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| 1 | Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice显示文摘AIM: To verify the validity of the International Ascites Club guidelines for treatment of spontaneous bacterial peritonitis (SBP) in clinical practice. METHODS: All SBP episodes occurring in a group of consecutive cirrhotics were managed accordingly and included in the study. SBP was diagnosed when the ascitic fluid polymorphonuclear (PMN) cell count was > 250 cells/mm3, and empirically treated with cefotaxime. RESULTS: Thirty-eight SBP episodes occurred in 32 cirrhotics (22 men/10 women; mean age: 58.6 ± 11.2 years). Prevalence of SBP, in our population, was 17%. Ascitic fluid culture was positive in nine (24%) cases only. Eleven episodes were nosocomial and 71% community-acquired. Treatment with cefotaxime was successful in 59% of cases, while 41% of episodes required a modification of the initial antibiotic therapy because of a less-than 25% decrease in ascitic PMN count at 48 h. Change of antibiotic therapy led to the resolution of infection in 87% of episodes. Among the cases with positive culture, the initial antibiotic therapy with cefotaxime failed at a percentage (44%) similar to that of the whole series. In these cases, the isolated organisms were either resistant or with an inherent insufficient susceptibility to cefotaxime. CONCLUSION: In clinical practice, ascitic PMN count is a valid tool for starting a prompt antibiotic treatment andevaluating its efficacy. The initial treatment with cefotaxime failed more frequently than expected. An increase in healthcare-related infections with antibiotic-resistant pathogens may explain this finding. A different first-line antibiotic treatment should be investigated. | Stefania Angeloni Cinzia Leboffe Antonella Parente Mario Venditti Alessandra Giordano Manuela Merli Oliviero Riggio | 2008 | World Journal of Gastroenterology2008，14，17： | 42 |
| 2 | Microbiota and the gut-liver axis:Bacterial translocation,inflammation and infection in cirrhosis显示文摘Liver disease is associated with qualitative and quantitative changes in the intestinal microbiota.In cirrhotic patients the alteration in gut microbiota is characterized by an overgrowth of potentially pathogenic bacteria(i.e.,gram negative species)and a decrease in autochthonous familiae.Here we summarize the available literature on the risk of gut dysbiosis in liver cirrhosis and its clinical consequences.We therefore described the features of the complex interaction between gut microbiota and cirrhotic host,the so called'gut-liver axis',with a particular attention to the acquired risk of bacterial translocation,systemic inflammation and the relationship with systemic infections in the cirrhotic patient.Such knowledge might help to develop novel and innovative strategies for the prevention and therapy of gut dysbiosis and its complication in liver cirrhosis. | Valerio Giannelli Vincenza Di Gregorio Valerio Iebba Michela Giusto Serena Schippa Manuela Merli Ulrich Thalheimer | 2014 | World Journal of Gastroenterology2014，20，45： | 43 |
| 3 | Targeted therapy or immunotherapy? Optimal treatment in hepatocellular carcinoma显示文摘Hepatocellular carcinoma(HCC) is the fifth leading cause of cancer mortality in the United States and the second leading cause of cancer mortality worldwide. Sorafenib is the only food and drug administration(FDA) approved as first line systemic treatment in HCC. Regorafenib and nivolumab are the only FDA approved second line treatment after progression on sorafenib. We will discuss all potential first and second line options in HCC. In addition, we also will explore sequencing treatment options in HCC, and examine biomarkers that can potentially predict benefits from treatments such as immune checkpoint inhibitor. This minireview summarizes potential treatments in HCC based on clinical trials that have been published in manuscript or abstract format from 1994-2018. | Merly Contratto Jennifer Wu | 2018 | World Journal of Gastrointestinal Oncology2018，10，5： | 12 |
