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| 1 | Small bowel capsule endoscopy in 2007:Indications,risks and limitations显示文摘囊内视镜检查法有 revoluzionized 由提供一个可靠方法评估的小肠的学习,内视镜的联盟者,全部小肠。在最后六年里,几份报纸被出版了处于不同临床的条件探索这考试的可能的角色。在现在的时间囊,内视镜检查法通常被推荐为第三考试,在否定双向内视镜检查法以后,在有阴暗胃肠的流血的病人。证据的成长身体也处于象 Crohn 的疾病,乳糜泻,小肠息肉病症候群或小肠肿瘤那样的另外的临床的条件为这考试建议一个重要角色。这考试的主要复杂并发症是在以前未知的小肠苛评的地点的设备的保留。然而,也由于这个工具的技术限制主要有一些另外的开的问题(它没从遥控被驾驶,是不能的拿活体检视到 insufflate 空气,正确地缩放并且定位损害到 suck 液体或碎片并且到有时) 。最近发达的双汽球肠脓毒病,尽管侵略、耗时,由于它的能力指向了活体检视探索小肠的大部分并且拿,能克服囊内视镜检查法的一些限制。在现在预定,在临床的条件的多数(即阴暗官方补给的流血),赢的策略似乎是联合这二种技术探索小肠在一无痛苦,安全、完全的方法(与囊内视镜检查法)并且识别了定义并且对待损害(与两倍汽球肠寄生物)。 | Emanuele Rondonotti Federica Villa Chris JJ Mulder Maarten AJM Jacobs Roberto de Franchis | 2007 | World Journal of Gastroenterology2007，13，46： | 30 |
| 2 | 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 |
| 3 | 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 |
| 4 | Surgical treatment of anal stenosis显示文摘Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classifi cation of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed. Ninety percent of anal stenosis is caused by overzealous hemorrhoidectomy. Treatment, both medical and surgical, should be modulated based on stenosis severity. Mild stenosis can be managed conservatively with stool softeners or fiber supplements. Sphincterotomy may be quite adequate for a patient with a mild degree of narrowing. For more severe stenosis, a formal anoplasty should be performed to treat the loss of anal canal tissue. Anal stenosis may be anatomic or functional. Anal stricture is most often a preventable complication. Many techniques have been used for the treatment of anal stenosis with variable healing rates. It is extremely diffi cult to interpret the results of the various anaplastic procedures de in the literature as prospective trials have not been performed. However, almost any approach will at least improve patient symptoms. | Giuseppe Brisinda Serafino Vanella Federica Cadeddu Gaia Marniga Pasquale Mazzeo Francesco Brandara Giorgio Maria | 2009 | World Journal of Gastroenterology2009，15，16： | 22 |
| 5 | 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 |
| 6 | Effectiveness of chest radiography,lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure显示文摘Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis. | Luciano Cardinale Adriano Massimiliano Priola Federica Moretti Giovanni Volpicelli | 2014 | World Journal of Radiology2014，6，6： | 16 |
| 7 | Disruption of the Sugar Transporters AtSWEET11 and AtSWEET12 Affects Vascular Development and Freezing Tolerance in Arabidopsis显示文摘Dear Editor, In plants,the transport of sugars from the site of biosynthesis to the site of utilization or storage relies on sugar transporters located in different subcellular compartments and different vascular cell types.The SWEET sugar transporter family is one such class and is represented by 17 members in Arabidopsis.AtSWEET1 was the first plant SWEET transporter to be characterized;it acts as a glucose uniporter in multiple systems (Chen et al.,2010). | Rozenn Le Hir Lara Spinner Patrick A. W. Klemens Dipankar Chakraborti Federica de Marco Francoise Vilaine Nelly Wolff Remi Lemoine Benoit Porcheron Carine Gery Evelyne Teoule Salem Chabout Gregory Mouille H. Ekkehard Neuhaus Sylvie Dinant Catherine Bellini | 2015 | Molecular Plant2015，8，11： | 16 |
| 8 | Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review显示文摘Chronic atrophic autoimmune gastritis(CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach's secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG. | Federica Cavalcoli Alessandra Zilli Dario Conte Sara Massironi | 2017 | World Journal of Gastroenterology2017，23，4： | 16 |
| 9 | Pneumatosis cystoides intestinalis显示文摘Pneumatosis cystoides intestinalis(PCI) is a rare condition that may be associated with a variety of diseases.The presenting clinical picture may be very heterogeneous and represent a challenge for the clinician.In the present paper we describe both a common and an uncommon clinical presentation of PCI and review the pertaining literature.Our cases confirm that,apart from asymptomatic cases,the clinical presentation of PCI may be widely different and suggest that a new onset of stipsis might be the presenting symptom.Diagnosis might be suggested by a simple X-ray of the digestive tract showing a change in the characteristics of the intestinal wall in two-thirds of these patients.However,one third of the patients do not have a suggestive X-ray and require a computed tomography(CT) scan/nuclear magnetic resonance that may reveal a thickened bowel wall containing gas to confirm the diagnosis and