0005 ) 。当 HCC 和 LC 病人根据孩子呸被划分成肝硬化严厉的 3 个班时,在 HCC 病人的价值比在为各相应的班的 LC 病人的那些显著地高(P <
0.01 ).CONCLUSION:在 HCC 病人的 IL-6 浆液层次比在 LC 病人和控制的那些高,建议由肿瘤的房间的这 cytokine 的增加的生产。sIL-6R 价值在所有组是类似的,仅仅在阶段 III HCC 病人增加。这些数据建议他们与肿瘤的团而非与剩余的工作有一种更靠近的关系肝的质量。 | Soresi Maurizio Giannitrapani Lydia D'Antona Fabio Florena Ada Maria La Spada Emanuele Terranova Angela Cervello Melchiorre D'Alessandro Natale Montalto Giuseppe | 2006 | World Journal of Gastroenterology2006，12，16： | 25 |
| 8 | Neoadjuvant chemotherapy for gastric cancer. Is it a must or a fake?显示文摘AIM To investigate the neoadjuvant chemotherapy(NAC) effect on the survival of patients with proper stomach cancer submitted to D2 gastrectomy.METHODS We proceeded to a review of the literature with Pub Med, Embase, ASCO and ESMO meeting abstracts as well as computerized use of the Cochrane Library for randomized controlled trials(RCTs) comparing NAC followed by surgery(NAC + S) with surgery alone(SA) for gastric cancer(GC). The primary outcome was the overall survival rate. Secondary outcomes were the site of the primary tumor, extension of node dissection according to Japanese Gastric Cancer Association(JGCA) performed in both arms, disease-specific(DSS) and disease-free survival(DFS) rates, clinical and pathological response rates and resectability rates after perioperative treatment. RESULTS We identified a total of 16 randomized controlled trials comparing NAC + S(n = 1089) with SA(n = 973) published in the period from January 1993-March 2017. Only 6 of these studies were well-designed, structured trials in which the type of lymph node(LN) dissection performed or at least suggested in the trial protocol was reported. Two out of three of the RCTs with D2 lymphadenectomy performed in almost all cases failed to show survival benefit in the NAC arm. Inthe third RCT, the survival rate was not even reported, and the primary end points were the clinical outcomes of surgery with and without NAC. In the remaining three RCTs, D2 lymph node dissection was performed in less than 50% of cases or only recommended in the 'Study Treatment' protocol without any description in the results of the procedure really perfomed. In one of the two studies, the benefit of NAC was evident only for esophagogastric junction(EGJ) cancers. In the second study, there was no overall survival benefit of NAC. In the last trial, which documented a survival benefit for the NAC arm, the chemotherapy effect was mostly evident for EGJ cancer, and more than one-fourth of patients did not have a proper stomach cancer. Additionally, several patients did not receive resectional surgery. Furthermore, the survival rates of international reference centers that provide adequate surgery for homogeneous stomach cancer patients' populations are even higher than the survival rates reported after NAC followed by incomplete surgery.CONCLUSION NAC for GC has been rapidly introduced in international western guidelines without an evidence-based medicinerelated demonstration of its efficacy for a homogeneous population of patients with only stomach tumors submitted to adequate surgery following JGCA guidelines with extended(D2) LN dissection. Additional larger sample-size multicentre RCTs comparing the newer NAC regimens including molecular therapies followed by adequate extended surgery with surgery alone are needed. | Rossella Reddavid Silvia Sofia Paolo Chiaro Fabio Colli Renza Trapani Laura Esposito Mario Solej Maurizio Degiuli | 2018 | World Journal of Gastroenterology2018，24，2： | 25 |
| 9 | Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation显示文摘Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).The most used treatments include transarterial chemoembolization and radiofrequency ablation.Surgical resection has also been successfully used as a bridging procedure,and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function.The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation,reducing HCC recurrence after transplantation,and improving post-transplant overall survival.To date,no data from prospective randomized studies are available;however,for HCC patients listed for LT within the Milan criteria,prolonging the waiting time over 6-12 mo is a risk factor for tumor spread.Bridging treatments are useful in containing tumor progression and decreasing dropout.Furthermore,the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT.Lastly,although a definitive conclusion can not be reached,the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival.Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT.Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging. | Maurizio Pompili Giampiero Francica Francesca Romana Ponziani Roberto Iezzi Alfonso Wolfango Avolio | 2013 | World Journal of Gastroenterology2013，19，43： | 24 |
