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| 1 | Gut-liver axis and probiotics: Their role in non-alcoholic fatty liver disease显示文摘The incidence of obesity and its related conditions, including non-alcoholic fatty liver disease(NAFLD), has dramatically increased in all age groups worldwide. Given the health consequences of these conditions, and the subsequent economic burden on healthcare systems, their prevention and treatment have become major priorities. Because standard dietary and lifestyle changes and pathogenically-oriented therapies(e.g., antioxidants, oral hypoglycemic agents, and lipid-lowering agents) often fail due to poor compliance and/or lack of efficacy, novel approaches directed toward other pathomechanisms are needed. Here we present several lines of evidence indicating that, by increasing energy extraction in some dysbiosis conditions or small intestinal bacterial overgrowth,specific gut microbiota and/or a'low bacterial richness'may play a role in obesity,metabolic syndrome,and fatty liver.Under conditions involving a damaged intestinal barrier('leaky gut'),the gut-liver axis may enhance the natural interactions between intestinal bacteria/bacterial products and hepatic receptors(e.g.,toll-like receptors),thus promoting the following cascade of events:oxidative stress,insulinresistance,hepatic inflammation,and fibrosis.We also discuss the possible modulation of gut microbiota by probiotics,as attempted in NAFLD animal model studies and in several pilot pediatric and adult human studies.Globally,this approach appears to be a promising and innovative add-on therapeutic tool for NAFLD in the context of multi-target therapy. | Giulia Paolella Claudia Mandato Luca Pierri Marco Poeta Martina Di Stasi Pietro Vajro | 2014 | World Journal of Gastroenterology2014，20，42： | 55 |
| 2 | Liver stiffness in the hepatitis B virus carrier:A non-invasive marker of liver disease influenced by the pattern of transaminases显示文摘AIM: To investigate the usefulness of transient elastography by Fibroscan (FS),a rapid non-invasive technique to evaluate liver fibrosis,in the management of chronic hepatitis B virus (HBV) carriers.METHODS: In 297 consecutive HBV carriers,we studied the correlation between liver stiffness (LS),stage of liver disease and other factors potentially influencing FS measurements.In 87 chronic hepatitis B (CHB) patients,we monitored the FS variations according to the spontaneous or treatment-induced variations of biochemical activity during follow-up.RESULTS: FS values were 12.3 ± 3.3 kPa in acute hepatitis,10.3 ± 8.8 kPa in chronic hepatitis,4.3 ± 1.0 kPa in inactive carriers and 4.6 ± 1.2 kPa in blood donors.We identified the cut-offs of 7.5 and 11.8 kPa for the diagnosis of fibrosis ≥ S3 and cirrhosis respectively,showing 93.9% and 86.5% sensitivity,88.5% and 96.3% specificity,76.7% and 86.7% positive predictive value (PPV),97.3% and 96.3% negative predictive value (NPV) and 90.1% and 94.2% diagnostic accuracy.At multivariate analysis in 171 untreated carriers,fibrosis stage (t = 13.187,P < 0.001),active vs inactive HBV infection (t = 6.437,P < 0.001),alanine aminotransferase (ALT) (t = 4.740,P < 0.001) and HBV-DNA levels (t = -2.046,P = 0.042) were independently associated with FS.Necroinflammation score (t = 2.158,> 10/18 vs ≤ 10/18,P = 0.035) and ALT levels (t = 3.566,P = 0.001) were independently associated with LS in 83 untreated patients without cirrhosis and long-term biochemical remission (t = 4.662,P < 0.001) in 80 treated patients.During FS monitoring (mean follow-up 19.9 ± 7.1 mo) FS values paralleled those of ALT in patients with hepatitis exacerbation (with 1.2 to 4.4-fold increases in CHB patients) and showed a progressive decrease during antiviral therapy.CONCLUSION: FS is a non-invasive tool to monitor liver disease in chronic HBV carriers,provided that the pattern of biochemical activity is taken into account.In the inactive carrier,it identifies non-HBV-related causes of liver damage and transient reactivations.In CHB patients,it may warrant a more appropriate timing of control liver biopsies. | Filippo Oliveri Barbara Coco Pietro Ciccorossi Piero Colombatto Veronica Romagnoli Beatrice Cherubini Ferruccio Bonino Maurizia Rossana Brunetto | 2008 | World Journal of Gastroenterology2008，14，40： | 43 |