distinguish PCI from intraluminal air or submucosal fat.CT also allows the detection of additional findings that may suggest an underlying,potentially worrisome cause of PCI such as bowel wall thickening,altered contrast mucosal enhancement,dilated bowel,soft tissue stranding,ascites and the presence of portal air.Our results also point out that clinicians and endoscopists should be aware of the possible presentations of PCI in order to correctly manage the patients affected with this disease and avoid unnecessary surgeries.The increasing number of colonoscopies performed for colon cancer screening makes PCI more frequently casually encountered and/or provoked,therefore the possible endoscopic appearances of this disease should be well known by endoscopists. | Francesco Azzaroli Laura Turco Liza Ceroni Stefania Sartoni Galloni Federica Buonfiglioli Claudio Calvanese Giuseppe Mazzella | 2011 | World Journal of Gastroenterology2011，17，44： | 16 |
| 10 | Optimizing proton pump inhibitors in Helicobacter pylori treatment:Old and new tricks to improve effectiveness显示文摘The survival and replication cycle of Helicobacter pylori(H.pylori)is strictly dependant on intragastric pH,since H.pylori enters replicative phase at an almost neutral pH(6-7),while at acid pH(3-6)it turns into its coccoid form,which is resistant to antibiotics.On these bases,it is crucial to increase intragastric pH by proton pump inhibitors(PPIs)when an antibiotic-based eradicating therapy needs to be administered.Therefore,several tricks need to be used to optimize eradication rate of different regimens.The administration of the highest dose as possible of PPI,by doubling or increasing the number of pills/day,has shown to be able to improve therapeutic outcome and has often proposed in rescue therapies,even if specific trials have not been performed.A pre-treatment with PPI before starting antibiotics does not seem to be effective,therefore it is discouraged.However,the choice of PPI molecule could have a certain weight,since second-generation substances(esomeprazole,rabeprazole)are likely more effective than those of first generation(omeprazole,lansoprazole).A possible explanation is due to their metabolism,which has been proven to be less dependent on cytochrome P450(CYP)2C19 genetic variables.Finally,vonoprazan,a competitive inhibitor of H+/K+-ATPase present on luminal membrane of gastric parietal cells has shown the highest efficacy,due to both its highest acid inhibition power and rapid pharmacologic effect.However current data come only from Eastern Asia,therefore its strong power needs to be confirmed outside this geographic area in Western countries as well as related to the local different antibiotic resistance rates. | Enzo Ierardi Giuseppe Losurdo Rosa Federica La Fortezza Mariabeatrice Principi Michele Barone Alfredo Di Leo | 2019 | World Journal of Gastroenterology2019，25，34： | 15 |
| 11 | Current therapeutic strategies for advanced pancreatic cancer: A review for clinicians显示文摘Pancreatic cancer(PC) would become the second leading cause of cancer death in the near future, despite representing only 3% of new cancer diagnosis. Survival improvement will come from a better knowledge of risk factors, earlier diagnosis, better integration of locoregional and systemic therapies, as well as the development of more efficacious drugs rising from a deeper understanding of disease biology. For patients with unresectable, non-metastatic disease, combined strategies encompassing primary chemotherapy and radiation seems to be promising. In fit patients, new polychemotherapy regimens can lead to better outcomes in terms of slight but significant survival improvement associated with a positive impact on quality of life. The upfront use of these regimes can also increase the rate of radical resections in borderline resectable and locally advanced PC. Second line treatments showed to positively affect both overall survival and quality of life in fit patients affected by metastatic disease. At present, oxaliplatin-based regimens are the most extensively studied. Nonetheless, other promising drugs are currently under evaluation. Presently, in addition to surgery and conventional radiation therapy, new locoregional treatment techniques are emerging as alternative options in the multimodal approach to patients or diseases not suitable for radical surgery. As of today, in contrast with other types of cancer, targeted therapies failed to show relevant activity either alone or in combination with chemotherapy and, thus, current clinical practice does not include them. Up to now, despite the fact of extremely promising results in different tumors, also immunotherapy is not in the actual therapeutic armamentarium for PC. In the present paper, we provide a comprehensive review of the current state of the art of clinical practice and research in PC aiming to offer a guide for clinicians on the most relevant topics in the management of this disease. | Rosella Spadi Federica Brusa Agostino Ponzetti Isabella Chiappino Nadia Birocco Libero Ciuffreda Maria Antonietta Satolli | 2016 | World Journal of Clinical Oncology2016，7，1： | 15 |
