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Hepatocellular carcinoma in the setting of interferon-free treatment for chronic HCV hepatitis - experience of a single center

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Hepatoma Research 2018年第1期4卷 21-30页

作者： elena laura iliescu Adriana Mercan-Stanciu Letitia Toma elena Simona Ioanitescu Radu Dumitru Daniel Rusie Department of Internal Medicine II Fundeni Clinical InstituteBucharest 022328Romania Department of Interventional Radiology Fundeni Clinical InstituteBucharest 022328Romania Department of General Surgery Clinical Emergency HospitalBucharest 014461Romania

Aim: This study aims to analyze the particularities of hepatitis C induced hepatocellular carcinoma (HCC), developed during or after treatment with direct-acting antivirals. Methods: We conducted an observational prospective study on 278 patients, who underwent treatment for hepatitis C related liver cirrhosis and respectively for F3 chronic hepatitis C. Liver status was assessed using biological parameters and imagistic evaluation (ultrasonography, computed tomography scan, magnetic resonance imaging). Results: The follow-up time was 14 months. Before therapy, 69.3% of the cirrhotic patients and 26.7% of those with F3 degree of liver fibrosis had high levels of alpha-fetoprotein, with no imagistic evidence of HCC. During treatment, HCC was confirmed in 5 patients, 2 of them presenting portal vein thrombosis (PVT). Antiviral therapy was not interrupted. Two patients developed HCC at the end of treatment, while 4 of them were diagnosed with HCC after three months of ending the treatment. Excepting the ones with PVT, all patients underwent trans-arterial chemoembolization. Conclusion: All patients acquired sustained virological response. The screening for HCC should not be stopped after achievement of sustained virological response. Patients who develop HCC after antiviral treatment often need to be evaluated by magnetic resonance imaging in order to detect the extensionof the disease.

关键词： Hepatitis C virus direct-acting antiviral therapy hepatocellular carcinoma trans-arterial chemoembolization

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Advancing immunosuppression in liver transplantation: A narrative review

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 441-448页

作者： Samuele Iesari Francesca laura Nava Ilaria elena Zais Laurent Coubeau Mariano Ferraresso Evaldo Favi Jan Lerut General Surgery and Kidney Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico15 Via della Commenda20122 MilanItaly Institut de Recherche Expérimentale et Clinique Universitécatholique de Louvain10 Avenue Hippocrate1200 BrusselsBelgium Service de Chirurgie et Transplantation Abdominale Cliniques Universitaires Saint-Luc55 Avenue Hippocrate1200 BrusselsBelgium Department of Clinical Sciences and Community Health Universitàdegli Studi di Milano19 Via della Commenda20122 MilanItaly

Immunosuppression is essential to ensure recipient and graft survivals after liver transplantation(LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solidorgan transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting.

关键词： Liver transplantation Immunosuppression Drug development Long-term results Clinical operational tolerance

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Major liver resections,perioperative issues and posthepatectomy liver failure:A comprehensive update for the anesthesiologist

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World Journal of Critical Care Medicine 2024年第2期13卷 49-71页

作者： Andrea De Gasperi laura Petrò Ombretta Amici Ilenia Scaffidi Pietro Molinari Caterina Barbaglio Eva Cibelli Beatrice Penzo elena Roselli Andrea Brunetti Maxim Neganov Alessandro Giacomoni Paolo Aseni elena Guffanti Former Head Anesthesia and Critical Care Service 2Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy AR1 Ospedale Papa Giovanni 23Bergamo 24100Italy Anesthesia and Critical Care Service 2 Grande Ospedale Metropolitano Niguarda AR2ASST GOM NiguardaMilan 20163Italy Anestesia e Terapia Intensiva Generale Istituto Clinico HumanitasRozzano 20089Italy Chirurgia Oncologica Miniinvasiva Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy Dipartimento di Medicina d’Urgenza ed Emergenza Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilano 20163MIItaly