| 3 | Autoimmune liver serology:Current diagnostic and clinical challenges显示文摘Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseas-es(AiLD),namely autoimmune hepatitis types 1 and 2(AIH-1 and 2),primary biliary cirrhosis(PBC),and the sclerosing cholangitis variants in adults and children.AIH-1 is specified by anti-nuclear antibody(ANA) and smooth muscle antibody(SMA).AIH-2 is specified by antibody to liver kidney microsomal antigen type-1(anti-LKM1) and anti-liver cytosol type 1(anti-LC1).SMA,ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation.PBC is specified by antimitochondrial antibodies(AMA) react-ing with enzymes of the 2-oxo-acid dehydrogenase complexes(chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly react-ing with nuclear pore gp210 and nuclear body sp100.Sclerosing cholangitis presents as at least two variants,first the classical primary sclerosing cholangitis(PSC) mostly affecting adult men wherein the only(and non-specific) reactivity is an atypical perinuclear antineutro-phil cytoplasmic antibody(p-ANCA),also termed peri-nuclear anti-neutrophil nuclear antibodies(p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis(ASC) with serological features resembling those of type 1 AIH.Liver diagnostic serol-ogy is a fast-expanding area of investigation as new purified and recombinant autoantigens,and automatedtechnologies such as ELISAs and bead assays,become available to complement(or even compete with) tradi-tional immunofluorescence procedures.We survey for the first time global trends in quality assurance impact-ing as it does on(1) manufacturers/purveyors of kits and reagents,(2) diagnostic service laboratories that fulfill clinicians' requirements,and(3) the end-user,the physician providing patient care,who must properly interpret test results in the overall clinical context. | Dimitrios P Bogdanos Diego Vergani Pietro Invernizzi Ian R Mackay | 2008 | World Journal of Gastroenterology2008，14，21： | 40 |
| 4 | Pediatric non-alcoholic fatty liver disease: Recent solutions, unresolved issues, and future research directions显示文摘Non-alcoholic fatty liver disease(NAFLD) in children is becoming a major health concern. A 'multiple-hit' pathogenetic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD. In addition to the accumulation of fat in the liver, insulin resistance(IR) and oxidative stress due to genetic/epigenetic background, unfavorable lifestyles, gut microbiota and gut-liver axis dysfunction, and perturbations of trace element homeostasis have been shown to be critical for disease progression and the development of more severe inflammatory and fibrotic stages [non-alcoholic steatohepatitis(NASH)]. Simple clinical and laboratory parameters, such as age, history, anthropometrical data(BMI and waist circumference percentiles), blood pressure, surrogate clinical markers of IR(acanthosis nigricans), abdominal ultrasounds, and serum transaminases, lipids and glucose/insulin profiles, allow a clinician to identify children with obesity and obesity-related conditions, including NAFLD and cardiovascular and metabolic risks. A liver biopsy(the 'imperfect' gold standard) is required for a definitive NAFLD/NASH diagnosis, particularly to exclude other treatable conditions or when advanced liver disease is expected on clinical and laboratory grounds and preferably prior to any controlled trial of pharmacological/surgical treatments. However, a biopsy clearly cannot represent a screening procedure. Advancements in diagnostic serum and imaging tools, especially for the non-invasive differentiation between NAFLD and NASH, have shown promising results, e.g., magnetic resonance elastography. Weight loss and physical activity should be the first option of intervention.Effective pharmacological treatments are still under development; however, drugs targeting IR, oxidative stress, proinflammatory pathways, dyslipidemia, gut microbiota and gut liver axis dysfunction are an option for patients who are unable to comply with the recommended lifestyle changes. When morbid obesity prevails, bariatric surgery should be considered. | Maria Grazia Clemente Claudia Mandato Marco Poeta Pietro Vajro | 2016 | World Journal of Gastroenterology2016，22，36： | 32 |