| 12 | Fatty liver,carotid disease and gallstones:A study of age-related associations显示文摘AIM: To evaluate carotid intima-media thickening (IMT) and plaques, gallstone disease (GD) and fatty liver (FL) as a function of age. METHODS: In 449 subjects, FL and carotid disease were assessed ultrasonographically. In a subgroup of 65/449 patients with non-alcoholic fatty liver disease (NAFLD), carotid disease, GD and associated factors were determined. RESULTS: FL of unspecified etiology was more common in younger and GD in older individuals. FL subjects had an increased prevalence of IMT and a decreased prevalence of plaques and manifested carotid disease earlier. Plaques were more common in subjects with GD. Age was an independent predictor of carotid disease outcome and FL was a protective factor for plaques. In NAFLD, there was an inverse correlation between body weight and age and the latter independently predicted carotid findings. CONCLUSION: Cardiovascular risk in patients with FL and NAFLD needs to be assessed as a function of age and body weight. | Amedeo Lonardo Silvia Lombardini Federica Scaglioni Stefano Ballestri Anna Maria Verrone Marco Bertolotti Lucia Carulli Dorval Ganazzi Nicola Carulli Paola Loria | 2006 | World Journal of Gastroenterology2006，12，36： | 14 |
| 13 | Nerve growth factor involvement in liver cirrhosis and hepatocellular carcinoma显示文摘AIM: To define NGF (nerve growth factor) and its high- affinity receptor trkANGF presence and distribution in fibrotic liver and in HCC, and to verify if NGF might have a role in fibrosis and HCC. METHODS: Intracellular distribution of NGF and trkANGF were assessed by immunohistochemistry and immuno- electron microscopy in liver specimens from HCC, cirrhosis or both. ELISA was used to measure circulating NGF levels. RESULTS: NGF and trkANGF were highly expressed in HCC tissue, mainly localized in hepatocytes, endothelial and some Kupffer cells. In the cirrhotic part of the liver they were also markedly expressed in bile ducts epithelial and spindle-shaped cells. Surprisingly, in cirrhotic tissue from patients without HCC, both NGF and trkANGF were negative. NGF serum levels in cirrhotic and/or HCC patient were up to 25-fold higher than in controls. CONCLUSION: NGF was only detected in liver tissue with HCC present. Intracellular distribution suggests paracrine and autocrine mechanisms of action. Better definition of mechanisms may allow for therapeutic and diagnostic/prognostic use of NGF. | Guido Rasi Annalucia Serafino Lia Bellis Maria Teresa Lonardo Federica Andreola Manuela Zonfrillo Giovanni Vennarecci Pasquale Pierimarchi Paola Sinibaldi Vallebona Giuseppe Maria Ettorre Eugenio Santoro Claudio Puoti | 2007 | World Journal of Gastroenterology2007，13，37： | 13 |
| 14 | Non-invasive diagnostic imaging of colorectal liver metastases显示文摘Colorectal cancer is one of the few malignant tumors in which synchronous or metachronous liver metastases [colorectal liver metastases(CRLMs)] may be treated with surgery. It has been demonstrated that resection of CRLMs improves the long-term prognosis. On the other hand, patients with un-resectable CRLMs may benefit from chemotherapy alone or in addition to liverdirected therapies. The choice of the most appropriate therapeutic management of CRLMs depends mostly on the diagnostic imaging. Nowadays, multiple non-invasive imaging modalities are available and those have a pivotal role in the workup of patients with CRLMs. Although extensive research has been performed with regards to the diagnostic performance of ultrasonography, computed tomography, positron emission tomography and magnetic resonance for the detection of CRLMs, the optimal imaging strategies for staging and follow up are still to be established. This largely due to the progressive technological and pharmacological advances which are constantly improving the accuracy of each imaging modality. This review describes the non-invasive imaging approaches of CRLMs reporting the technical features, the clinical indications, the advantages and the potential limitations of each modality, as well as including some information on the development of new imaging modalities, the role of new contrast media and the feasibility of using parametric image analysis as diagnostic marker of presence of CRLMs. | Pier Paolo Mainenti Federica Romano Laura Pizzuti Sabrina Segreto Giovanni Storto Lorenzo Mannelli Massimo Imbriaco Luigi Camera Simone Maurea | 2015 | World Journal of Radiology2015，7，7： | 13 |