Significant advances in surgical techniques and relevant medium-and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver *** support these outstanding results and to reduce perioperative complications,anesthesiologists must address and master key perioperative issues(preoperative assessment,proactive intraoperative anesthesia strategies,and implementation of the Enhanced Recovery After Surgery approach).Intensive care unit monitoring immediately following liver surgery remains a subject of active and often unresolved *** postoperative complications,posthepatectomy liver failure(PHLF)occurs in different grades of severity(A-C)and frequency(9%-30%),and it is the main cause of 90-d postoperative ***,recently redefined with pragmatic clinical criteria and perioperative scores,can be predicted,prevented,or *** review highlights:(1)The systemic consequences of surgical manipulations anesthesiologistsmust respond to or prevent,to positively impact PHLF(a proactive approach);and(2)the maximal intensivetreatment of PHLF,including artificial options,mainly based,so far,on Acute Liver Failure treatment(s),to buytime waiting for the recovery of the native liver or,when appropriate and in very selected cases,toward *** a clinical context requires a strong commitment to surgeons,anesthesiologists,and intensivists towork together,for a fruitful collaboration in a mandatory clinical continuum.

关键词： Liver resection Chronic liver disease Preoperative assessment Vascular clamping Intraoperative hemodynamic monitoring Postoperative intensive care unit Posthepatectomy liver failure Artificial liver support

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Behavioral plasticity, behavioral syndromes and animal personality in crustacean decapods： An imperfect map is better than no map

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Current Zoology 2012年第4期58卷 567-579页

作者： Francesca GHERARDI laura AQUILONI elena TRICARICO Dipartimento di Biologia Evoluzionistica 'Leo Pardi' Universith degli Studi di Firenze Via Romana 17 50125 Firenze Italy

Despite their key role as model organisms in many behavioral studies, crustacean decapods have been only slightly touched upon by the recent surge of scientific interest in animal personality. Only seven articles investigated the issue in a handful of species among hermit crabs, crabs, and crayfish. Obviously, a limited number of publications does not mean that personality is rare in decapods. On the contrary, few studies might be the result of a form of reluctance by behavioral ecologists to deal with such a phenomenon in these and other invertebrates. This reluctance contrasts with the enthusiasm shown in tackling the beha- vioral plasticity issue. Here we discuss the possible theoretical and methodological difficulties raised by applying the animal per-sonality perspective to decapods and analyze implications of personality studies for their ecology, conservation, and welfare. By highlighting gaps in knowledge and directions of future research, our intention is to increase scientific emphasis on the issue.

关键词： Crustacean decapods Behavioral plasticity Animal personality Behavioral syndromes Conservation Animal welfare

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Effect of Lactobacillus rhamnosus HN001 and Bifidobacterium longum BB536 on the healthy gut microbiota composition at phyla and species level: A preliminary study

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World Journal of Gastroenterology 2017年第15期23卷 2696-2704页

作者： Marco Toscano Roberta De Grandi laura Stronati elena De Vecchi Lorenzo Drago Laboratory of Clinical Microbiology Department of Biomedical Science for HealthUniversity of Milan Department of Cellular Biotechnology and Hematology Laboratory of Clinical Chemistry and Microbiology IRCCS Galeazzi Orthopaedic InstituteUniversity of Milan

AIMTo evaluate the ability of Lactobacillus rhamnosus HN001 and Bifidobacterium longum BB536 to colonize the intestinal environment of healthy subjects and modify the gut microbiota *** healthy Italian volunteers, eight males and twelve females, participated in the study. Ten subjects took a sachet containing 4 × 109 colony-forming units (CFU) of Bifidobacterium longum BB536 and 109 CFU of Lactobacillus rhamnosus HN001, 30 min before breakfast (pre-prandial administration), while ten subjects took a sachet of probiotic product 30 min after breakfast (post-prandial administration). The ability of Lactobacillus rhamnosus HN001 and Bifidobacterium longum BB536 to colonize human gut microbiota was assessed by means of quantitative real-time PCR, while changes in gut microbiota composition were detected by using Ion Torrent Personal Genome *** after 1-mo of probiotic administration, B. longum BB536 and L. rhamnosus HN001 load was increased in the majority of subjects in both pre-prandial and post-prandial groups. This increase was found also 1 mo after the end of probiotic oral intake in both groups, if compared to samples collected before probiotic consumption. At phyla level a significant decrease in Firmicutes abundance was detected immediately after 1-mo of B. longum BB536 and L. rhamnosus HN001 oral intake. This reduction persisted up to 1 mo after the end of probiotic oral intake together with a significant decrease of Proteobacteria abundance if compared to samples collected before probiotic administration. Whereas, at species level, a higher abundance of Blautia producta, Blautia wexlerae and Haemophilus ducrey was observed, together with a reduction of Holdemania filiformis, Escherichia vulneris, Gemmiger formicilis and Streptococcus sinensis abundance. In addition, during follow-up period we observed a further reduction in Escherichia vulneris and Gemmiger formicilis, together with a decrease in