| 5 | Introducing an enhanced recovery after surgery program in colorectal surgery:A single center experience显示文摘AIM:To study the implementation of an enhanced recovery after surgery(ERAS)program at a large University Hospital from'pilot study'to'standard of care'.METHODS:The study was designed as a prospective single centre cohort study.A prospective evaluation of compliance to a protocol based on full application of all ERAS principles,through the progressive steps of its implementation,was performed.Results achieved in the initial pilot study conducted by a dedicated team(n=47)were compared to those achieved in the shared protocol phase(n=143)three years later.Outcomes were length of postoperative hospital stay,readmission rate,compliance to the protocol and morbidity.Primary endpoint was the description of the results and the identification of critical issues of large scale implementation of an ERAS program in colorectal surgery emerged in the experience of a single center.Secondary endpoint was the identification of interventions that have been proven to be effective for facilitating the transition from traditional care pathways to a multimodal management protocol according to ERAS principles in colorectal surgery at a single center.RESULTS:During the initial pilot study(March 2009 to December 2010;47 patients)conducted by a dedicated multidisciplinary team,compliance to the items of ERAS protocol was 93%,with a median length of hospital stay(LOS)of 3 d.Early anastomotic fistulas were observed in 2 cases(4.2%),which required reoperation(Clavien-Dindo gradeⅢb).None of the patients had been discharged before the onset of the complication,which could therefore receive prompt treatment.There were also four(8.5%)minor complications(ClavienDindo gradeⅡ).Thirty days readmission rate was 4%.Perioperative mortality was nil.After implementation of the protocol throughout the Hospital in unselected patients(May 2012 to December 2012;147 patients)compliance was 74%,with a median LOS of 6 d.Early anastomotic fistulas were observed in 11 cases(7.7%),5(3.5%)of which required reoperation(Clavien-Dindo gradeⅢb).Two early anastomotic fistulas were treated by radiologic/endoscopic manoeuvres and 4 were treated conservatively.There were also 36(25.2%)minor complications,21(14.7%)of which were Clavien-Dindo gradeⅡand 15(10.5%)of which were Clavien-Dindo gradeⅠ.Only two patients whose course was adversely affected by the development of an anastomotic leak had been discharged before the onset of the complication itself,requiring readmission.Readmission rate within 30 d was 4%.Perioperative mortality was 1%.CONCLUSION:Our results confirm that introduction of an ERAS protocol for colorectal surgery allows quickerpostoperative recovery and shortens the length of stay compared to historical series. | Stefano Bona Mattia Molteni Riccardo Rosati Ugo Elmore Pietro Bagnoli Roberta Monzani Monica Caravaca Marco Montorsi | 2014 | World Journal of Gastroenterology2014，20，46： | 30 |
| 6 | Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia显示文摘AIM:To investigate the predictive value of narrowband imaging with magnifying endoscopy (NBI-ME) for identifying gastric intestinal metaplasia (GIM) in unselected patients. METHODS:We prospectively evaluated consecutive patients undergoing upper endoscopy for various indications, such as epigastric discomfort/pain, anaemia, gastro-oesophageal reflux disease, suspicion of peptic ulcer disease, or chronic liver diseases. Patients underwent NBI-ME, which was performed by three blinded, experienced endoscopists. In addition, five biopsies (2 antrum, 1 angulus, and 2 corpus) were taken and examined by two pathologists unaware of the endoscopic findings to determine the presence or absence of GIM. The correlation between light blue crest (LBC) appearance and histology was measured. Moreover, we quantified the degree of LBC appearance as less than 20% (+), 20%-80% (++) and more than 80% (+++) of an image field, and the semiquantitative evaluation of LBC appearance was correlated with IM percentage from the histological findings. RESULTS:We enrolled 100 (58 F/42 M) patients who were mainly referred for gastro-esophageal reflux disease/dyspepsia (46%), cancer screening/anaemia (34%), chronic liver disease (9%), and suspected celiac disease (6%); the remaining patients were referred for other indications. The prevalence of Helicobacter pylori (H. pylori ) infection detected from the biopsies was 31%, while 67% of the