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| 1 | Treatment of gastric cancer显示文摘The authors focused on the current surgical treatment of resectable gastric cancer,and significance of periand post-operative chemo or chemoradiation.Gastric cancer is the 4thmost commonly diagnosed cancer and the second leading cause of cancer death worldwide.Surgery remains the only curative therapy,while perioperative and adjuvant chemotherapy,as well as chemoradiation,can improve outcome of resectable gastric cancer with extended lymph node dissection.More than half of radically resected gastric cancer patients relapse locally or with distant metastases,or receive the diagnosis of gastric cancer when tumor is disseminated;therefore,median survival rarely exceeds12 mo,and 5-years survival is less than 10%.Cisplatin and fluoropyrimidine-based chemotherapy,with addition of trastuzumab in human epidermal growth factor receptor 2 positive patients,is the widely used treatment in stageⅣpatients fit for chemotherapy.Recent evidence supports the use of second-line chemotherapy after progression in patients with good performance | Michele Orditura Gennaro Galizia Vincenzo Sforza Valentina Gambardella Alessio Fabozzi Maria Maddalena Laterza Francesca Andreozzi Jole Ventriglia Beatrice Savastano Andrea Mabilia Eva Lieto Fortunato Ciardiello Ferdinando De Vita | 2014 | World Journal of Gastroenterology2014，20，7： | 116 |
| 2 | Slow transit constipation: A functional disorder becomes an enteric neuropathy显示文摘慢运输便秘传统地被看作了并且分类机能紊乱。然而,临床、压力计的证据一直在积累那建议大多数在 STC 的活动性改变怎么可能神经病的类型被考虑。另外,进一步的调查显示出那伤寒神经系统的微妙的改变,不是对常规组织学的检查明显,可能在这些病人在场。在现在的文章,我们将讨论这些证据,并且将试着与处于这个病理学的条件记录的大肠的反常运动机能把他们放在关系。 | Gabrio Bassotti Vincenzo Villanacci | 2006 | World Journal of Gastroenterology2006，12，29： | 38 |
| 3 | Incidental gallbladder cancer during laparoscopic cholecystectomy:Managing an unexpected finding显示文摘AIM:To evaluate the impact of incidental gallbladder cancer on surgical experience.METHODS:Between 1998 and 2008 all cases of cholecystectomy at two divisions of general surgery,one university based and one at a public hospital,were retrospectively reviewed.Gallbladder pathology was diagnosed by history,physical examination,and laboratory and imaging studies [ultrasonography and computed tomography(CT)].Patients with gallbladder cancer(GBC) were further analyzed for demographic data,and type of operation,surgical morbidity and mortality,histopathological classification,and survival.Incidental GBC was compared with suspected or preoperatively diagnosed GBC.The primary endpoint was diseasefree survival(DFS).The secondary endpoint was the difference in DFS between patients previously treated with laparoscopic cholecystectomy and those who had oncological resection as first intervention.RESULTS:Nineteen patients(11 women and eight men) were found to have GBC.The male to female ratio was 1:1.4 and the mean age was 68 years(range:45-82 years).Preoperative diagnosis was made in 10 cases,and eight were diagnosed postoperatively.One was suspected intraoperatively and confirmed by frozen sections.The ratio between incidental and nonincidental cases was 9/19.The tumor node metastasis stage was:pTis(1),pT1a(2),pT1b(4),pT2(6),pT3(4),pT4(2);five cases with stageⅠa(T1 a-b);two with stageⅠb(T2 N0);one with stage Ⅱa(T3 N0);six with stage Ⅱb(T1-T3 N1);two with stage Ⅲ(T4 Nx Nx);and one with stage Ⅳ(Tx Nx Mx).Eighty-eight percent of the incidental cases were discovered at an early stage(≤Ⅱ).Preoperative diagnosis of the 19 patients with GBC was:GBC with liver invasion diagnosed by preoperative CT(nine cases),gallbladder abscess perforated into hepatic parenchyma and involving the transversal mesocolon and hepatic hilum(one case),porcelain gallbladder(one case),gallbladder adenoma(one case),and chronic cholelithiasis(eight cases).Every case,except one,with a T1b or more advanced invasion underwent Ⅳb + Ⅴ wedge liver resection and