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| 1 | 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 |
| 2 | The Plant Vascular System: Evolution, Development and Functions显示文摘The emergence of the tracheophyte-based vascular system of land plantshad major impacts on the evolution of terrestrial biology, in general,through its role in facilitating the development of plants with increasedstature, photosynthetic output, and ability to colonize a greatly expandedrange of environmental habitats. Recently, considerable progress hasbeen made in terms of our understanding of the developmental andphysiological programs involved in the formation and function of theplant vascular system. In this review, we first examine the evolutionaryevents that gave rise to the tracheophytes, followed by analysis of thegenetic and hormonal networks that cooperate to orchestrate vasculardevelopment in the gymnosperms and angiosperms. The two essentialfunctions performed by the vascular system, namely the delivery of resources (water, essential mineralnutrients, sugars and amino acids) to the various plant organs and provision of mechanical support arenext discussed. Here, we focus on critical questions relating to structural and physiological propertiescontrolling the delivery of material through the xylem and phloem. Recent discoveries into the role ofthe vascular system as an effective long-distance communication system are next assessed in termsof the coordination of developmental, physiological and defense-related processes, at the whole-plantlevel. A concerted effort has been made to integrate all these new findings into a comprehensive pictureof the state-of-the-art in the area of plant vascular biology. Finally, areas important for future researchare highlighted in terms of their likely contribution both to basic knowledge and applications to primaryindustry. | William J. Lucas Andrew Groover Raffael Lichtenberger Kaori Furuta Shri-Ram Yadav Yk Helariutta Xin-Qiang He Hiroo Fukuda Julie Kang Siobhan M. Brady John W. Patrick John Sperry Akiko Yoshida Ana-Flor López-Millan Michael A. Grusak Pradeep Kachroo | 2013 | Journal of Integrative Plant Biology2013，55，4： | 30 |
| 3 | Transarterial chemoembolization:Evidences from the literature and applications in hepatocellular carcinoma patients显示文摘Transarterial chemoembolization(TACE) is the current standard of care for patients with large or multinodular hepatocellular carcinoma(HCC), preserved liver function, absence of cancer-related symptoms and no evidence of vascular invasion or extrahepatic spread(i.e., those classified as intermediate stage according to the Barcelona Clinic Liver Cancer staging system). The rationale for TACE is that the intra-arterial injection of a chemotherapeutic drug such as doxorubicin or cisplatin followed by embolization of the blood vessel will result in a strong cytotoxic effect enhanced by ischemia. However, TACE is a very heterogeneous operative technique and varies in terms of chemotherapeutic agents, treatment devices and schedule. In order to overcome the major drawbacks of conventional TACE(c TACE), non-resorbable drug-eluting beads(DEBs) loaded with cytotoxic drugs have been developed. DEBs are able to slowly release the drug upon injection and increase the intensity and duration of ischemia while enhancing the drug delivery to the tumor. Unfortunately, despite the theoretical advantages of this new device and the promising results of the pivotal studies, definitive data in favor of its superiority over c TACE are still lacking. The recommendation for TACE as the standard-of-care for intermediate-stage HCC is based on the demonstration of improved survival compared with best supportive care or suboptimal therapies in a meta-analysis of six randomized controlled trials, but other therapeutic options(namely, surgery and radioembolization) proved competitive in selected subsets of intermediate HCC patients. Other potential fields of application of TACE in hepato-oncology are the pre-transplant setting(as downstaging/bridging treatment) and the early stage(in patients unsuitable to curative therapy). The potential of TACE in selectedadvanced patients with segmental portal vein thrombosis and preserved liver function deserves further reports. | Antonio Facciorusso Raffaele Licinio Nicola Muscatiello Alfredo Di Leo Michele Barone | 2015 | World Journal of Hepatology2015，7，16： | 25 |