patients used proton pump inhibitors. LBCs were found in the antrum of 33 patients (33%); 20 of the cases were classified as LBC+, 9 as LBC++, and 4 as LBC+++. LBCs were found in the gastric body of 6 patients (6%), with 5 of them also having LBCs in the antrum. The correlation between the appearance of LBCs and histological GIM was good, with a sensitivity of 80% (95%CI:67-92), a specificity of 96% (95%CI:93-99), a positive predictive value of 84% (95%CI:73-96), a negative predictive value of 95% (95%CI:92-98), and an accuracy of 93% (95%CI:90-97). The NBI-ME examination overlooked GIM in 8 cases, but the GIM was less than 5% in 7 of the cases. Moreover, in the 6 false positive cases, the histological examination showed the presence of reactive gastropathy (4 cases) or H. pylori active chronic gastritis (2 cases). The semiquantitative correlation between the rate of LBC appearance and the percentage of GIM was 79% (P < 0.01). CONCLUSION:NBI-ME achieved good sensitivity and specificity in recognising GIM in an unselected population. In routine clinical practice, this technique can reliably target gastric biopsies. | Edoardo Savarino Marina Corbo Pietro Dulbecco Lorenzo Gemignani Elisa Giambruno Luca Mastracci Federica Grillo Vincenzo Savarino | 2013 | World Journal of Gastroenterology2013，19，17： | 23 |
| 7 | Long-term albumin infusion improves survival in patients with cirrhosis and ascites: An unblinded randomized trial显示文摘瞄准:在幸存上调查长期的白朊管理的效果,腹水的复发和另外的复杂并发症的发作。方法:为第一发作的腹水招收的 100 个连续病人被使随机化加人的白朊收到利尿剂第一年和 25 g 里的 25 g/wk 每二 wk 此后(组 1 ) 或利尿剂独自一个(组 2 ) 。没有肝移植,主要端点是幸存。第二等的端点是腹水的复发和另外的复杂并发症的出现。结果:中部的后续是 84 (2-120 ) 瞬间。对待白朊的病人有显著地更大的累积幸存率(Breslow test=7.05, P=0.0078 ) 并且腹水复发的更低的概率(51% 对 94% , P<0.0001 ) 。长期的白朊注入导致了 16 瞬间的幸存的吝啬的增加。结论:在第一发作的腹水以后的长期的白朊管理显著地改进病人的幸存并且减少腹水复发的风险。 | Roberto Giulio Romanelli Giorgio La Villa Giuseppe Barletta Francesco Vizzutti Fabio Lanini Umberto Arena Vieri Boddi Roberto Tarquini Pietro Pantaleo Paolo Gentilini Giacomo Laffi | 2006 | World Journal of Gastroenterology2006，12，9： | 22 |
| 8 | Clinical features and management of primary biliary cirrhosis显示文摘Primary biliary cirrhosis(PBC),which is characterised by progressive destruction of intrahepatic bile ducts,is not a rare disease since both prevalence and incidence are increasing during the last years mainly due to the improvement of case finding strategies.The prognosis of the disease has improved due to both the recognition of earlier and indolent cases,and to the wide use of ursodeoxycholic acid(UDCA).New indicators of prog-nosis are available that will be useful especially for the growing number of patients with less severe disease.Most patients are asymptomatic at presentation.Pruri-tus may represent the most distressing symptom and,when UDCA is ineffective,cholestyramine represents the mainstay of treatment.Complications of long-standing cholestasis may be clinically relevant only in very ad-vanced stages.Available data on the effects of UDCA on clinically relevant end points clearly indicate that the drug is able to slow but not to halt the progression of the disease while,in advanced stages,the only thera-peutic option remains liver transplantation. | Andrea Crosignani Pier Maria Battezzati Pietro Invernizzi Carlo Selmi Elena Prina Mauro Podda | 2008 | World Journal of Gastroenterology2008，14，21： | 23 |
| 9 | Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease显示文摘AIM:To explore the association between hepatocellular carcinoma(HCC) and type 2 diabetes mellitus, describe the temporal relations between the onset of diabetes and the development of HCC and evaluate the possible effects of antidiabetic therapy on HCC risk.METHODS:We recruited 465 HCC patients, 618 with cirrhosis and 490 control subjects.We evaluated the odds ratio(OR) for HCC by univariate and multivariate analysis.Moreover, OR for HCC in diabetic subjects treated with insulin or sulphanylureas and with metformin were calculated.RESULTS:The prevalence of diabetes mellitus was 31.2% in HCC, 23.3% in cirrhotic patients and 12.7% in the Control group.By univariate and multivariate analysis, the OR for HCC in diabetic patients were respectively 3.12(CI 2.2-4.4, P < 0.001) and 2.2(CI 1.2-4.4, P = 0.01).In 84.9% of cases, type 2 diabetes mellitus was present before the diagnosis of HCC.Moreover, we report an OR for HCC of 2.99(CI 1.34-6.65, P = 0.007) in diabetic patients treated with insulin or sulphanylureas, and an OR of 0.33(CI 0.1-0.7, P = 0.006) in diabetic patients treated with metformin.CONCLUSION:Our study confi rms that type 2 diabetes mellitus is an independent risk factor for HCC and pre-exists in the majority of HCC patients.Moreover, in male patients with type 2 diabetes mellitus, our data shows a direct association of HCC with insulin and sulphanylureas treatment and an inverse relationship with metformin therapy. | Valter Donadon Massimiliano Balbi Michela Ghersetti Silvia Grazioli Antonio Perciaccante Giovanni Della Valentina Rita Gardenal Maria Dal Mas Pietro Casarin Giorgio Zanette Cesare Miranda | 2009 | World Journal of Gastroenterology2009，15，20： | 23 |
| 10 | Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery显示文摘AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer.METHODS: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision(TME) with curative intent between January 2008 and December 2014(robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage?Ⅰ-Ⅲ disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared.RESULTS: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME(L-TME) and 342 min for robotic TME(R-TME)(P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. Thepatients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients(8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group(18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients(1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between groups.CONCLUSION: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies. | Francesco Feroci Andrea Vannucchi Paolo Pietro Bianchi Stefano Cantafio Alessia Garzi Giampaolo Formisano Marco Scatizzi | 2016 | World Journal of Gastroenterology2016，22，13： | 22 |
| 11 | Non-invasive assessment of liver fibrosis in chronic hepatitis B显示文摘The goal of this review is to provide a comprehensive picture of the role,clinical applications and future perspectives of the most widely used non-invasive techniques for the evaluation of hepatitis B virus(HBV)infection.During the past decade many non-invasive methods have been developed to reduce the need for liver biopsy in staging fibrosis and to overcome whenever possible its limitations,mainly:invasiveness,costs,low reproducibility,poor acceptance by patients.Elastographic techniques conceived to assess liver stiffness,in particular transient elastography,and the most commonly used biological markers will be assessed against their respective role and limitations in staging hepatic fibrosis.Recent evidence highlights that both liver stiffness and some bio-chemical markers correlatewith survival and major clinical end-points such as liver decompensation,development of hepatocellular carcinoma and portal hypertension.Thus the non-invasive techniques here discussed can play a major role in the management of patients with chronic HBV-related hepatitis.Given their prognostic value,transient elastography and some bio-chemical markers can be used to better categorize patients with advanced fibrosis and cirrhosis and assign them to different classes of risk for clinically relevant outcomes.Very recent data indicates that the combined measurements of liver and spleen stiffness enable the reliable prediction of portal hypertension and esophageal varices development. | Federica Branchi Clara Benedetta Conti Alessandra Baccarin Pietro Lampertico Dario Conte Mirella Fraquelli | 2014 | World Journal of Gastroenterology2014，20，40： | 20 |
| 12 | Laparoscopic resection vs laparoscopic radiofrequency ablation for the treatment of small hepatocellular carcinomas: A single-center analysis显示文摘AIM To compare survival and recurrence after laparoscopic liver resection(LLR) and laparoscopic radiofrequency ablation(LRFA) for the treatment of small hepatocellular carcinoma(HCC).METHODS Between June 1, 2005 and November 30, 2010, 46 patients(62.26 ± 8.55 years old; female/male: 12/34) treated for small HCC were enrolled following strict criteria. Patients with better liver function and larger tumors were referred for LLR(n = 24), while those with poorer liver function and multiple tumors were referred for LRFA(n = 22), and they were then followed for similar durations(44.74 ± 21.3 mo for LLR vs 40.27 ± 30.8 mo for LRFA). RESULTS The LLR and LRFA groups