| 4 | 急性脊髓损伤患者治疗的临床操作指南:关于MRI基线在临床治疗决策与结果预测中作用的几点建议(英文)显示文摘The objective of this guideline is to outline the role of magnetic resonance imaging(MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury(SCI).Methods A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI.This review focused on longitudinal studies that controlled for baseline neurologic status.A multidisciplinary Guideline Development Group(GDG) used this information,their clinical expertise,and patient input to develop recommendations on the use of MRI for SCI patients.Based on GRADE(Grading of Recommendation,Assessment,Development and Evaluation),a strong recommendation is worded as ' we recommend,' whereas a weaker recommendation is indicated by 'we suggest.' Results Based on the limited available evidence and the clinical expertise of the GDG,our recommendations were:(1) 'We suggest that MRI be performed in adult patients with acute SCI prior to surgical intervention,when feasible,to facilitate improved clinical decision-making'(quality of evidence,very low) and(2) 'We suggest that MRI should be performed in adult patients in the acute period following SCI,before or after surgical intervention,to improve prediction of neurologic outcome '(quality of evidence,low).Conclusions These guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with SCI. | Fehlings MG Martin AR Tetreault LA Aarabi B Anderson P Arnold PM Brodke D Burns AS Chiba K Dettori JR Furlan JC Hawryluk G Holly LT Howley S Jeji T Kalsi-Ryan S Kotter M Kurpad S Kwon BK Marino RJ Massicotte E Merli G Middleton JW Nakashima H Nagoshi N Palmieri K Singh A Skelly AC Tsai EC Vaccaro A Wilson JR Yee A Harrop JS | 2017 | 中华神经外科疾病研究杂志2017，16，6： | 8 |
| 5 | Accuracy of the automated cell counters for management of spontaneous bacterial peritonitis显示文摘AIM: To evaluate the accuracy of automated blood cell counters for ascitic polymorphonuclear (PMN) determination for: (1) diagnosis, (2) efficacy of the ongoing antibiotic therapy, and (3) resolution of spontaneous bacterial peritonitis (SBP). METHODS: One hundred and twelve ascitic fluid samples were collected from 52 consecutive cirrhotic patients, 16 of them with SBP. The agreement between the manual and the automated method for PMN count was assessed. The sensitivity/specificity and the positive/negative predictive value of the automated blood cell counter were also calculated by considering the manual method as the 'gold standard' . RESULTS: The mean ± SD of the difference between manual and automated measurements was 7.8 ± 58 cells/mm3, while the limits of agreement were +124 cells/mm3 [95% confidence interval (CI): +145 to +103] and -108 cells/mm3 (95% CI: -87 to -129). The automated cell counter had a sensitivity of 100% and a specificity of 97.7% in diagnosing SBP, and a sensitivity of 91% and a specificity of 100% for the efficacy of the ongoing antibiotic therapy. The two methods showed a complete agreement for the resolution of infection. CONCLUSION: Automated cell counters not only have a good diagnostic accuracy, but are also very effective in monitoring the antibiotic treatment in patients with SBP. Because of their quicker performance, they should replace the manual counting for PMN determination in the ascitic fluid of patients with SBP. | Oliviero Riggio Stefania Angeloni Antonella Parente Cinzia Leboffe Giorgio Pinto Teresa Aronne Manuela Merli | 2008 | World Journal of Gastroenterology2008，14，37： | 6 |
| 6 | Changes in nutritional status after liver transplantation显示文摘Chronic liver disease has an important effect on nutritional status, and malnourishment is almost universally present in patients with end-stage liver disease who undergo liver transplantation. During recent decades,a trend has been reported that shows an increase in number of patients with end-stage liver disease and obesity in developed countries. The importance of carefully assessing the nutritional status during the workup of patients who are candidates for liver replacement is widely recognised. Cirrhotic patients with depleted lean body mass(sarcopenia) and fat deposits have an increased surgical risk; malnutrition may further impact morbidity, mortality and costs in the post-transplantation setting. After transplantation and liver function is restored, many metabolic alterations are corrected,dietary intake is progressively normalised, and lifestyle