| 15 | Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology显示文摘There are many causes of gastrointestinal bleeding(GIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric GIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality. To assist medical care providers in the evaluation and management of children with GIB, the 'Gastro-Ped Bleed Team' of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition(SIGENP) carried out a systematic search on MEDLINE via Pub Med(http://gffzz16a62c593b5540ceh5q5ub56o5xqc6fnw.ffgz.tsg.suse.edu.cn/pubmed/) to identify all articles published in English from January 1990 to 2016; the following key words were used to conduct the electronic search: 'upper GIB' and 'pediatric' [all fields]; 'lower GIB' and 'pediatric' [all fields]; 'obscure GIB' and 'pediatric' [all fields]; 'GIB' and 'endoscopy' [all fields]; 'GIB' and 'therapy' [all fields]. The identified publications included articles describing randomized controlled trials, reviews, case reports, cohort studies, casecontrol studies and observational studies. References from the pertinent articles were also reviewed. This paper expresses a position statement of SIGENP that can have an immediate impact on clinical practice and for which sufficient evidence is not available in literature. The experts participating in this effort were selected according to their expertise and professional qualifications. | Claudio Romano Salvatore Oliva Stefano Martellossi Erasmo Miele Serena Arrigo Maria Giovanna Graziani Sabrina Cardile Federica Gaiani Gian Luigi de'Angelis Filippo Torroni | 2017 | World Journal of Gastroenterology2017，23，8： | 12 |
| 16 | Current approach in the treatment of hepatocellular ca显示文摘Hepatocellular carcinoma (HCC) is the most common malignant hepatobiliary disease; it is responsible for about 1 million deaths per year. Risk factors include hepatitis B and C, hepatic cirrhosis, including alcohol related hepatitis, metabolic and nutritional hepatic damage. The main modality of diffusion is intrahepatic in the natural course of the disease. There are two leading types of treatment: local and systemic. Surgical resection and liver transplantation constitute the most appropriate local treatments and are considered the only real possibility for recovery. Other local approaches include: radiofrequency ablation, percutaneous ethanol ablation, hepatic endoarterial chemoembolization and intrahepatic radiotherapy (SIRT: selective internal radiation therapy). These last treatments are used to control the disease when surgery or transplantation is not achievable; in some cases they are able to prolong survival while theyconstitute mainly a palliative treatment. Systemic treatments include: chemotherapy, immunological and hormonal therapies and, more recently, the introduction of new specific molecular target drugs. At the moment, in this group, the only drug that has given positive results during phase trials (SHARP study) is Sorafenib.Sorafenib represents the only primary systemic therapy that has demonstrated, unlike the other treatments previously described, an increase in survival rate in patients affected with advanced HCC. Currently, other studies are taking place that are further developing the potential of this drug. These studies, including phase trials, aredirected in order to test the activity and safety of new emerging drugs with targeted activity. Examples of these new agents are: Sunitinib, Gef itinib, Cetuximab, Bevacizumab and Erlotinib. | Luigi Rossi Federica Zoratto Anselmo Papa Francesca Iodice Marina Minozzi Luigi Frati Silverio Tomao | 2010 | World Journal of Gastrointestinal Oncology2010，2，9： | 11 |