| 4 | MicroRNAs as possible biomarkers for diagnosis and prognosis of hepatitis b- and c-related-hepatocellularcarcinoma显示文摘Aim of the present review is to summarize the current knowledge about the potential relationship between mi RNAs and hepatitis B virus(HBV)-hepatitis C virus(HCV) related liver diseases. A systematic computerbased search of published articles, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis Statement, was performed to identify relevant studies on usefulness of serum/plasma/urine mi RNAs, as noninvasive biomarkers for early detection of HBV and HCV-induced hepatocellular carcinoma(HCC) development, as well as for its prognostic evaluation. The used Medical Subject Headings terms and keywords were: 'HBV', 'HCV', 'hepatocellular carcinoma', 'micro RNAs', 'mi RNAs', 'diagnosis', 'prognosis', 'therapy', 'treatment'. Some serum/plasma mi RNAs, including mi R-21, mi R-122, mi-125a/b, mi R-199a/b, mi R-221, mi R-222, mi R-223, mi R-224 might serve as biomarkers for early diagnosis/prognosis of HCC, but, to date, not definitive results or well-defined panels of mi RNAs have been obtained. More well-designed studies, focusing on populations of different geographical areas and involving larger series of patients, should be carried out to improve our knowledge on the potential role of mi RNAs for HCC early detection and prognosis. | Sirio Fiorino Maria Letizia Bacchi-Reggiani Michela Visani Giorgia Acquaviva Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Luca Di Tommaso Arrigo Bondi Sergio Sabbatani Andrea Domanico Carlo Fabbri Paolo Leandri Annalisa Pession Elio Jovine Dario de Biase | 2016 | World Journal of Gastroenterology2016，22，15： | 25 |
| 5 | Evidence that chronic hypoxia causes reversible impairment on male fertility显示文摘瞄准:在人的精子发生的参数和他们的复原时间上评估长期的组织缺氧的效果。方法:六男健康的山缓慢艰辛地旅行 ers 的 Seminological 参数在海水平在 normoxia 被评估。在到高度的 26 天暴露以后(从 2 000 m 到 5 600 m,古代蒙古帝国旧都遗迹远征) 一样的参数再在回到海水平以后被评估。这些参数再次在 6 个月以后在 1 个月以后然后再被评估。结果:精子计数被发现在回到海水平以后立即更低(P = 0.0004 ) 并且再在一个月以后(P = 0.0008 ) 。正常层次在 6 个月以后被到达。精子的活动性(%) 不在回到海水平以后立即显示出减小(P = 0.0583 ) ,而在 1 个月以后这减小是重要的(P = 0.0066 ) 。在 6 个月以后,到 pre-hypoxic 暴露值有恢复。在回到海以后立即增加的反常或不成熟的精子(%) 铺平(P = 0.0067 ) 然后再在 1 个月以后(P = 0.0004 ) 。在 6 个月以后,到起始的值有完全的恢复。在精液的能动精子的全部的数字被发现在回到海水平以后立即更低(P = 0.0024 ) 然后再在 1 个月以后(P = 0.0021 ) 。在 6 个月以后,到 pre-hypoxic 暴露值有恢复。结论:在 6 个月在精子发生和男富饶的生理的机制显示氧供应的影响以后,长期的组织缺氧在以前的 normoxic 条件的恢复导致精子减少的一个状态和如此的 seminological 参数的正规化。 | Vittore Verratti Francesco Berardinelli Camillo Di Giulio Gerardo Bosco Marisa Cacchio Mario Pellicciotta Michele Nicolai Stefano Martinotti Raffaele Tenaglia | 2008 | Asian Journal of Andrology2008，10，4： | 21 |
| 6 | Serum uric acid as a prognostic marker in the setting of advanced vascular disease: a prospective study in the elderly显示文摘BackgroundMany 流行病学的研究分析在 hyperuricemia 和心血管的结果之间的关系。这观察未来的研究调查有在一张老人口的不利心血管的事件和死亡的尿酸(SUA ) 层次由百和 76 个老病人由先进动脉粥样硬化影响了的先进 atherosclerosis.MethodsTwo 影响了的浆液的协会(217 男性和 59 女性;71.2 ±7.8 年) 被包括。所有病人为心血管的疾病,癌症,肥胖和传统的风险因素的历史被估计。病人们为约 31 ± 被跟随;11 个月。主要事件在后续,定义同样心肌的梗塞,服的局部缺血,心肌或外部的 revascularization 和 death.ResultsMean SUA 期间被记录水平是 5.47 ±1.43 mg/dL;然后,我们进一步在二个组划分了人口,根据中部的价值(5.36 mg/dL ) 。在期间一中部列在后面在上面 31,月(5 ~ 49 个月) , 66 个心血管的事件, 9 个致命的心血管的事件和 14 癌症相关的死亡发生了。有增加的 SUA 水平的病人介绍了全部的心血管的事件的更高重要的发生(HR:1.867, P = 0.014, 95% CI:1.134-3.074 ) 。一样的病人显示出癌症相关的死亡的重要增加的风险(HR:4.335, P = 0.025, 95% CI:1.204-15.606 ).ConclusionsIncreased SUA 层次独立地并且显著地与心血管的事件的风险被联系,癌症在外部 vasculopathy 影响的主要老的病人的一张人口联系了死亡。 | Giuseppe Di Stolfo Sandra Mastroianno Domenico Rosario Potenza Giovanni De Luca Carmela d'Arienzo Michele Antonio Pacilli Mario Fanelli Aldo Russo Raffaele Fanelli | 2015 | Journal of Geriatric Cardiology2015，12，5： | 20 |
