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| 1 | Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis显示文摘AIM: To evaluate acute cholecystitis, complicated by peritonitis, acute phase response and immunological status in patients treated by laparoscopic or open approach. METHODS: From January 2002 to May 2012, we conducted a prospective randomized study on 45 consecutive patients (27 women, 18 men; mean age 58 years). These subjects were taken from a total of 681 patients who were hospitalised presenting similar preoperative findings: acute upper abdominal pain with tenderness, involuntary guarding under the right hypochondrium and/or in the flank; fever higher than 38 ℃, leukocytosis greater than 10 × 10 9 /L or both, and ultrasonographic evidence of calculous cholecystitis possibly complicated by peritonitis. These patients had undergone cholecystectomy for acute calculous cholecystitis,complicated by bile peritonitis. Randomly, 23 patients were assigned to laparoscopic cholecystectomy (LC), and 22 patients to open cholecystectomy (OC). Blood samples were collected from all patients before operation and at days 1, 3 and 6 after surgery. Serum bacteraemia, endotoxaemia, white blood cells (WBCs), WBC subpopulations, human leukocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin-1 (IL-1) and IL-6, and C-reactive protein (CRP) were measured at 0, 30, 60, 90, 120 and 180 min, at 4, 6, 12, 24 h, and then daily (8 A.M.) until post-operative day 6.RESULTS: The two groups were comparable in the severity of peritoneal contamination as indicated by the viable bacterial count (open group = 90% of positive cultures vs laparoscopic group = 87%) and endotoxin level (open group = 33.21 ± 6.32 pg/mL vs laparoscopic group = 35.02 ± 7.23 pg/mL). Four subjects in the OC group (18.1%) and 1 subject (4.3%) in the LC group (P < 0.05) developed intra-abdominal abscess. Severe leukocytosis (range 15.8-19.6/mL) was observed only after OC but not after LC, mostly due to an increase in neutrophils (days 1 and 3, P < 0.05). This value returned to the normal range within 3-4 d after LC and 5-7 d after OC. Other WBC types and lymphocyte subpopulations showed no significant variation. On the first day after surgery, a statistically significant difference was observed in HLA-DR expression between LC (13.0 ± 5.2) and OC (6.0 ± 4.2) (P < 0.05). A statistically significant change in plasma elastase concentration was recorded post-operatively at days 1, 3, and 6 in patients from the OC group when compared to the LC group (P < 0.05). In the OC group, the serum levels of IL-1 and IL-6 began to increase considerably from the first to the sixth hour after surgery. In the LC group, the increase of serum IL-1 and IL-6 levels was delayed and the peak values were notably lower than those in the OC group. Significant differences between the groups, for these two cytokines, were observed from the second to the twenty-fourth hour (P < 0.05) after surgery. The mean values of serum CRP in the LC group on post-operative days (1 and 3) were also lower than those in the OC group (P < 0.05). Systemic concentration of endotoxin was higher in the OC group at all intra-operative sampling times, but reached significance only when the gallbladder was removed (OC group = 36.81 ± 6.4 ρg/mLvs LC group = 16.74 ± 4.1 ρg/mL, P < 0.05). One hour after surgery, microbiological analysis of blood cultures detected 7 different bacterial species after laparotomy, and 4 species after laparoscopy (P < 0.05). CONCLUSION: OC increased the incidence of bacteraemia, endotoxaemia and systemic inflammation compared with LC and caused lower transient immunological defense, leading to enhanced sepsis in the patients examined. | Federico Sista Mario Schietroma Giuseppe De Santis Antonella Mattei Emanuela Marina Cecilia Federica Piccione Sergio Leardi Francesco Carlei Gianfranco Amicucci | 2013 | World Journal of Gastrointestinal Surgery2013，5，4： | 23 |
| 2 | Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment显示文摘 | Schietroma Mario Piccione Federica Carlei Francesco Clementi Marco Bianchi Zuleyka de Vita Fabiola Amicucci Gianfranco | 2012 | EN2012，，5： | 2 |
| 3 | Colorectal Infraperitoneal Anastomosis: The Effects of Perioperative Supplemental Oxygen Administration on the Anastomotic Dehiscence显示文摘 | Mario Schietroma Francesco Carlei Emanuela Marina Cecilia Federica Piccione Zuleyka Bianchi Gianfranco Amicucci | 2012 | Journal of Gastrointestinal Surgery2012，，2： | 2 |