pericholedochic/hepatoduodenal lymphadenectomy.One patient with stage T1b GBC refused further surgery.Cases with Tis and T1a involvement were treated with cholecystectomy alone.One incidental case was diagnosed by intraoperative frozen section and treated with cholecystectomy alone.Six of the nine patients with incidental diagnosis reached 5-year DFS.One patient reached 38 mo survival despite a port-site recurrence 2 years after original surgery.Cases with non incidental diagnosis were more locally advanced and only two patients experienced 5-year DFS.CONCLUSION:Laparoscopic cholecystectomy does not affect survival if implemented properly.Reoperation should have two objectives:R0 resection and clearance of the lymph nodes. | Andrea Cavallaro Gaetano Piccolo Vincenzo Panebianco Emanuele Lo Menzo Massimiliano Berretta Antonio Zanghì Maria Di Vita Alessandro Cappellani | 2012 | World Journal of Gastroenterology2012，18，30： | 33 |
| 4 | Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation(Part Ⅱ:Treatment)显示文摘The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation.There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation.Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre.Osmotic laxatives may be effective in patients who do not respond to fibre supplements.Stimulant laxatives should be reserved for patients who do not respond to osmotic laxatives.Controlled trials have shown that serotoninergic enterokinetic agents,such as prucalopride,and prosecretory agents,such as lubiprostone,are effective in the treatment of patients with chronic constipation.Surgery is sometimes necessary.Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coli who are resistant to medical therapy and who do not have defecatory disorders,generalised motility disorders or psychological disorders.Randomised controlled trials have established the efficacy of rehabilitative treatment in dys-synergic defecation.Many surgical procedures may be used to treat obstructed defecation in patients with acquired anatomical defects,but none is considered to be the gold standard.Surgery should be reserved for selected patients with an impaired quality of life.Obstructed defecation is often associated with pelvic organ prolapse.Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse,but the efficacy and safety of such procedures have not yet been established. | Antonio Bove Massimo Bellini Edda Battaglia Renato Bocchini Dario Gambaccini Vincenzo Bove Filippo Pucciani Donato Francesco Altomare Giuseppe Dodi Guido Sciaudone Ezio Falletto Vittorio Piloni | 2012 | World Journal of Gastroenterology2012，18，36： | 33 |
| 5 | Helicobacter species sequences in liver samples from patients with and without hepatocellular carcinoma显示文摘AIM:Only a minority of patients carrying a defined viral aetiologic agent develop cirrhosis and ultimately hepatocellular carcinoma (HCC), the mechanism underlying the worsening is still undefined. Experimental infection by Helicobacter hepaticusin mice causes chronic hepatitis and HCC and recently, more Helicobacter species (Helicobacter spp.) have been detected in the liver of patients suffering from cholestatic diseases and HCC arising from non-cirrhotic liver. We investigated whether Helicobacter spp. sequences could be detected in the liver of patients with cirrhosis and HCC compared to subjects with metastasis to liver from colon cancer.METHODS:Twenty-three liver samples from patients operated upon for HCC superimposed on hepatitis C virus (HCV)-related cirrhosis and 6 from patients with resected metastases from colorectal cancer, were tested by polymerase chain reaction for presence of genomic 16S rRNA of Helicobacter genus using specific primers. DNA sequencing and cagA gene analysis were also performed.RESULTS:Genomic sequences of Helicobacter spp. were found in 17 of 20 (85%) liver samples from patients with HCC and in 2 of 6 samples from patients with liver metastasis.In three samples of the first group the result was uncertain.Hpyloriwas revealed in 16 out of 17 positive samples and Helicobacter pullorum in the other.CONCLUSION: Helicobacter spp., carcinogenic in mice,were found at a higher frequency in the liver of patients with HCV-related cirrhosis and HCC than those in patients without primary liver disease. | RinaldoPellicano MarioRizzetto AntonioPonzetto Vincenzo Mazzaferro Walter Franco Grigioni MiguelAngelCutufia SharmilaFagoonee LorenzoSilengo | 2004 | World Journal of Gastroenterology2004，10，4： | 28 |