| 10 | An ant colony optimization method for generalized TSP problem显示文摘也就是,集中于欧几里德几何学的旅行售货员问题(TSP ) 的一个变化概括旅行售货员问题(GTSP ) ,这篇论文从 TSP 扩大蚂蚁殖民地优化方法到这块地。由考虑组影响,一个改进方法进一步被改进。为了避免锁住进本地最小,一个变化过程和一个本地人,寻找的技术也被介绍进这个方法。数字结果证明建议方法能相当处理 GTSP 问题很好,并且发达变化过程和本地人寻找技术是有效的。 | Jinhui Yang Xiaohu Shi Maurizio Marchese Yanchun Liang | 2008 | Progress in Natural Science:Materials International2008，18，11： | 24 |
| 11 | Hypoxia,angiogenesis and liver fibrogenesis in the progression of chronic liver diseases显示文摘Angiogenesis is a dynamic,hypoxia-stimulated and growth factor-dependent process,and is currently referred to as the formation of new vessels from preexisting blood vessels.Experimental and clinical studies have unequivocally reported that hepatic angiogenesis,irrespective of aetiology,occurs in conditions of chronic liver diseases(CLDs) characterized by perpetuation of cell injury and death,inflammatory response and progressive fibrogenesis.Angiogenesis and related changes in liver vascular architecture,that in turn concur to increase vascular resistance and portal hypertension and to decrease parenchymal perfusion,have been proposed to favour fibrogenic progression of the disease towards the end-point of cirrhosis.Moreover,hepatic angiogenesis has also been proposed to modulate the genesis of portal-systemic shunts and increase splanchnic blood flow,thus potentially affecting complications of cirrhosis.Hepatic angiogenesis is also crucial for the growth and progression of hepatocellular carcinoma.Recent literature has identified a number of cellular and molecular mechanisms governing the cross-talk between angiogenesis and fibrogenesis,with a specifi c emphasis on the crucial role of hypoxic conditions and hepatic stellate cells,particularly when activated to the myofibroblast-like pro-fibrogenic.Experimental anti-angiogenic therapy has been proven to be effective in limiting the progression of CLDs in animal models.From a clinical point of view,anti-angiogenic therapy is currently emerging as a new pharmacologic intervention in patients with advanced fibrosis and cirrhosis. | Claudia Paternostro Ezio David Erica Novo Maurizio Parola | 2010 | World Journal of Gastroenterology2010，16，3： | 23 |
| 12 | Portal 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 | 2019 | World Journal of Gastroenterology2019，25，31： | 23 |
| 13 | Correlation between expression of cyclooxygenase-2 and the presence of inflammatory cells in human primary hepatocellular carcinoma: Possible role in tumor promotion and angiogenesis显示文摘AIM: To investigate the association of cyclooxygenase-2(COX-2) expression with angiogenesis and the number and type of inflammatory cells (macrophages/Kupffer cells;mast cells) within primary hepatocellular carcinoma (HCC)tissues and adjacent non-tumorous (MT) tissues.METHODS: Immunohistochemistry for COX-2, CD34,CD68 and mast cell tryptase (MCT) was performed on 14 well-characterized series of liver-cirrhosis-associated HCC patients. COX-2 expression and the number of inflammatory cells in tumor lesions and surrounding liver tissues of each specimen were compared. Moreover,COX-2, CD34 staining and the number of inflammatory cells in areas with different histological degrees within each tumor sample were comparatively analyzed.RESULTS: The percentage of COX-2 positive cells was significantly higher in NT tissues than in tumors. COX-2 expression was higher in well-differentiated HCC than in poorly-differentiated tissues. Few mast cells were observed within the tumor mass, whereas a higher number was observed in the surrounding tissue, especially in peri-portal spaces of NT tissues. Abundant macrophages/Kupffer cells were observed in NT