| 7 | Obesity and colorectal cancer:Role of adipokines in tumor initiation and progression显示文摘Obesity-associated diseases account for a large portion of public health challenges.Among obesity-related disorders,a direct and independent relationship has been ascertained for colorectal cancer(CRC).The evidence that adipocyte hypertrophy and excessive adipose tissue accumulation(mainly visceral)can promote pathogenic adipocyte and adipose tissue-related diseases,has led to formulate the concept of'adiposopathy',defined as adipocyte and adipose tissue dysfunction that contributes to metabolic syndrome.Adipose tissue can,indeed,be regarded as an important and highly active player of the innate immune response,in which cytokine/adipokine secretion is responsible for a paracrine loop between adipocytes and macrophages,thus contributing to the systemic chronic low-grade inflammation associated with visceral obesity,which represents a favorable niche for tumor development.The adipocyte itself participates as a central mediator of this inflammatory response in obese individuals by secreting hormones,growth factors and proinflammatory cytokines,which are of particular relevance for the pathogenesis of CRC.Among adipocyte-secreted hormones,the most relevant to colorectal tumorigenesis are adiponectin,leptin,resistin and ghrelin.All these molecules have been involved in cell growth and proliferation,as well as tumor angiogenesis and it has been demonstrated that their expression changes from normal colonic mucosa to adenoma and adenocarcinoma,suggesting their involvement in multistep colorectal carcinogenesis.These findings have led to the hypothesis that an unfavorable adipokine profile,with a reduction of those with an anti-inflammatory and anti-cancerous activity,might serve as a prognostic factor in CRC patients and that adipokines or their analogues/antagonists might become useful agents in the management or chemoprevention of CRC. | Silvia Riondino Mario Roselli Raffaele Palmirotta David Della-Morte Patrizia Ferroni Fiorella Guadagni | 2014 | World Journal of Gastroenterology2014，20，18： | 20 |
| 8 | Modulation of microbiota as treatment for intestinal inflammatory disorders: An uptodate显示文摘Alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. There is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation(FMT). To summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, Pub Med was searched using terms microbiota, intestinal flora, probiotics, prebiotics, fecal transplantation. More than three hundred articles published up to 2015 were selected and reviewed. Randomized placebo-controlled trials and meta-analysis were firstly included, mainly for probiotics. A meta-analysis was not performed because of the heterogeneity of these studies. Most of relevant data derived from studies on probiotics, reporting some efficacy in ulcerative colitis and in pouchitis, while disappointing results are available for Crohn's disease. Probiotic supplementation may significantly reduce rates of rotavirus diarrhea. Efficacy of probiotics in NSAID enteropathy and irritable bowel syndrome is still controversial. Finally, FMT has been recently recognized as an efficacious treatment for recurrent Clostridium difficile infection. Modulation of intestinal flora represents a very interesting therapeutic target, although it still deserves some doubts and limitations. Future studies should be encouraged to provide new understanding about its therapeutical role. | Antonella Gallo Giovanna Passaro Antonio Gasbarrini Raffaele Landolfi Massimo Montalto | 2016 | World Journal of Gastroenterology2016，22，32： | 19 |