| 4 | FOXP3蛋白复合体及调节性T细胞功能研究进展显示文摘FOXP3+CD4+CD25+调节性T细胞(FOXP3+Tregs)负责正常机体免疫稳态的维持。人类许多重大免疫性疾病均与调节性T细胞的功能异常相关。叉头状家族转录蛋白FOXP3是调节性T细胞中特异性表达的关键转录因子,对调节性T细胞的发育与功能有着重要作用。近年来的研究表明,FOXP3蛋白转录调控复合体的装配及其翻译后修饰调节对调节性T细胞的功能至关重要,相关生理过程受到各种炎症微环境的动态调节。深入研究FOXP3+Tregs活性调节的分子机制将为攻克人类重大免疫及相关性疾病提供创新性线索。 | 孔超 李丹 陈祚珈 PICCION Miranda 袁晓君 李斌 | 2014 | 科技导报2014，32，15： | 2 |
| 5 | 第三十二指肠的部分的腺癌: 案例报告和文学的评论显示文摘We focus on the diagnostic and therapeutic problemsof duodenal adenocarcinoma,reporting a case and reviewing the literature.A 65-year old man with adenocarcinoma in the third duodenal portion was successfully treated with a segmental resection of the third part of the duodenum,avoiding a duodeno-cephalo-pancreatectomy.This tumor is very rare and frequently affects the Ⅲ and Ⅳduodenal portion.A precocious diagnosis and the exact localization of this neoplasia are crucial factors in order to decide the surgical strategy.Given a non-specificity of symptoms,endoscopy with biopsy is the diagnostic gold standard.Duodeno-ceph-alo-pancreatectomy(DCP) and segmental resection of the duodenum(SRD) are the two surgical options,with overlapping morbidity(27% vs 18%) and post operative mortality(3% vs 1%).The average incidence of postoperative long-term survival is 100%,73.3% and31.6% of cases after 1,3 and 5 years from surgery,respectively.Long-term survival is made worse by two factors:the presence of metastatic lymph nodes and tumor localization in the proximal duodenum.The two surgical options are radical:DCP should be used only for proximal localizations while SRD should be chosen for distal | Federico Sista Giuseppe De Santis Antonio Giuliani Emanuela Marina Cecilia Federica Piccione Laura Lancione Sergio Leardi Gianfranco Amicucci | 2012 | World Journal of Gastrointestinal Surgery2012，4，1： | 2 |
| 6 | Assessment of oxidative stress in dry and lactating cows显示文摘 | Piccione G Borruso M Giannetto C | 2007 | Acta Agriculturae Seandinaviea Section A-Animal Science2007，57，2： | 1 |
| 7 | Defense mechanisms as outcome measure in short-term psychotherapy related to symptoms, severity and overall functioning: a preliminary study显示文摘 | Coccanari de' Fornari MA Piccione M Maiello L | 2011 | Res Psychiatry2011，46，1： | 1 |
| 8 | Daily rhythmicity in nutrient content of asinine milk显示文摘 | PICCIONE G FAZIO F CAOLA G | 2008 | Livestock Science2008，116，： | 1 |
| 9 | Human lung tumor growth established in the lung and subcutaneous tissue of mice with severe combined immunodeficiency显示文摘 | Reddy S Piccione D Takita H | 1987 | Cancer Res1987，47，9： | 1 |
| 10 | Modulation of affeetive symptoms and resting state activity by brain stimulation in a treatment-resistant case of obsessive-compulsive disorder显示文摘 | Volpato C Piccione F Cavinato M | 2013 | Neurocase2013，19，4： | 1 |
| 11 | Peritonitis from perfo- rated appendicitis: stress response after laparoscopic or open treatment 显示文摘 | Schietroma M Piccione F Carlei F | 2012 | Am Surg2012，78，5： | 1 |
| 12 | Dyke-Davidoff-Masson syndrome:case report of fetal unilateral ventriculomegaly and hypoplastic left middle cerebral artery显示文摘 | Piro E Piccione M Marrone G | 2013 | Ital J Pediatr2013，39，： | 1 |
| 13 | The ‘Black Pad’ Failure Mechanism-From Beginning to End显示文摘 | Ronad A Bulwith Michael Troshy Lous M Piccione | 2002 | Global SMT & Packaging Journal2002，9，： | 1 |
| 14 | Peritonitis from perfo- rated peptic ulcer and Immune response 显示文摘 | Schietroma M Piccione F Carlei F | 2013 | J Invest Surg2013，26，5： | 1 |
| 15 | Homologous intrauterine insemination in controlled ovarian hyperstimulation cycles: A comparison among three different regimens显示文摘 | Casadei L Zamaro V Calcagrti M Ticconi C Dorrucci M Piccione E | 2006 | Eur J Obstet Gynccol Rcprod Biol2006，8，： | 1 |
| 16 | Variational aspects of the geodesics problem in sub-Riemannian geometry显示文摘 | Piccione P | 2001 | Journal of Geometry and Physics2001，39，： | 1 |
| 17 | Recurrence rate of endometrioma after laparoscopic cystectomy: A comparative randomized trial between post-operative hormonal suppression treatment or dietary therapy vs. placebo显示文摘 | Francesco Sesti Talia Capozzolo Adalgisa Pietropolli Massimiliano Marziali Maria Rosa Bollea Emilio Piccione | 2009 | European Journal of Obstetrics and Gynecology2009，，1： | 1 |
| 18 | Sex reversal from functional disomy of Xp:prenatal and post-mortem findings显示文摘 | Piccione M Maresi E Zollino M | 2008 | Am J Med Genet A2008，146，20： | 1 |
| 19 | The economics of hubs:The case of monopoly显示文摘 | Hendricks K Piccione M Tan G F | 1995 | The Review of Economic Studies1995，62，1： | 1 |
| 20 | The 'Black Pad' Failure Mechanism From Beginning to End显示文摘 | Bulwith R A Troshy M Piccione I M | 2002 | Global SMT & Packaging Journal2002，，9： | 1 |
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