were homogeneous with regard to age, sex, etiology of liver cirrhosis, and AFP levels. The overall survival(OS) and disease-free survival(DFS) probability was 0.354 and 0.260, respectively. A significantly higher OS was observed in the LLR group(LLR: 0.442; LRFA: 0.261; P = 0.048), whereas no statistical difference was found for DFS(LLR: 0.206; LRFA: 0.286; P = 0.205). In the LRFA group was treated a greater number of nodules(LLR: 1.41 ± 0.77; LRFA: 2.72 ± 1.54; P < 0.001). Cox regression analysis found the number of intraoperative HCC nodules as the unique variable statistically significant for OS(hazard ratio: 2.225; P < 0.001). The rank-hazard plot showed a steeper increase of relative hazard for intraoperative nodules > 2.CONCLUSION Our preliminary results confirm the superiority of hepatic resection on thermoablation in the treatment of small HCC in selected patients, when both approaches are made laparoscopically. LLR showed better results compared to LRFA in terms of OS. These data need to be confirmed by further studies on a larger number of patients. | Marco Casaccia Gregorio Santori Giuliano Bottino Pietro Diviacco Enzo Andorno | 2017 | World Journal of Gastroenterology2017，23，4： | 20 |
| 13 | Endoscopic ultrasound-guided treatments: Are we getting evidence based- a systematic review显示文摘The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancreatic fluid collections,EUS-guided necrosectomy,EUS-guided cholangiography and biliary drainage,EUSguided pancreatography and pancreatic duct drainage,EUS-guided gallbladder drainage,EUS-guided drainage of abdominal and pelvic fluid collections,EUS-guided celiac plexus block and celiac plexus neurolysis,EUSguided pancreatic cyst ablation,EUS-guided vascular interventions,EUS-guided delivery of antitumoral agents and EUS-guided fiducial placement and brachytherapy.However these procedures are technically challenging and require expertise in both EUS and interventional endoscopy,such as endoscopic retrograde cholangiopancreatography and gastrointestinal stenting.We undertook a systematic review to record the entire body of literature accumulated over the past 2decades on EUS-guided interventions with the objective of performing a critical appraisal of published articles,based on the classification of studies according to levels of evidence,in order to assess the scientific progress made in this field. | Carlo Fabbri Carmelo Luigiano Andrea Lisotti Vincenzo Cennamo Clara Virgilio Giancarlo Caletti Pietro Fusaroli | 2014 | World Journal of Gastroenterology2014，20，26： | 18 |
| 14 | Bone marrow derived stem cells for the treatment of end-stage liver disease显示文摘End-stage disease due to liver cirrhosis is an important cause of death worldwide. Cirrhosis results from progressive, extensive fibrosis and impaired hepatocyte regeneration. The only curative treatment is liver transplantation, but due to the several limitations of this procedure, the interest in alternative therapeutic strategies is increasing. In particular, the potential of bone marrow stem cell(BMSC) therapy in cirrhosis has been explored in different trials. In this article, we evaluate the results of 18 prospective clinical trials, and we provide a descriptive overview of recent advances in the research on hepatic regenerative medicine. The main message from the currently available data in the literature is that BMSC therapy is extremely promising in the context of liver cirrhosis. However, its application should be further explored in randomized, controlled trials with large cohorts and long follow-ups. | Cristina Margini Ranka Vukotic Lucia Brodosi Mauro Bernardi Pietro Andreone | 2014 | World Journal of Gastroenterology2014，20，27： | 18 |