关键词： Probiotics Gut microbiota Bifidobacterium Lactobacillus Human health

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Extra-anatomic aortic bypass for the treatment of a mycotic pseudoaneurysm after liver transplantation for hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2021年第3期20卷 285-287页

作者： laura Llado elena Iborra Emilio Ramos Nuria Sabé Alba Cachero Joan Fabregat Liver Transplant Unit Hospital Universitari BellvitgeUniversity of BarcelonaBarcelonaSpain Vascular Surgery Department Hospital Universitari BellvitgeUniversity of BarcelonaBarcelonaSpain Infectious Disease Department Hospital Universitari BellvitgeUniversity of BarcelonaBarcelonaSpain

Liver transplantation(LT) after neoadjuvant chemoradiotherapy in patients with unresectable hilar cholangiocarcinoma(HC) is an accepted treatment strategy [1]. Neoadjuvant therapy is associated with an increased risk of arterial and portal complications after LT [1,2]. In most cases, radiation therapy makes the use of the native hepatic artery inadvisable, and an aortic anastomosis is needed, either with or without a graft [2].

关键词： aortic arterial treatment after

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Mepolizumab induced palmoplantar psoriasis:A case report

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世界临床病例杂志 2023年第26期11卷 6154-6158页

作者： Fabio Artosi laura Diluvio Martina Vultaggio elena Campione Luca Bianchi Department of Systems Medicine University of Rome“Tor Vergata”Rome 00133Italy Department of Dermatology Dermatology UnitPoliclinico Tor VergataRome 00133Italy Department of Dermatology University Roma Tor VergataRome 00133Italy

BACKGROUND Atopic dermatitis and asthma are two diseases whose pathogenesis is largely attributable to the activation,at least in the initial stages,of T helper(Th)-2 Lymphocytes,the related cytokine axis,and B lymphocytes with antibody *** is conversely a pathology resulting from a recruitment of Th-17 and Th-1 lymphocytes,after an initial role of innate *** is a humanized monoclonal antibody directed against interleukin(IL)-5,a central cytokine in the Th-2 axis,therefore involved in the pathogenesis of *** authors have described the appearance of psoriatic lesions in patients with asthma or atopic dermatitis following the therapy with dupilumab,a monoclonal antibody that blocks the interleukin(IL)-4,another Th-2 *** SUMMARY We present the case of a 59-year-old patient who developed psoriasiform lesions on the palms after mepolizumab therapy for asthma,for the activation of the parallel cytokine cascade after the blockade of *** successfully treated the patient with a topical calcipotriol and betamethasone *** We should investigate with further attention the possible impact on the human immunological ecosystem put in place by the inhibition of the activity of individual inflammatory mediators,so as to be able to recognize the initial adverse effects early.

关键词： Psoriasis Interleukin-5 Mepolizumab Asthma Immunology Case report

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The IL13α 2R paves the way for anti-glioma nanotherapy

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Genes & Diseases 2023年第1期10卷 89-100页

作者： Ilya V.Ulasov Anton Borovjagin Anastasia Laevskaya Margarita Kamynina Peter Timashev laura Cerchia elena A.Rozhkova Group of Experimental Biotherapy and Diagnostic Institute for Regenerative MedicineWorld-Class Research Center"Digital Biodesign and Personalized Healthcare"Sechenov First Moscow State Medical University(Sechenov University)8-2 Trubetskaya St.Moscow 119991Russia Department of BioMedical Engineering University of Alabama at BirminghamBirminghamAL 35294USA Institute for Regenerative Medicine World-Class Research Center"Digital Biodesign and Personalized Healthcare"Sechenov First Moscow State Medical University(Sechenov University)8-2 Trubetskaya St.Moscow119991Russia Department of Polymers and Composites N.N.Semenov Institute of Chemical Physics4 Kosygin StMoscow119991Russia Chemistry Department Lomonosov Moscow State UniversityLeninskiye Gory 1-3Moscow 119991Russia Institute of Experimental Endocrinology and Oncology"G.Salvatore"”(IEOS) National Research Council(CNR)Naples 80131Italy Center for Nanoscale Materials Argonne National LaboratoryArgonneIL 60439USA