| 6 | Esophageal motility abnormalities in gastroesophageal reflux disease显示文摘Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophagealmotility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from nonerosive reflux disease to erosive reflux disease and Barrett's esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted. | Irene Martinucci Nicola de Bortoli Maria Giacchino Giorgia Bodini Elisa Marabotto Santino Marchi Vincenzo Savarino Edoardo Savarino | 2014 | World Journal of Gastrointestinal Pharmacology and Therapeutics2014，5，2： | 24 |
| 7 | Unsedated ultrathin upper endoscopy is better than conventional endoscopy in routine outpatient gastroenterology practice:A randomized trial显示文摘AIM: to compare the feasibility and patients' tolerance of esophagogastroduodenoscopy (EGD) using a thin endoscope with those of conventional oral EGD and to determine the optimal route of introduction of small-caliber endoscopes. METHODS: One hundred and sixty outpatients referred for diagnostic EGD were randomly allocated to 3 groups: conventional (C)-EGD (9.8 mm in diameter), transnasal (TN)-EGD and transoral (TO)-EGD (5.9 mm in diameter). Pre-EGD anxiety was measured using a 100-mm visual analogue scale (VAS). After EGD, patients and endoscopists completed a questionnaire on the pain, nausea, choking, overall discomfort, and quality of the examination either using VAS or answering some questions. The duration of EGD was timed. Blood oxygen saturation (SaO2) and heart rate (HR) were monitored during EGD. RESULTS: Twenty-one patients refused to participate in the study. The 3 groups were well-matched for age, gender, experience with EGD, and anxiety. EGD was completed in 91.1% (41/45), 97.5% (40/41), and 96.2% (51/53) of cases in TN-EGD, TO-EGD, and C-EGD groups, respectively. TN-EGD lasted longer (3.11 ± 1.60 min) than TO-EGD (2.25 ± 1.45 min) and C-EGD (2.49 ± 1.64 min) (P < 0.05). The overall tolerance was higher (P < 0.05) and the overall discomfort was lower (P < 0.05) in TN-EGD group than in C-EGD group. EGD was tolerated 'better than expected' in 73.2% of patients in TN-EGD group and 55% and 39.2% of patients in TO-EGD and C-EGD groups, respectively (P < 0.05). Endoscopy was tolerated 'worst than expected' in 4.9% of patients in TN-EGD group and 17.5% and 23.5% of patients in TO-EGD and C-EGD groups, respectively (P < 0.05). TN-EGDcaused mild epistaxis in one case. The ability to insufflate air, wash the lens, and suction of the thin endoscope were lower than those of conventional instrument (P < 0.001). All biopsies performed were adequate for histological assessment. CONCLUSION: Diagnostic TN-EGD is better tolerated than C-EGD. Narrow-diameter endoscope has a level of diagnostic accuracy comparable to that of conventional gastroscope, even though some technical characteristics of these instruments should be improved. Transnasal EGD with narrow-diameter endoscope should be proposed to all patients undergoing diagnostic EGD. | Lucio Trevisani Viviana Cifalà Sergio Sartori Giuseppe Gilli Giancarlo Matarese Vincenzo Abbasciano | 2007 | World Journal of Gastroenterology2007，13，6： | 24 |
| 8 | 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 |