| 15 | Pancreatico-biliary endoscopic ultrasound:A systematic review of the levels of evidence,performance and outcomes显示文摘Our aim was to record pancreaticobiliary endoscopic ultrasound(EUS) literature of the past 3 decades and evaluate its role based on a critical appraisal of published studies according to levels of evidence(LE).Original research articles(randomized controlled trials,prospective and retrospective studies),meta-analyses,reviews and surveys pertinent to gastrointestinal EUS were included.All articles published until September 2011 were retrieved from PubMed and classified according to specific disease entities,anatomical subdivisions and therapeutic applications of EUS.The North of England evidencebased guidelines were used to determine LE.A total of 1089 pertinent articles were reviewed.Published research focused primarily on solid pancreatic neoplasms,followed by disorders of the extrahepatic biliary tree,pancreatic cystic lesions,therapeutic-interventional EUS,chronic and acute pancreatitis.A uniform observation in all six categories of articles was the predominance of LE Ⅲ studies followed by LE Ⅳ,Ⅱb,Ⅱa,Ⅰb and Ⅰ a,in descending order.EUS remains the most accurate method for detecting small(< 3 cm) pancreatic tumors,ampullary neoplasms and small(< 4 mm) bile duct stones,and the best test to define vascular invasion in pancreatic and peri-ampullary neoplasms.Detailed EUS imaging,along with biochemical and molecular cyst fluid analysis,improve the differentiation of pancreatic cysts and help predict their malignant potential.Early diagnosis of chronic pancreatitis appears feasible and reliable.Novel imaging techniques(contrast-enhanced EUS,elastography) seem promising for the evaluation of pancreatic cancer and autoimmune pancreatitis.Therapeutic applications currently involve pancreaticobiliary drainage and targeted fine needle injection-guided antitumor therapy.Despite the ongoing development of extra-corporeal imaging modalities,such as computed tomography,magnetic resonance imaging,and positron emission tomography,EUS still holds a leading role in the investigation of the pancreaticobiliary area.The major challenge of EUS evolution is its expanding therapeutic potential towards an effective and minimally invasive management of complex pancreaticobiliary disorders. | Pietro Fusaroli Dimitrios Kypraios Giancarlo Caletti Mohamad A Eloubeidi | 2012 | World Journal of Gastroenterology2012，18，32： | 17 |
| 16 | Infectious burden and atherosclerosis: A clinical issue显示文摘Atherosclerotic cardiovascular diseases, chronic inflam-matory diseases of multifactorial etiology, are the lead-ing cause of death worldwide. In the last decade, more infectious agents, labeled as 'infectious burden', rather than any single pathogen, have been showed to con-tribute to the development of atherosclerosis through different mechanisms. Some microorganisms, such as Chlamydia pneumoniae(C. pneumoniae), human cytomegalovirus, etc. may act directly on the arterial wall contributing to endothelial dysfunction, foam cell formation, smooth muscle cell proliferation, platelet ag-gregation as well as cytokine, reactive oxygen specie, growth factor, and cellular adhesion molecule produc-tion. Others, such as Helicobacter pylori(H. pylori), in-fluenza virus, etc. may induce a systemic inflammation which in turn may damage the vascular wall(e.g., by cytokines and proteases). Moreover, another indirect mechanism by which some infectious agents(such as H. pylori, C. pneumoniae, periodontal pathogens, etc.) may play a role in the pathogenesis of atherosclero-sis is molecular mimicry. Given the complexity of the mechanisms by which each microorganism may con-tribute to atherosclerosis, defining the interplay of moreinfectious agents is far more difficult because the pro-atherogenic effect of each pathogen might be ampli-fied. Clearly, continued research and a greater aware-ness will be helpful to improve our knowledge on the complex interaction between the infectious burden and atherosclerosis. | Rosa Sessa Marisa Di Pietro Simone Filardo Ombretta Turriziani | 2014 | World Journal of Clinical Cases2014，2，7： | 17 |
| 17 | 一种面向边缘计算的高效异步联邦学习机制显示文摘随着物联网和移动设备性能的不断提高,一种新型计算架构——边缘计算——应运而生.边缘计算的出现改变了数据需要集中上传到云端进行处理的局面,最大化利用边缘物联网设备的计算和存储能力.边缘计算节点对本地数据进行处理,不再需要把大量的本地数据上传到云端进行处理,减少了数据传输的延时.在边缘网络设备上进行人工智能运算的需求也在逐日增大,因为联邦学习机制不需要把数据集中后进行模型训练,所以更适合于节点平均数据量有限的边缘网络机器学习的场景.针对以上挑战,提出了一种面向边缘网络计算的高效异步联邦学习机制(efficient asynchronous federated learning mechanism for edge network computing,EAFLM),根据自适应的阈值对训练过程中节点与参数服务器之间的冗余通信进行压缩.其中,双重权重修正的梯度更新算法,允许节点在学习的任何过程中加入或退出联邦学习.实验显示提出的方法将梯度通信压缩至原通信次数的8.77%时,准确率仅降低0.03%. | 芦效峰 廖钰盈 Pietro Lio Pan Hui | 2020 | 计算机研究与发展2020，57，12： | 16 |