| 9 | Silymarin in non alcoholic fatty liver disease显示文摘AIM: This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD). METHODS: In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time. These evaluations were repeated after 6 mo of treatment. RESULTS: Serum levels of some metabolic and anti-inflammatory data nonsignificantly lowered after 6 mo of silymarin. On the contrary, Steato test, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase were significantly (P < 0.001) reduced. Instead, the AST/ALT ratio unchanged. Finally, the hepatorenal brightness ratio, as an index of hepatic steatosis, significantly (P < 0.05) dropped. CONCLUSION: The obtained results indicate that silymarin appears to be effective to reduce the biochemical, inflammatory and ultrasonic indices of hepatic steatosis. Some parameters indicative of early stage of atherosclerosis were also lowered. | Fulvio Cacciapuoti Anna Scognamiglio Rossella Palumbo Raffaele Forte Federico Cacciapuoti | 2013 | World Journal of Hepatology2013，5，3： | 17 |
| 10 | 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 |
| 11 | ERCP in acute pancreatitis:What takes place in routine clinical practice?显示文摘AIM:To evaluate the data from a survey carried out in Italy regarding the endoscopic approach to acute pancreatitis in order to obtain a picture of what takes place after the release of an educational project on acute pancreatitis sponsored by the Italian Association for the Study of the Pancreas.METHODS:Of the 1 173 patients enrolled in our survey,the most frequent etiological category was biliary forms(69.3%) and most patients had mild pancreatitis(85.8%).RESULTS:344/1 173(29.3%) underwent endoscopic retrograde cholangiopancreatography(ERCP).The mean interval between the onset of symptoms and ERCP was 6.7 ± 5.0 d;only 89 examinations(25.9%) were performed within 72 h from the onset of symptoms.The main indications for ERCP were suspicion of common bile duct stones(90.3%),jaundice(44.5%),clini cal worsening of acute pancreatitis(14.2%) and cho langitis(6.1%).Biliary and pancreatic ducts were visua lized in 305 patients(88.7%) and in 93 patients(27.0%) respectively.The success rate in obtaining a cholangio gram was statistically higher(P = 0.003) in patients with mild acute pancreatitis(90.6%) than in patients with severe disease(72.2%).Biliary endoscopic sphinc terotomy was performed in 295 of the 305 patients(96.7%) with no difference between mild and severe disease(P = 0.985).ERCP morbidity was 6.1% and mortality was 1.7%;the mortality was due to the complications of acute pancreatitis and not the endoscopic procedure.CONCLUSION:The results of this survey,as with those carried out in other countries,indicate a lack of compliance with the guidelines for the indications for interventional endoscopy. | Armando Gabbrielli Raffaele Pezzilli Generoso Uomo Alessandro Zerbi Luca Frulloni Paolo De Rai Laura Castoldi Guido Costamagna Claudio Bassi Valerio Di Carlo | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，9： | 14 |
| 12 | Spinal cord involvement in patients with cirrhosis显示文摘A severe spinal cord involvement may rarely occur in patients with cirrhosis and other chronic liver diseases;this complication is usually associated with overt liver failure and surgical or spontaneous porto-systemic shunt.Hepatic myelopathy(HM)is characterized by progressive weakness and spasticity of the lower extremities,while sensory and sphincter disturbances have rarely been described and are usually less important.The diagnosis is assigned in the appropriate clinical setting on clinical grounds after the exclusion of other clinical entities leading to spastic paraparesis.Magnetic resonance imaging is often unremarkable;however,also intracerebral corticospinal tract abnor-malities have