| 9 | Molecular and phenotypic characterization of human amniotic fluid cells and their differentiation potential显示文摘学习的主要目标是多识别人的新奇来源有势力房间,克服涉及胚胎的干细胞研究和很成年的干细胞的有限可获得性的道德的问题。羊膜的液体房间(声频抗流圈) 习惯性地为出生前的诊断被获得并且能在 vitro 被扩展;他们的起源和性质的不过当前的知识是有限的。声频抗流圈的二十件样品在文化暴露于 adipogenic, osteogenic,神经原并且 myogenic 媒介。区别用免疫细胞化学, RT-PCR 并且西方的弄污被评估。在处理前,声频抗流圈显示出异构的形态学。他们为 MyoD, Myf-5, MRF4, Myogenin 和 Desmin 是否定的但是为由 RT-PCR 的 osteocalcin, PPARgamma2, GAP43, NSE, Nestin, MAP2, GFAP 和贝它导管素 III 积极。房间表示了 Oct-4, Rex-1 和 Runx-1,它描绘无差别的干细胞状态。由免疫细胞化学,他们表示了 neural-glial 蛋白质,间充质、上皮的标记。在文化以后,当占优势的细胞的部件是 fibroblastic 时,声频抗流圈区分了进 adipocytes 和造骨细胞。就算没有 neuronal 形态学是可检测的,早、迟了的 neuronal 抗原仍然是在在神经特定的媒介的 2 星期文化以后的现在。我们的结果提供人的羊膜的液体与为几个系显示出茎和织物特定的基因 / 蛋白质存在的多系潜力包含祖先房间的证据。 | Patrizia Bossolasco Tiziana Montemurro Lidia Cova Stefano Zangrossi Cinzia Calzarossa Simona Buiatiotis Davide Soligo Silvano Bosari Vincenzo Silani Giorgio Lambertenghi Deliliers PaoloRebulla LorenzaLazzari | 2006 | Cell Research2006，16，4： | 20 |
| 10 | Consensus statement AIGO/SICCR:Diagnosis and treatment of chronic constipation and obstructed defecation(partⅠ:Diagnosis)显示文摘Chronic constipation is a common and extremely troublesome disorder that significantly reduces the quality of life,and this fact is consistent with the high rate at which health care is sought for this condition.The aim of this project was to develop a consensus for the diagnosis and treatment of chronic constipation and obstructed defecation.The commission presents its results in a 'Question-Answer' format,including a set of graded recommendations based on a systematic review of the literature and evidence-based medicine.This section represents the consensus for the diagnosis.The history includes information relating to the onset and duration of symptoms and may reveal secondary causes of constipation.The presence of alarm symptoms and risk factors requires investigation.The physical examination should assess the presence of lesions in the anal and perianal region.The evidence does not support the routine use of blood testing and colonoscopy or barium enema for constipation.Various scoring systems are available to quantify the severity of constipation;the Constipation Severity Instrument for constipation and the obstructed defecation syndrome score for obstructed defecation are the most reliable.The Constipation-Related Quality of Life is an excellent tool for evaluating the patient's quality of life.No single test provides a pathophysiological basis for constipation.Colonic transit and anorectal manometry define the pathophysiologic subtypes.Balloon expulsion is a simple screening test for defecatory disorders,but it does not define the mechanisms.Defecography detects structural abnormalities and assesses functional parameters.Magnetic resonance imaging and/or pelvic floor sonography can further complement defecography by providing information on the movement of the pelvic floor and the organs that it supports.All these investigations are indicated to differentiate between slow transit constipation and obstructed defecation because the treatments differ between these conditions. | Antonio Bove Filippo Pucciani Massimo Bellini Edda Battaglia Renato Bocchini Donato Francesco Altomare Giuseppe Dodi Guido Sciaudone Ezio Falletto Vittorio Piloni Dario Gambaccini Vincenzo Bove | 2012 | World Journal of Gastroenterology2012，18，14： | 20 |
| 11 | 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 |
| 12 | Enteric glial cells and their role in gastrointestinal motor abnormalities: Introducing the neuro-gliopathies显示文摘The role of enteric glial cells has somewhat changed from that of mere mechanical support elements, gluing together the various components of the enteric nervous system, to that of active participants in the complex interrelationships of the gut motor and inflammatory events. Due to their multiple functions, spanning from supporting elements in the myenteric plexuses to neurotransmitters, to neuronal homeostasis, to antigen presenting cells, this cell population has probably more intriguing abilities than previously thought. Recently, some evidence has been accumulating that shows how these cells may be involved in the pathophysiological aspects of some diseases. This review will deal with the properties of the enteric glial cells more strictly related to gastrointestinal motor function and the human pathological conditions in which these cells may play a role, suggesting the possibility of enteric neuro- gliopathies. | Gabrio Bassotti Vincenzo Villanacci Simona Fisogni Elisa Rossi Paola Baronio Carlo Clerici Christoph A Maurer Gieri Cathomas Elisabetta Antonelli | 2007 | World Journal of Gastroenterology2007，13，30： | 16 |