| 17 | Implication of the Hedgehog pathway in hepatocellular carcinoma显示文摘The prognosis for patients who are diagnosed with advanced stage hepatocellular carcinoma(HCC)is poor because there are few treatment options.Recent research has focused on the identification of novel molecular entities that can be targeted to inhibit oncogenic signals that are involved in the carcinogenesis,proliferation and progression of HCC.Among all of the pathways that are involved in the development of HCC,Hedgehog(HH)signalling has demonstrated a substantial role in hepatocarcinogenesis and HCC progression.HH plays a physiological role in embryogenesis,through the induction of the differentiation of hepatocytes from endodermal progenitors.The re-activation of the HH pathway in chronic damaged liver is a mechanism of fibrotic degeneration and is implicated in various stages of HCC development.HH activation sustains the subpopulation of immature liver epithelial cells that are involved in the pathogenesis of cirrhosis and HCC,and HH itself is a mediator of the alcohol-derived malignant transformation of liver cells.High levels of expression of HH protein markers in liver tumour tissues are correlated with aggressive histological and biological features and a poor clinical outcome.In vitro and in vivo inhibition models of the HH pathway confirm that HH is essential in maintaining tumour growth,metastasis and a mesenchymal phenotype. | Carminia Maria Della Corte Giuseppe Viscardi Federica Papaccio Giovanna Esposito Giulia Martini Davide Ciardiello Erika Martinelli Fortunato Ciardiello Floriana Morgillo | 2017 | World Journal of Gastroenterology2017，23，24： | 10 |
| 18 | Surveillance for early diagnosis of hepatocellular carcinoma: How best to do it?显示文摘Surveillance for hepatocellular carcinoma(HCC)is considered a standard of care for patients with chronic liver disease who are at risk of developing this malignancy.Several studies have shown that surveillance can improve the prognosis of patients diagnosed with HCC through an increased likelihood of application of curative or effective treatments.Repetition of liver ultrasonography(US)every 6 mo is the recommended surveillance program to detect early HCCs,and a positive US has to entrain a well-defined recall policy based on contrast-enhanced,dynamic radiological imaging or biopsy for the diagnosis of HCC.Although HCC fulfills the accepted criteria regarding cost-effective cancer screening and surveillance,the implementation of surveillance in clinical practice is defective and this has a negative impact on the cost-effectiveness of the procedure.Education of both physicians and patients is of paramount importance in order to improve the surveillance application and its benefits in patients at risk of HCC.The promotion of specific educational programs for practitioners,clinicians and patients is instrumental in order to expand the correct use of surveillance in clinical practice and eventually improve HCC prognosis. | Edoardo G Giannini Alessandro Cucchetti Virginia Erroi Francesca Garuti Federica Odaldi Franco Trevisani | 2013 | World Journal of Gastroenterology2013，19，47： | 10 |
| 19 | 男性与女性糖尿病患者致死性冠心病的额外危险:37个前瞻性队列研究的汇总分析显示文摘目的:估计男性和女性糖尿病患者致死性冠心病的相对危险。设计:前瞻性队列研究的汇总分析。数据来源:自1966年至2005年3月间Embase和Medline确认并发表的研究,加上源自亚太队列研究协作组的研究,采用正文词组与MeSH主题词相结合的策略进行检索。综述方法:对入选研究的要求为报告有或无糖尿病的男性与女性致死性冠心病的相对危险比较的估计值。如果对估计值仅做年龄调整(而其它因素来经调整——泽者注),则将该研究排除在外。结果:总共纳入37项2型糖尿病和致死性冠心病的研究,涉及447064例患者。糖尿病患者的致死性冠心病发生率显著高于非糖尿病患者(5.4%比1.6%)。与无糖尿病者相比,糖尿病患者发生致死性冠心病的总的相对危险,女性为3.50,95%可信区间为2.70~4.53,显著高于男性患者(2.06,95%可信区间1.81~2.34)。在除外8项仅根据年龄调整的研究后,两性之间危险的差异大大减小,但仍然具有极显著统计学意义。汇集29项经多因素调整估计值的研究,总的相对危险比(女性比男性)为1.46(1.14~1.88)。结论:糖尿病相关的致死性冠心病相对危险,女性比男性高出50%。这种额外的冠心病危险可以通过女性糖尿病患者具有更多不利的心血管危险因素特点以及倾向于对男性患者更注重治疗的可能偏差来解释。 | Rachel Huxley Federica Barzi Mark Woodward 杨靓(译) 刘靖(校) | 2006 | 英国医学杂志中文版2006，9，3： | 9 |
| 20 | Epilepsy associated tumors: Review article显示文摘Long-term epilepsy associated tumors(LEAT) represent a well known cause of focal epilepsies. Glioneuronaltumors are the most frequent histological type consisting of a mixture of glial and neuronal elements and most commonly ariseing in the temporal lobe. Cortical dysplasia or other neuronal migration abnormalities often coexist. Epilepsy associated with LEAT is generally poorly controlled by antiepileptic drugs while, on the other hand, it is high responsive to surgical treatment. However the best management strategy of tumor-related focal epilepsies remains controversial representing a contemporary issues in epilepsy surgery. Temporo-mesial LEAT have a widespread epileptic networkwith complex epileptogenic mechanisms. By using an epilepsy surgery oriented strategy LEAT may have an excellent seizure outcome therefore surgical treatment should be offered early, irrespective of pharmacoresistance, avoiding both the consequences of uncontrolled seizures as well as the side effects of prolonged pharmacological therapy and the rare risk of malignant transformation. | Marco Giulioni Gianluca Marucci Matteo Martinoni Anna Federica Marliani Francesco Toni Fiorina Bartiromo Lilia Volpi Patrizia Riguzzi Francesca Bisulli Ilaria Naldi Roberto Michelucci Agostino Baruzzi Paolo Tinuper Guido Rubboli | 2014 | World Journal of Clinical Cases2014，2，11： | 9 |
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