tissues, whereas the number of cells was significantly lower in the tumor mass.However, a higher cell number was observed in the well-differentiated tumor and progressively decreased in relation to the differentiation grade. Within the tumor, a positive correlation was found between COX-2 expression and the number of macrophages/Kupffer cells and mast cells. Moreover, there was a positive correlation between CD34 and COX-2 expression in tumor tissues. Comparison between well- and poorly-differentiated HCC showed that the number of CD34-positive cells decreased with dedifferentiation. However, COX-2 was the only independent variable showing a positive correlation with CD34 in a multivariate analysis.CONCLUSION: The presence of inflammatory cells and COX-2 expression in liver tumor suggests a possible relationship with tumor angiogenesis. COX-2 expressing cells and the number of macrophages/Kupffer cells and mast cells decrease with progression of the disease. | Melchiorre Cervello Daniela Foderà Ada Maria Florena Maurizio Soresi Claudio Tripodo Natale D'Alessandro Giuseppe Montalto | 2005 | World Journal of Gastroenterology2005，11，30： | 21 |
| 14 | Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: Beyond the known frontiers显示文摘Hepatocellular carcinoma is one of the most frequent malignant tumors worldwide:Portal vein tumor thrombosis(PVTT)occurs in about 35%-50%of patients and represents a strong negative prognostic factor,due to the increased risk of tumor spread into the bloodstream,leading to a high recurrence risk.For this reason,it is a contraindication to liver transplantation and in several prognostic scores sorafenib represents its standard of care,due to its antiangiogenetic action,although it can grant only a poor prolongation of life expectancy.Recent scientific evidences lead to consider PVTT as a complex anatomical and clinical condition,including a wide range of patients with different prognosis and new treatment possibilities according to the degree of portal system involvement,tumor biological aggressiveness,complications caused by portal hypertension,patient’s clinical features and tolerance to antineoplastic treatments.The median survival has been reported to range between 2.7 and 4 mo in absence of therapy,but it can vary from 5 mo to 5 years,thus depicting an extremely variable scenario.For this reason,it is extremely important to focus on the most adequate strategy to be applied to each group of PVTT patients. | Lucia Cerrito Brigida Eleonora Annicchiarico Roberto Iezzi Antonio Gasbarrini Maurizio Pompili Francesca Romana Ponziani | 2019 | World Journal of Gastroenterology2019，25，31： | 21 |
| 15 | Speckle tracking echocardiography:A new approach to myocardial function显示文摘Echocardiography is the most common diagnostic method for assessing cardiac function but some limitations affect this technique.Until now,visual assessment of wall motion and thickening has allowed only a subjective evaluation of myocardial function and requires long-term training.Recently,new echocardiographic techniques have been introduced to evaluate myocardial mechanics.Tissue Doppler imaging(TDI)technique is limited by angle-dependency such that only deformation along the ultrasound beam can be derived from velocities,while myocardium deforms simultaneously in three dimensions.Speckle tracking echocardiography (STE)is a more recent technique that provides a global approach to left ventricular myocardial mechanics,giving information about the three spatial dimensions of cardiac deformation.In this editorial,we describe the physical and pathophysiological concepts of STE,discussing the differences compared to TDI and underlining the pitfalls of this new technique. | Simona Sitia Livio Tomasoni Maurizio Turiel | 2010 | World Journal of Cardiology2010，2，1： | 19 |