| 18 | Hepatocellular carcinoma treated with transarterial chemoembolization: Dynamic perfusion-CT in the assessment of residual tumor显示文摘AIM: To asses the value of computed tomography (CT)-perfusion in the detection of residual hepatocellular carcinoma (HCC) vascularization after transarterial chemoembolization (TACE). METHODS: Thirty-two consecutive patients were pro-spectively included in this study. All patients had liver cirrhosis and a conf irmed HCC lesion which was treated with TACE. One month after treatment, perfusion measurements of treated lesions were carried out. The CTperfusion (CT-p) protocol was performed with 16 slice multidetector computed tomography which included the following parameters: 8 dynamic slices/scan per 40 scans after iv injection of 50 mL of iodinated contrast (350 mg/mL) at a flow rate of 6 mL/s. Treated lesions were evaluated using dedicated perfusion software, which generated a quantitative colour map of perfusion. The following parameters were considered: hepatic perfusion (HP), arterial perfusion (AP), blood volume (BV), hepatic perfusion index (HPI), and time to peak (TTP). Perfusion parameters were described with quartile values of their distribution and statistically analyzed. RESULTS: Perfusion parameters of the treated lesions could be quantitatively assessed using CT-p analysis. The presence of residual tumor tissue was observed in 13 of the 32 patients. The values of the perfusion parameters measured within the relapse tissue were: HP (mL/100 g per minute): median = 44.4 (1stqt = 31.3, 3rdqt = 55.8); BV (mL/100 g): median = 18.7 (1stqt = 11.5, 3rdqt = 22.5); AP (mL/min): median = 39.0 (1stqt = 36.5, 3rdqt = 61.3); HPI (%): median = 34.0 (1stqt = 30.4, 3rdqt = 38.9); TTP (s): median = 17.3 (1stqt = 15.8, 3rdqt = 26.5). With the use of the univariate paired Wilcoxon signed rank test, HP, AP and HPI were shown to be significantly higher (P<0.001) in the relapse site than in the primary lesion. The BV and TTP parameters showed a tendency to be greater and lower, respectively, in the relapse site than in the primary lesion. CONCLUSION: In patients with HCC treated with TACE, CT-p provides measurement of flow parameters related to residual arterial structures in viable tumor, thus helping in the assessment of therapeutic response. | Davide Ippolito Pietro Andrea Bonaff ini Laura Ratti Laura Antolini Rocco Corso Ferruccio Fazio Sandro Sironi | 2010 | World Journal of Gastroenterology2010，16，47： | 15 |
| 19 | Antidiabetic thiazolidinediones induce ductal differentiation but not apoptosis in pancreatic cancer cells显示文摘AIM: Thiazolidinediones (TZD) are a new class of oral antidiabetic drugs that have been shown to inhibit growth of same epithelial cancer cells. Although TZD were found to be ligands for peroxisome proliferator-activated receptor γ (PPARγ), the mechanism by which TZD exert their anticancer effect is presently unclear. In this study,we analyzed the mechanism by which TZD inhibit growth of human pancreatic carcinoma cell lines in order to evaluate the potential therapeutic use of these drugs in pancreatic adenocarcinoma.METHODS: The effects of TZD in pancreatic cancer cells were assessed in anchorage-independent growth assay.Expression of PPARγ was measured by reverse-transcription polymerase chain reaction and confirmed by Western blot analysis. PPARγ activity was evaluated by transient reporter gene assay. Flow cytometry and DNA fragmentationassay were used to determine the effect of TZD on cell cycle progression and apoptosis respectively. The effect of TZD on ductal differentiation markers was performed by Western blot.RESULTS: Exposure to TZD inhibited colony formation in a PPARγ-dependent manner. Growth inhibition was linked to G1 phase cell cycle arrest through induction of the ductal differentiation program without any increase of the apoptotic rate.CONCLUSION: TZD treatment in pancreatic cancer cells has potent inhibitory effects on growth by a PPAR-dependent induction of pacreatic ductal differentiation. | Elisabetta Ceni Tommaso Mello Mirko Tarocchi David W Crabb Anna Caldini Pietro Invernizzi Calogero Surrenti Stefano Milani Andrea Galli | 2005 | World Journal of Gastroenterology2005，11，8： | 15 |
| 20 | 人为因素导致的地面沉降(英文)显示文摘天然气、石油、地下水、地热热水和卤水等流体运移出地下储存地层时,地层耗尽了流体而产生压缩变形,这些变形传递到地表表面就形成了人为的地面沉降。在本文中:(1)列举了世界上主要的地面沉降区域;(2)论述了引发地面沉降的力学机制,这些可以量测的地面沉降发生在地下含水层体系、天然气气田和石油油田之上;(3)描述了目前可以用于地面沉降测量和岩石变形原位测试的技术手段;(4)简要介绍了几个地面沉降预测的数值模型;(5)说明了用于控制地面沉降发展和减轻相关环境影响的几种防治措施。 | Giuseppe GAMBOLATI Pietro TEATINI Massimiliano FERRONATO | 2006 | 地学前缘2006，13，1： | 14 |
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