been reported recently.The study of motor evoked potentials may disclose central conduction abnormalities even before HM is clinically manifest.HM responds poorly to blood ammonia-lowering and other conservative medical therapy.Liver transplantation represents a potentially definitive treatment for HM in patients with decompensated cirrhosis of Child-Pugh B and C grades.Other surgical treatment options in HM include surgical ligation,shunt reduction,or occlusion by interventional procedures. | Raffaele Nardone Yvonne Hller Monica Storti Piergiorgio Lochner Frediano Tezzon Stefan Golaszewski Francesco Brigo Eugen Trinka | 2014 | World Journal of Gastroenterology2014，20，10： | 12 |
| 13 | Fat:A matter of disturbance for the immune system显示文摘Obesity is increasingly being recognized as a risk factor for a number of benign and malignant gastrointestinal conditions. However, literature on the underlying pathophysiological mechanisms is sparse and ambiguous. There is compelling evidence that both overnutrition and undernutrition negatively interfere with the immune system. Overnutrition has been found to increase susceptibility to the development of inflammatory diseases, autoimmune diseases and cancer. In the regulation of immune and in? ammatory processes, white adipose tissue plays a critical role, not only as an energy store but also as an important endocrine organ. The obese state is characterised by a low-grade systemic in? ammation, mainly as a result of increased adipocytes as well as fat resident-and recruited-macrophage activity. In the past few years, various products of adipose tissue including adipokines and cytokines have been characterised and a number of pathways linking adipose tissue metabolism with the immune system have been identified. Activation of the innate immune system plays a major role in hepatic steatosis. Non-alcoholic fatty liver disease includes a wide spectrum of diseases, from pure steatosis to non-alcoholic steato-hepatitis in the absence of signif icant alcohol consumption. Although steatosis is considered a non-progressive disease, non-alcoholic steatohepatitis may deteriorate in advanced chronic liver diseases, cirrhosis, and hepatocellular carcinoma. An important parallel between obesityrelated pathology of adipose tissue and liver pertains to the emerging role of macrophages, and growing evidence suggests that Kupffer cells critically contribute to progression of non-alcoholic fatty liver disease. Moreover, a close link between specif ic immune activation and atherosclerosis has been well established, suggesting that fat can directly trigger immune responses. This review discusses the role of fat as 'a matter of disturbance for the immune system' with a focus on hepatic steatosis. | Alessandro Federico Elena D’Aiuto Francesco Borriello Giusi Barra Antonietta Gerarda Gravina Marco Romano Raffaele De Palma | 2010 | World Journal of Gastroenterology2010，16，38： | 12 |
| 14 | Management and treatment of lactose malabsorption显示文摘乳糖吸收不良是肠的乳糖酶缺乏描绘的一个很普通的条件。主要乳糖吸收不良是在世界的人口的多数在场的继承赤字,当第二等的 hypolactasia 能是肠的疾病的后果时。在结肠的腔的 malabsorbed 乳糖的存在引起胃肠的症状。条件作为乳糖不耐被知道。在有乳糖酶的病人非坚持,如果不耐症状是在场的,治疗应该只被考虑。当指南不在时,普通治疗学的途径趋于从食谱排除牛奶和奶店产品。然而,这策略可以有严肃的营养的劣势。几研究被执行了发现其他的途径,例如为他们的细菌的乳糖酶活动的外长的贝它牛乳糖,酸乳酪和职业人员生命学,药理学、非药理学能延长的策略联系在推迟胃肠的运输时间,和长期的乳糖摄取提高结肠的改编的酶和底层之间的时间。在这评论,这些途径的实用性被讨论,有一份流动图表的一个治疗学的管理被建议。 | Massimo Montalto Valentina Curigliano Luca Santoro Monica Vastola Giovanni Cammarota Raffaele Manna Antonio Gasbarrini Giovanni Gasbarrini | 2006 | World Journal of Gastroenterology2006，12，2： | 12 |