Glioblastoma(GBM)is one of the most aggressive(grade IV)gliomas characterized by a high rate of recurrence,resistance to therapy and a grim survival *** long-awaited improvement in GBM patients'survival rates essentially depends on advances in the development of new therapeutic *** preclinical studies show that nanoscale materials could greatly contribute to the improvement of diagnosis and management of brain *** the current review,we will discuss how specific features of glioma pathobiology can be employed for designing efficient targeting ***,we willsummarize the main evidence for the potential of the IL-13R alpha 2 receptor(IL13α2R)targeting in GBM early diagnosis and experimental therapy.

关键词： Braintumor Experimental therapy GBM IL-13Ra.2 Nanoparticles Receptor Viral vectors

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Dynamic contrast enhanced ultrasound in gastrointestinal diseases:A current trend or an indispensable tool?

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World Journal of Gastroenterology 2023年第25期29卷 4021-4035页

作者： Mattia Paratore Matteo Garcovich Maria elena Ainora laura Riccardi Antonio Gasbarrini Maria Assunta Zocco Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterFondazione Policlinico Universitario A.Gemelli IRCCSRome 00168Italy Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterUniversità Cattolica del Sacro CuoreFondazione Policlinico Universitario A.Gemelli IRCCSRome 00168Italy

Contrast enhanced ultrasound(CEUS)has been widely implemented in clinical practice because of the enormous quantity of information it provides,along with its low cost,reproducibility,minimal invasiveness,and safety of the secondgeneration ultrasound contrast *** overcome the limitation of CEUS given by the subjective evaluation of the contrast enhancement behaviour,quantitative analysis of contrast kinetics with generation of time-intensity curves has been introduced in recent *** quantification of perfusion parameters[named as dynamic-CEUS(D-CEUS)]has several applications in gastrointestinal neoplastic and inflammatory ***,the limited availability of large studies and the heterogeneity of the technologies employed have precluded the standardisation of D-CEUS,which potentially represents a valuable tool for clinical practice in management of gastrointestinal *** this article,we reviewed the evidence exploring the application of D-CEUS in gastrointestinal diseases,with a special focus on liver,pancreas,and inflammatory bowel diseases.

关键词： Quantitative perfusion analysis Gastrointestinal diseases Time-intensity curve Multiparametric ultrasound

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Quality of life in chronic pancreatitis

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World Journal of Gastroenterology 2006年第39期12卷 6249-6251页

作者： Raffaele Pezzilli laura Bini Lorenzo Fantini elena Baroni Davide Campana Paola Tomassetti Roberto Corinaldesi Department of Internal Medicine University of Bologna Sant'Orsola-Malpighi Hospital. Bologna Italy

In an era such as the present one in which there is a high demand for health services with the associated pressure of controlling spending, health care organizations are concerned about the cost-effectiveness of quality improvement interventions. On the other hand, the impact of the disease and the treatment on the patient’s overall well-being and functioning has become a topic of growing interest not only in clinical research but also in practice. The clinical evaluation of the benefits of specific treatments for chronic, debilitating and incurable diseases should increasingly include formal assessment of patient activity and well-being. Thus, health-related quality of life as subjectively perceived by the patient, is becoming a major issue in the evaluation of any therapeutic intervention, mainly in patients with chronic or difficult diseases where the aim of the intervention is to keep patients either symptom-free and capable of living in the community for a long time or to reduce the discomfort caused by the disease. In this paper, we review the current knowledge on the quality of life assessment in chronic pancreatitis patients.

关键词： Pancreatitis Pancreatitis Alcoholic Quality of Life Questionnaires

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