| 16 | Genetic association of interleukin-6 polymorphism (-174 G/C) with chronic liver diseases and hepatocellular carcinoma显示文摘Interleukin-6 (IL-6) is a pleiotropic cytokine which is expressed in many inflammatory cells in response to different types of stimuli, regulating a number of biological processes. The IL-6 gene is polymorphic in both the 5' and 3' flanking regions and more than 150 single nucleotide polymorphisms have been identified so far. Genetic polymorphisms of IL-6 may affect the outcomes of several diseases, where the presence of high levels of circulating IL-6 have been correlated to the stage and/or the progression of the disease itself. The -174 G/C polymorphism is a frequent polymorphism, that is located in the upstream regulatory region of the IL-6 gene and affects IL-6 production. However, the data in the literature on the genetic association between the -174 G/C polymorphism and some specific liver diseases characterized by different etiologies are still controversial. In particular, most of the studies are quite unanimous in describing a correlation between the presence of the high-producer genotype and a worse evolution of the chronic liver disease. This is valid for patients with hepatitis C virus (HCV)-related chronic hepatitis and liver cirrhosis and hepatocellu-lar carcinoma (HCC) whatever the etiology. Studies in hepatitis B virus-related chronic liver diseases are not conclusive, while specific populations like non alcoholic fatty liver disease/non-alcoholic steatohepatitis, autoimmune and human immunodeficiency virus/HCV coinfected patients show a higher prevalence of the lowproducer genotype, probably due to the complexity of these clinical pictures. In this direction, a systematic revision of these data should shed more light on the role of this polymorphism in chronic liver diseases and HCC. | Lydia Giannitrapani Maurizio Soresi Daniele Balasus Anna Licata Giuseppe Montalto | 2013 | World Journal of Gastroenterology2013，19，16： | 19 |
| 17 | Eubiotic properties of rifaximin: Disruption of the traditional concepts in gut microbiota modulation显示文摘Antibiotics are usually prescribed to cure infections but they also have significant modulatory effects on the gut microbiota. Several alterations of the intestinal bacterial community have been reported during antibiotic treatment, including the reduction of beneficial bacteria as well as of microbial alpha-diversity. Although after the discontinuation of antibiotic therapies it has been observed a trend towards the restoration of the original condition, the new steady state is different from the previous one, as if antibiotics induced some kind of irreversible perturbation of the gut microbial community. The poorly absorbed antibiotic rifaximin seem to be different from the other antibiotics, because it exerts non-traditional effects additional to the bactericidal/bacteriostatic activity on the gut microbiota. Rifaximin is able to reduce bacterial virulence and translocation, has anti-inflammatory properties and has been demonstrated to positively modulate the gut microbial composition. Animal models, culture studies and metagenomic analyses have demonstrated an increase in Bifidobacterium, Faecalibacterium prausnitzii and Lactobacillus abundance after rifaximin treatment, probably consequent to the induction of bacterial resistance, with no major change in the overall gut microbiota composition. Antibiotics are therefore modulators of the symbiotic relationship between the host and the gut microbiota. Specific antibiotics, such as rifaximin, can also induce eubiotic changes in the intestinal ecosystem; this additional property may represent a therapeutic advantage in specific clinical settings. | Francesca Romana Ponziani Maria Assunta Zocco Francesca D’Aversa Maurizio Pompili Antonio Gasbarrini | 2017 | World Journal of Gastroenterology2017，23，25： | 17 |
| 18 | Minimally invasive surgery for gastric cancer: A comparison between robotic, laparoscopic and open surgery显示文摘AIM To investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological outcomes.METHODS This is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy(RG), laparoscopic gastrectomy(LG), open gastrectomy(OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also provided.RESULTS The present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients(RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery(P = 0.42) and stage of the disease(P = 0.16). Intraoperative blood loss was significantly lower in the LG(95.93 ± 119.22) and RG(117.91 ± 68.11) groups compared to the OG(127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG(27.78 ± 11.45), LG(24.58 ± 13.56) and OG(25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay(P < 0.0001). A similar complications rate was found(P = 0.13). The leakage rate was not different(P = 0.78) between groups.CONCLUSION Laparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recovery. | Amilcare Parisi Daniel Reim Felice Borghi Ninh T Nguyen Feng Qi Andrea Coratti Fabio Cianchi Maurizio Cesari Francesca Bazzocchi Orhan Alimoglu Johan Gagnière Graziano Pernazza Simone D'Imporzano Yan-Bing Zhou Juan-Santiago Azagra Olivier Facy Steven T Brower Zhi-Wei Jiang Lu Zang Arda Isik Alessandro Gemini Stefano Trastulli Alexander Novotny Alessandra Marano Tong Liu Mario Annecchiarico Benedetta Badii Giacomo Arcuri Andrea Avanzolini Metin Leblebici Denis Pezet Shou-Gen Cao Martine Goergen Shu Zhang Giorgio Palazzini Vito D'Andrea Jacopo Desiderio | 2017 | World Journal of Gastroenterology2017，23，13： | 17 |
| 19 | Exocrine pancreatic insufficiency in adults:A shared position statement of the Italian association for the study of the pancreas显示文摘This is a medical position statement developed by the Exocrine Pancreatic Insufficiency collaborative group which is a part of the Italian Association for the Study of the Pancreas(AISP).We covered the main diseases associated with exocrine pancreatic insufficiency(EPI)which are of common interest to internists/gastroenterologists,oncologists and surgeons,fully aware that EPI may also occur together with many other diseases,but less frequently.A preliminary manuscript based on an extended literature search(Medline/PubMed,Cochrane Library and Google Scholar)of published reports was prepared,and key recommendations were proposed.The evidence was discussed at a dedicated meeting in Bologna during the National Meeting of the Association in October 2012.Each of the proposed recommendations and algorithms was discussed and an initial consensus was reached.The final draft of the manuscript was then sent to the AISP Council for approval and/or modification.All concerned parties approved the final version of the manuscript in June 2013. | Raffaele Pezzilli Angelo Andriulli Claudio Bassi Gianpaolo Balzano Maurizio Cantore Gianfranco Delle Fave Massimo Falconi Luca Frulloni the Exocrine Pancreatic Insufficiency collaborative(EPIc) Group | 2013 | World Journal of Gastroenterology2013，19，44： | 16 |
| 20 | Effect of rifaximin on gut microbiota composition in advanced liver disease and its complications显示文摘Liver cirrhosis is a paradigm of intestinal dysbiosis. The qualitative and quantitative derangement of intestinal microbial community reported in cirrhotic patients seems to be strictly related with the impairment of liver function. A kind of gut microbial 'fingerprint',characterized by the reduced ratio of 'good' to 'potentially pathogenic' bacteria has recently been outlined,and is associated with the increase in Model for End-Stage Liver Disease and Child Pugh scores. Moreover,in patients presenting with cirrhosis complications such as spontaneous bacterial peritonitis(SBP),hepatic encephalopathy(HE),and,portal hypertension intestinal microbiota modifications or the isolation of bacteria deriving from the gut are commonly reported. Rifaximin is a non-absorbable antibiotic used in the management of several gastrointestinal diseases. Beyond bactericidal/bacteriostatic,immune-modulating and anti-inflammatory activity,a little is known about its interaction with gut microbial environment. Rifaximin has been demonstrated to exert beneficial effects on cognitive function in patients with HE,and also to prevent the development of SBP,to reduce endotoxemia and to improve hemodynamics in cirrhotics. These results are linked to a shift in gut microbes functionality,triggering the production of favorable metabolites. The low incidence of drug-related adverse events due to the small amount of circulating drug makes rifaximin a relatively safe antibiotic for the modulation of gut microbiota in advanced liver disease. | Francesca Romana Ponziani Viviana Gerardi Silvia Pecere Francesca D'Aversa Loris Lopetuso Maria Assunta Zocco Maurizio Pompili | 2015 | World Journal of Gastroenterology2015，21，43： | 16 |
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