changes may improve physical activity. Few studies have examined the modifications in body composition that occur in liver recipients. During the first 12 mo, the fat mass progressively increases in those patients who had previously depleted body mass, and the muscle mass recovery is subtle and non-significant by the end of the first year. In some patients, unregulated weight gain may lead to obesity and may promote metabolicdisorders in the long term. Careful monitoring of nutritional changes will help identify the patients who are at risk for malnutrition or over-weight after liver transplantation. Physical and nutritional interventions must be investigated to evaluate their potential beneficial effect on body composition and muscle function after liver transplantation. | Michela Giusto Barbara Lattanzi Vincenza Di Gregorio Valerio Giannelli Cristina Lucidi Manuela Merli | 2014 | World Journal of Gastroenterology2014，20，31： | 5 |
| 7 | An analytical method for Fe(Ⅱ) and Fe(Ⅲ) determination in pharmaceutical grade iron sucrose complex and sodium ferric gluconate complex显示文摘A robust voltammetric method has been developed and validated for the determination of Fe(Ⅱ) and Fe(Ⅲ) in pharmaceutical iron polysaccharidic complexes. Undesirable low molecular weight iron complexes, at concentration about 3% in the pharmaceutical formulation, can be easily determined with good accuracy and precision. This methodology can be proposed as a viable, environmentally sustainable substitute for the conventional Normal Pulse Polarographic method in US Pharmacopeia, with better analytical figures of merit, and reduced Hg consumption. A deeper insight in Fe(Ⅱ) and Fe(Ⅲ) composition can be gained by the combined use of a new potentiometric technique after chemical decomposition of the complex. | Daniele Merli Antonella Profumo Carlo Dossi | 2012 | Journal of Pharmaceutical Analysis2012，2，6： | 5 |
| 8 | Incidence and natural history of small esophageal varices in cirrhotic patients显示文摘 | Manuela Merli Giorgia Nicolini Stefania Angeloni Vittorio Rinaldi Adriano De Santis Carlo Merkel Adolfo Francesco Attili Oliviero Riggio | 2002 | Journal of Hepatology2002，，3： | 4 |
| 9 | TM6SF2 E167K variant predicts severe liver fibrosis for human immunodeficiency/hepatitis C virus co-infected patients, and severe steatosis only for a non-3 hepatitis C virus genotype显示文摘AIM To evaluate the impact of the Glu167Lys(E167K) transmembrane 6 superfamily member 2(TM6SF2) variant on the biochemical and morphologic expression of liver lesions in human immunodeficiency virus(HIV)/hepatitis C virus(HCV) co-infected patients.METHODS The study comprised 167 consecutive patients with HIV/HCV coinfection and biopsy-proven chronic hepatitis. A pathologist graded liver fibrosis and necroinflammation using the Ishak scoring system, and steatosis using Kleiner's scoring system. Patients were genotyped for TM6SF2 E167K(rs58542926) by real-time Polymerase chain reaction. The 167 patients, 35 therapy-naive and 132 receiving ART, were prevalently males(73.6%), the median age was 40.7 years and the immunological condition good(median CD4+ cells/mm3 = 505.5).RESULTS The 17 patients with the TM6SF2 E167 K variant, compared with the 150 with TM6SF2-E/E, showed higher AST(P = 0.02) and alanine aminotransferase(P = 0.02) and higher fibrosis score(3.1 ± 2.0 vs 2.3 ± 1.5, P = 0.05). In a multivariate analysis, TM6SF2 E167 K was independently associated with severe fibrosis. The same analysis showed that HCV-genotype 3, present in 42.2% of patients was an independent predictor of severe steatosis. The association of TM6SF2 E167 K with severe steatosis, absent for the whole group of 167 patients, was re-evaluated separately for HCVgenotype 3 and non-3 patients: No factor was independently associated with severe steatosis in the HCV-genotype-3 subgroup, whereas an independent association was observed between severe steatosis and TM6SF2 E167 K in non-3 HCV genotypes. No association between the TM6SF2 E167 K variant and severe liver necroinflammation was observed.CONCLUSION In HIV/HCV coinfection the TM6SF2 E167 K variant is an independent predictor of severe fibrosis, but appears to be independently associated with severe steatosis only for patients with a non-3 HCV genotype. | Caterina Sagnelli Marco Merli Caterina Uberti-Foppa Hamid Hasson Anna Grandone Grazia Cirillo Stefania Salpietro Carmine Minichini Mario Starace Emanuela Messina Patrizia Morelli Emanuele Miraglia Del Giudice Adriano Lazzarin Nicola Coppola Evangelista Sagnelli | 2016 | World Journal of Gastroenterology2016，22，38： | 4 |