| 15 | Intra-hepatic and extra-hepatic cholangiocarcinoma:New insight into epidemiology and risk factors显示文摘Cholangiocarcinoma(CCA) is a malignant tumour that arises from biliary epithelium at any portion of the biliary tree.CCA is currently classified as intra-hepatic or extra-hepatic CCA(EH-CCA).Recent evidences suggest that intra-hepatic CCA(IH-CCA) and EH-CCA are biologically different cancers,giving further support to a number of recent epidemiological studies showing large differences in terms of incidence,mortality and risk factors.The purpose of this manuscript is to review recent literature dealing with the descriptive epidemiology and risk factors of CCA with a special effort to compare IH-with EH-CCA. | Vincenzo Cardinale Rossella Semeraro Alessia Torrice Manuela Gatto Cristina Napoli Maria Consiglia Bragazzi Raffaele Gentile Domenico Alvaro | 2010 | World Journal of Gastrointestinal Oncology2010，2，11： | 12 |
| 16 | Is the pancreas affected in patients with septic shock?——a prospective study显示文摘BACKGROUND:Hyperamylasemia can be observed anecdotally during the course of severe sepsis or septic shock.This study aimed to investigate the possibility of pancreatic involvement in patients with septic shock using serum pancreatic enzyme determinations and imaging techniques in 21 consecutive patients with septic shock and 21 healthy subjects as controls. METHODS:The serum activity of pancreatic amylase and lipase was assayed initially in all subjects and 24 and 48 hours after the initial observation in the 21 patients with septic shock All patients also underwent radiological examination to detect pancreatic abnormalities. RESULTS:The serum activity of pancreatic amylase was significantly higher in the 21 patients with septic shock than in the 21 control subjects during the study period while the serum activity of lipase was similar to that of the control subjects.Amylase and lipase serum activity did not significantly changed throughout the study period in the 21 patients with septic shock.None of the patients with pancreatic hyperenzymemia had clinical signs or morphological alterations compatible with acute pancreatitis CONCLUSION:The presence of pancreatic hyperenzymemia in septic shock patients is not a biochemical manifestation of acute pancreatic damage,and the management of these patients should be dependent on the clinical situation and not merely the biochemical results. | Raffaele Pezzilli Alessandra Barassi Andrea Imbrogno Dario Fabbri Antonina Pigna Antonio M.Morselli-Labate Roberto Corinaldesi Gianvico Melzi d'Eril | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，2： | 11 |
| 17 | Transcranial Doppler ultrasonography: From methodology to major clinical applications显示文摘Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called 'paradoxical embolism', most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called 'microembolic signal grading score'. In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage(caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve. | Antonello D'Andrea Marianna Conte Massimo Cavallaro Raffaella Scarafile Lucia Riegler Rosangela Cocchia Enrica Pezzullo Andreina Carbone Francesco Natale Giuseppe Santoro Pio Caso Maria Giovanna Russo Eduardo Bossone Raffaele Calabrò | 2016 | World Journal of Cardiology2016，8，7： | 10 |
| 18 | Etiology of chronic pancreatitis:Has it changed in the last decade?显示文摘The evidence from recent surveys on chronic pancreatitis carried out around the world shows that alcohol remains the main factor associated with chronic pancreatitis, even if at a frequency lower than that reported previously. It has further conf irmed that heavy alcohol consumption and smoking are independent risk factors for chronic pancreatitis. Autoimmune pancreatitis accounts for 2%-4% of all forms of chronic pancreatitis, but this frequency will probably increase over the next few years. The rise in idiopathic chronic pancreatitis, especially in India, represents a black hole in recently published surveys. Despite the progress made so far regarding the possibility of establishing the hereditary forms of chronic pancreatitis and the recognition of autoimmune pancreatitis, it is possible that we are more inaccurate today than in the past in identifying the factors associated with chronic pancreatitis in our patients. | Raffaele Pezzilli | 2009 | World Journal of Gastroenterology2009，15，38： | 10 |