| 13 | Estrogens in males: what have we learned in the last 10 years?显示文摘This review focuses on the role of estrogen in men, mainly in male reproduction. The continuing increase in data obtained, and recent discoveries in this area will enable a better understanding of male physiology; these, in turn, will have important clinical implications. | Vincenzo Rochira Antonio R. M. Granata Bruno Madeo Lucia Zirilli Giuseppina Rossi Cesare Carani | 2005 | Asian Journal of Andrology2005，7，1： | 15 |
| 14 | Ultrasound detection of abdominal lymphadenomegaly in subjects with hepatitis C virus infection and persistently normal transaminases:a predictive index of liver histology severity显示文摘UltrasounddetectionofabdominallymphadenomegalyinsubjectswithhepatitisCvirusinfectionandpersistentlynormaltransaminases:apredi... | Maurizio Soresi, Antonio Carroccio, Giulio Bonfissuto, Vincenzo Agate 1, Carmela Magliarisi, Federico Aragona 1, Massimo Levrero 2, Alberto Notarbartolo and Giuseppe Montalto Cattedra di Medicina Interna, 1Istituto di Anatomia Patologica, Univ | 1998 | World Journal of Gastroenterology1998，4，3： | 15 |
| 15 | Antioxidant dietary approach in treatment of fatty liver: New insights and updates显示文摘Non-alcoholic fatty liver disease(NAFLD) is a common clinicopathological condition, encompassing a range of conditions caused by lipid deposition within liver cells. To date, no approved drugs are available for the treatment of NAFLD, despite the fact that it represents a serious and growing clinical problem in the Western world. Identification of the molecular mechanisms leading to NAFLD-related fat accumulation, mitochondrial dysfunction and oxidative balance impairment facilitates the development of specific interventions aimed at preventing the progression of hepatic steatosis. In this review, we focus our attention on the role of dysfunctions in mitochondrial bioenergetics in the pathogenesis of fatty liver. Major data from the literature about the mitochondrial targeting of some antioxidant molecules as a potential treatment for hepatic steatosis are described and critically analysed. There is ample evidence of the positive effects of several classes of antioxidants, such as polyphenols(i.e., resveratrol, quercetin, coumestrol, anthocyanins, epigallocatechin gallate and curcumin), carotenoids(i.e., lycopene, astaxanthin and fucoxanthin) and glucosinolates(i.e., glucoraphanin, sulforaphane, sinigrin and allyl-isothiocyanate), on the reversion of fatty liver. Although the mechanism of action is not yet fully elucidated, in some cases an indirect interaction with mitochondrial metabolism is expected. We believe that such knowledge will eventually translate into the development of novel therapeutic approaches for fatty liver. | Alessandra Ferramosca Mariangela Di Giacomo Vincenzo Zara | 2017 | World Journal of Gastroenterology2017，23，23： | 15 |