| 10 | Cirrhotic Patients Are at Risk for Health Care–Associated Bacterial Infections显示文摘 | Manuela Merli Cristina Lucidi Valerio Giannelli Michela Giusto Oliviero Riggio Marco Falcone Lorenzo Ridola Adolfo Francesco Attili Mario Venditti | 2010 | Clinical Gastroenterology and Hepatology2010，，11： | 3 |
| 11 | Immunotherapy in pancreatic cancer:Unleash its potential through novel combinations显示文摘Pancreatic cancer is the third leading cause of cancer mortality in both men and women in the United States,with poor response to current standard of care,short progression-free and overall survival.Immunotherapies that target cytotoxic T lymphocyte antigen-4,programmed cell death protein-1,and programmed death-ligand 1 checkpoints have shown remarkable activities in several cancers such as melanoma,renal cell carcinoma,and nonsmall cell lung cancer due to high numbers of somatic mutations,combined with cytotoxic T-cell responses.However,single checkpoint blockade was ineffective in pancreatic cancer,highlighting the challenges including the poor antigenicity,a dense desmoplastic stroma,and a largely immunosuppressive microenvironment.In this review,we will summarize available clinical results and ongoing efforts of combining immune checkpoint therapies with other treatment modalities such as chemotherapy,radiotherapy,and targeted therapy.These combination therapies hold promise in unleashing the potential of immunotherapy in pancreatic cancer to achieve better and more durable clinical responses by enhancing cytotoxic T-cell responses. | Songchuan Guo Merly Contratto George Miller Lawrence Leichman Jennifer Wu | 2017 | World Journal of Clinical Oncology2017，8，3： | 3 |
| 12 | Evaluation of a locked nucleic acid form of antisense oligo targeting HIF-1α in advanced hepatocellular carcinoma显示文摘BACKGROUND Hypoxia-inducible factor 1α(HIF-1α) is a gene that regulates tumor survival,neovascularization and invasion. Overexpression of HIF-1α correlates with poor prognosis in hepatocellular carcinoma(HCC). RO7070179 is a HIF-1α inhibitor that decreases HIF-1α mRNA and its downstream targets, it could be a potential treatment in HCC.AIM To evaluate safety and preliminary activity of RO7070179 in patients with previously treated HCC, with focus on a patient with prolonged response to RO7070179.METHODS In the preclinical study of RO7070179 in a HCC xenograft model, the mice wereseparated into 4 groups with each group received doses of 0, 3, 10 and 30 mg/kg for total 10 doses. HCC patients who failed at least one line of systemic treatment,received RO7070179 as a weekly infusion, each cycle is 6 wk. We evaluated the safety and HIF-1α mRNA levels of RO7070179.RESULTS Preclinical evaluation of RO7070179 in orthotopic HCC xenograft model showed no significant differences in HCC tumor weight between the 3 and 10 mg/kg groups. However, dose of 10 mg/kg of RO7070179, has shown 76% reduction of the amount of HIF-1α mRNA in HCC tissue. In the phase 1 b study of RO7070179 in previously treated HCC patients, 8 out of 9 were evaluable: 1 achieved PR and1 SD. The patient with PR responded after 2 cycles treatments, which has been maintained for 12 cycles. This patient also showed reduction in perfusion of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) after 1 cycle of treatment. After 1 cycle of treatment, both patients with PR and SD showed decrease in HIF-1α mRNA at the root of biopsies(each biopsy was divided into 2 specimens, the tip and the root).CONCLUSION RO7070179 can reduce HIF-1α mRNA level in HCC patients with SD or PR. It is well tolerated at 10 mg/kg, with transaminitis as the dose of increased toxicity.This study indicates that RO7070179 might benefit HCC patients, and an early signal for clinical benefit can potentially be predicted through changes in either m RNA level or DCE-MRI within 1 cycle of therapy. | Jennifer Wu Merly Contratto Krishna P Shanbhogue Gulam A Manji Bert H O'Neil Anne Noonan Robert Tudor Ray Lee | 2019 | World Journal of Clinical Oncology2019，10，3： | 2 |