| 19 | Endoscopic sphincterotomy in acute biliary pancreatitis:A question of anesthesiological risk显示文摘Two consecutive surveys of acute pancreatitis in Italy,based on more than 1000 patients with acute pancreatitis,reported that the etiology of the disease indicates biliary origin in about 60% of the cases.The United Kingdom guidelines report that severe gallstone pancreatitis in the presence of increasingly deranged liver function tests and signs of cholangitis(fever,rigors,and positive blood cultures) requires an immediate and therapeutic endoscopic retrograde cholangiopancreatography(ERCP).These guidelines also recommend that patients with gallstone pancreatitis should undergo prompt cholecystectomy,possibly during the same hospitalization.However,a certain percentage of patients are unfit for cholecystectomy because advanced age and presence of comorbidity.We evaluated the early and longterm results of endoscopic intervention in relation to the anesthesiological risk for 87 patients with acute biliary pancreatitis.All patients underwent ERCP and were evaluated according to the American Society of Anesthesiology(ASA) criteria immediately before the operative procedure.The severity of acute pancreatitis was positively related to the anesthesiological grade.There was no significant relationship between the frequency of biliopancreatic complications during the follow-up and the ASA grade.The frequency of cholecystectomy was inversely related to the ASA grade and multivariate analysis showed that the ASA grade and age were significantly related to survival.Finally,endoscopic treatment also appeared to be safe and effective in patients at high anesthesiological risk with acute pancreatitis.These results further support the hypothesis that endoscopic sphincterotomy might be considered a definitive treatment for patients with acute biliary pancreatitis and an elevated ASA grade. | Raffaele Pezzilli | 2009 | World Journal of Gastrointestinal Endoscopy2009，1，1： | 9 |
| 20 | Pancreatic steatosis: Is it related to either obesity or diabetes mellitus?显示文摘The accumulation of fat in the pancreatic gland has been referred to using various synonyms,such as pancreatic lipomatosis,fatty replacement,fatty infiltration,fatty pancreas,lipomatous pseudohypertrophy,non-alcoholic fatty pancreatic disease and pancreatic steatosis We believe that pancreatic steatosis is the best description of fat accumulation in the pancreatic gland without fat replacement,and this term also describes the possibility that the fat accumulation is a reversible process.A review of the existing literature was carried out,and it was found that there was notable evidence from both the pathological and the imaging point of view that pancreatic steatosis is an increasing problem due to the increasing incidence of obesity.The conclusion was that pancreatic steatosis was easily detectable using modern imaging techniques,such as ultrasonography,endoscopic ultrasonography,computed tomography and magnetic resonance imaging.Pancreatic steatosis was not due to the presence of diabetes mellitus but was highly associated with the metabolic syndrome.The possible presence of steatopancreatitis should be better evaluated,especially regarding the inflammatory cascade,and additional studies are needed which are capable of assessing whether non-alcoholic steatopancreatitis really exists as does non-alcoholic steatohepatitis.Finally,the presence of exocrine pancreatic function should be extensively evaluated in patients with pancreatic steatosis. | Raffaele Pezzilli Lucia Calculli | 2014 | World Journal of Diabetes2014，5，4： | 8 |
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