| 16 | 胰腺的液体集合的内视镜的指导超声的排水显示文摘 Pancreatic fluid collections (PFCs) develop secondary to either fluid leakage or liquefaction of pancreatic necrosis following acute pancreatitis, chronic pancreatitis, surgery or abdominal trauma. Pancreatic fluid collections include acute fluid collections, acute and chronic pancreatic pseudocysts, pancreatic abscesses and pancreatic necrosis. Before the introduction of linear endoscopic ultrasound (EUS) in the 1990s and the subsequent development of endoscopic ultrasound-guided drainage (EUS-GD) procedures, the available options for drainage in symptomatic PFCs included surgical drainage, percutaneous drainage using radiological guidance and conventional endoscopic transmural drainage. In recent years, it has gradually been recog-nized that, due to its lower morbidity rate compared to the surgical and percutaneous approaches, endoscopic treatment may be the preferred first-line approach for managing symptomatic PFCs. Endoscopic ultrasound-guided drainage has the following advantages, when compared to other alternatives such as surgical, per-cutaneous and non-EUS-guided endoscopic drainage.EUS-GD is less invasive than surgery and therefore does not require general anesthesia. The morbidity rate is lower, recovery is faster and the costs are lower. EUS-GD can avoid local complications related to per-cutaneous drainage. Because the endoscope is placed adjacent to the fluid collection, it can have direct ac-cess to the fluid cavity, unlike percutaneous drainage which traverses the abdominal wall. Complications such as bleeding, inadvertent puncture of adjacent viscera, secondary infection and prolonged periods of drainage with resultant pancreatico-cutaneous fistulae may be avoided. The only difference between EUS and non-EUS drainage is the initial step, namely, gaining access to the pancreatic fluid collection. All the sub-sequent steps are similar, i.e., insertion of guide-wires with fluoroscopic guidance, balloon dilatation of the cystogastrostomy and insertion of transmural stents or nasocystic catheters. With the introduction of the EUS-scope equipped with a large operative channel which permits drainage of the PFCs in 'one step', EUS-GD has been increasingly carried out in many tertiary care centers and has expanded the safety and efficacy of this modality, allowing access to and drainage of overly challenging fluid collections. However, the nature of the PFCs determines the outcome of this procedure. The technique and review of current literature regarding EUS-GD of PFCs will be discussed. | Carlo Fabbri Carmelo Luigiano Antonella Maimone Anna Maria Polifemo Ⅰlaria Tarantino Vincenzo Cennamo | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，11： | 13 |
| 17 | Autoimmune thyroid diseases and Helicobacter pylori: The correlation is present only in Graves's disease显示文摘AIM: To investigate the correlation between autoimmune thyroid diseases (ATDs) and the prevalence of Cag-A positive strains of Helicobacter pylori (H. pylori) in stool samples. METHODS: We investigated 112 consecutive Caucasian patients (48 females and 4 males with Graves' disease and 54 females and 6 males with Hashimoto' s thyroiditis HT), at their first diagnosis of ATDs. We tested for H. pylori in stool samples using an amplified enzyme immunoassay and Cag-A in serum samples using an enzyme-linked immunoassay method (ELISA). The results were analyzed using the two-sided Fisher' s exact test and the respective odds ratio (OR) was calculated. RESULTS: A marked correlation was found between the presence of H. pylori (P ≤ 0.0001, OR 6.3) and, in particular, Cag-A positive strains (P ≤ 0.005, OR 5.3)in Graves' disease, but not in Hashimoto's thyroiditis, where we found only a correlation with Cag-A strains (P ≤ 0.005, OR 8.73) but not when H. pylori was present. CONCLUSION: The marked correlation between H. pylori and Cag-A, found in ATDs, could be dependent on the different expression of adhesion molecules in the gastric mucosa. | Vincenzo Bassi Gennaro Marino Alba Iengo Olimpia Fattoruso Crescenzo Santinelli | 2012 | World Journal of Gastroenterology2012，18，10： | 13 |