| 13 | MELD score is better than Child–Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt显示文摘 | Francesco Salerno Manuela Merli Massimo Cazzaniga Valentina Valeriano Plinio Rossi Andrea Lovaria Daniele Meregaglia Antonio Nicolini Lorenzo Lubatti Oliviero Riggio | 2002 | Journal of Hepatology2002，，4： | 2 |
| 14 | The Silk Road agenda of the Pan-Eurasian Experiment (PEEX) program显示文摘The Silk Road Economic Belt and the 21st-Century Maritime Silk Road(B&R)aims at facilitating the twenty-first Century economic development of China.However,climate change,air quality and related feedbacks are affecting the successful development of the environment and societies in the B&R geographical domain.The most urgent risks related to the atmospheric system,to the land system and to hydrospheric and cryospheric processes are changing climate-air quality interactions,air pollution,changing monsoon dynamics,land degradation,and the melting of Tibetan Plateau glaciers.A framework is needed in which a science and technology-based approach has the critical mass and expertise to identify the main steps toward solutions and is capable to implement this roadmap.The Pan-Eurasian Experiment(PEEX)program,initiated in 2012,aims to resolve science,technology and sustainability questions in the Northern Eurasian region.PEEX is now identifying its science agenda for the B&R region.One fundamental element of the PEEX research agenda is the availability of comprehensive ground-based observations together with Earth observation data.PEEX complements the recently launched international scientific program called Digital Belt and Road(DBAR).PEEX has expertise to coordinate the ground-based observations and initiate new flagship stations,while DBAR provides a big data platform on Earth observation from China and countries along the Belt and Road region.The DBAR and PEEX have joint interests and synergy expertise on monitoring on ecological environment,urbanization,cultural heritages,coastal zones,and arctic cold regions supporting the sustainable development of the Belt and Road region.In this paper we identify the research themes of the PEEX related Silk Road agenda relevant to China and give an overview of the methodological requirements and present the infrastructure requirements needed to carry out large scale research program. | Hanna K.Lappalainen Markku Kulmala Joni Kujansuu Tuukka Petaja Alexander Mahura Gerrit de Leeuw Sergej Zilitinkevich Merli Juustila Veli-Matti Kerminen Bob Bornstein Zhang Jiahua Xue Yong Qiu Yubao Liang Dong Liu Jie Guo Huadong | 2018 | Big Earth Data2018，2，1： | 2 |
| 15 | Recipient Interleukin-28B Rs12979860 C/T Polymorphism and Acute Cellular Rejection After Liver Transplantation: Role of the Calcineurin Inhibitor Used显示文摘 | Davide Bitetto Carlo Fabris Edmondo Falleti Ezio Fornasiere Claudio Avellini Sara Cmet Annarosa Cussigh Elisabetta Fontanini Mario Pirisi Stefano Ginanni Corradini Manuela Merli Antonio Molinaro Pierluigi Toniutto | 2012 | Transplantation Journal2012，，10： | 2 |
| 16 | Use of emerging oral anticoagulants in clinical practice: translating results from clinical trials to orthopedic and general surgical patient populations 显示文摘 | Merli G Spyropoulos AC Caprini JA | 2009 | Ann Surg2009，250，2： | 1 |
| 17 | Endothelial dysfunction in acute and chronic coronary syndromes: evidence for a pathogenetic role of oxidative stress显示文摘 | Valgimigli M Merli E Malagutti P | 2003 | Arch Biochem Biophys2003，420，2： | 1 |
| 18 | Analysis at the clonal level of T-cell phenotype and functions in severe aplastic anemia patients显示文摘 | Viale M Merli A Bacigalupo A | 1991 | Blood1991，78，： | 1 |
| 19 | Biology, incidence and preventon of deep vein thrombosis in acute cord injury显示文摘 | Merli GJ Grabbe S Paluzzi RG | 1993 | Arch Phys Med Rehabil1993，74，： | 1 |
| 20 | Treatment of industrial landfill leachate by means of evaporation and reverse osmosis 显示文摘 | Palma L D Ferrantelli P Merli C | 2002 | Waste Management2002，22，8： | 1 |
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