| 18 | Simultaneous intraductal papillary neoplasms of the bile duct and pancreas treated with chemoradiotherapy显示文摘Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological features.These include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous carcinoma.To date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated surgically.We hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct IPMN-P.Since surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and radio-therapy.This was effective in decreasing the mass size and in resolving subsequent jaundice.This is also the f irst reported case of IPMN-B successfully treated with chemoradiotherapy.Clinicians should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery. | Roberto Valente Gabriele Capurso Paola Pierantognetti Elsa Iannicelli Matteo Piciucchi Adriana Romiti Paolo Mercantini Alberto Larghi Giulia Francesca Federici Viola Barucca Maria Falchetto Osti Emilio Di Giulio Vincenzo Ziparo Gianfranco Delle Fave | 2012 | World Journal of Gastrointestinal Oncology2012，4，2： | 13 |
| 19 | Therapeutic and clinical aspects of portal vein thrombosis in patients with cirrhosis显示文摘Portal vein thrombosis(PVT) is a frequent complication in cirrhosis, particularly in advanced stages of the disease. As for general venous thromboembolism, risk factors for PVT are slow blood flow, vessel wall damage and hypercoagulability, all features of advanced cirrhosis. Actually, the old dogma of a hemorrhagic tendency in cirrhosis has been challenged by new laboratory tools and the clinical evidence that venous thrombosis also occurs in cirrhosis. The impaired hepatic synthesis of both pro- and anticoagulants leads to a rebalanced hemostasis, more liable to be tipped towards thrombosis or even bleeding. Conventional anticoagulant drugs(low molecular weight heparin or vitamin K antagonists) may be used in cirrhosis patients with PVT, particularly in those eligible for liver transplantation, to prevent thrombosis progression thus permitting/facilitating liver transplant. However, several doubts exist on the level of anticoagulation achieved as estimated by coagulation tests, on the efficacy of treatment monitoring and on the correct timing for discontinuation in non-transplant candidates, while in transplant candidates there is expert consensus on continuing anticoagulation until transplantation. The recent introduction of direct acting oral anticoagulant drugs(DOACs) in other clinical settings generates much interest on their possible application in patients with cirrhosis and PVT. However, DOACs were not evaluated yet in patients with liver disease and cannot be recommended for the present time. | Massimo Primignani Giulia Tosetti Vincenzo La Mura | 2015 | World Journal of Hepatology2015，7，29： | 13 |
| 20 | Chronic intestinal pseudo-obstruction显示文摘Chronic intestinal pseudo-obstruction (CIPO) is a se- vere digestive syndrome characterized by derangement of gut propulsive motility which resembles mechanical obstruction, in the absence of any obstructive process. Although uncommon in clinical practice, this syndrome represents one of the main causes of intestinal failure and is characterized by high morbidity and mortality. It may be idiopathic or secondary to a variety of diseases. Most cases are sporadic, even though familial forms with either dominant or recessive autosomal inheritance have been described. Based on histological features in- testinal pseudo-obstruction can be classified into three main categories:neuropathies, mesenchymopathies, and myopathies, according on the predominant involvement of enteric neurones, interstitial cells of Cajal or smooth muscle cells, respectively. Treatment of intestinal pseu- do-obstruction involves nutritional, pharmacological and surgical therapies, but it is often unsatisfactory and the long-term outcome is generally poor in the majority of cases. | Alexandra Antonucci Lucia Fronzoni Laura Cogliandro Rosanna F Cogliandro Carla Caputo Roberto De Giorgio Francesca Pallotti Giovanni Barbara Roberto Corinaldesi Vincenzo Stanghellini | 2008 | World Journal of Gastroenterology2008，14，19： | 12 |
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