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Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery

World Journal of Gastroenterology 2016年第13期22卷 3602-3610页

作者： Francesco Feroci Andrea Vannucchi Paolo Pietro Bianchi Stefano Cantafio Alessia Garzi giampaolo Formisano Marco Scatizzi Department of General and Oncological Surgery Santo Stefano Hospital Department of General and Minimally Invasive Surgery Misericordia Hospital

AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal ***: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision(TME) with curative intent between January 2008 and December 2014(robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage?Ⅰ-Ⅲ disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and ***: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME(L-TME) and 342 min for robotic TME(R-TME)(P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. Thepatients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients(8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group(18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients(1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between ***: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies.

关键词： Robotic surgery Laparoscopic surgery Rectal cancer Total mesorectal excision Minimally invasive surg

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Alterations of seminal and hormonal parameters:An extrahepatic manifestation of HCV infection?

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World Journal of Gastroenterology 2006年第19期12卷 3073-3076页

作者： Marilena Durazzo Alberto Premoli Cataldo Di Bisceglie Angela Bertagna Emanuela Fagà giampaolo Biroli Chiara Manieri Simona Bo Gianfranco Pagano Department of Internal Medicine University of Turin Italy Division of Endocrinology and Metabolic Diseases A.O.S.Giovanni Battista TurinItaly

瞄准：在精液的参数和繁殖神经质的浆液层次上评估 HCV 感染和相对抗病毒的处理的可能的影响。方法：有 HCV 相关的长期的肝炎和 16 个健康男志愿者的十个男病人被学习。在所有使精液的参数遭到(nemaspermic 集中，进步活动性，形态学)... 详细信息

瞄准：在精液的参数和繁殖神经质的浆液层次上评估 HCV 感染和相对抗病毒的处理的可能的影响。方法：有 HCV 相关的长期的肝炎和 16 个健康男志愿者的十个男病人被学习。在所有使精液的参数遭到(nemaspermic 集中，进步活动性，形态学) 并且神经质的层次被决定。精液的参数和抑制素 B，刺激滤泡的荷尔蒙， luteinizing，总数和免费睾丸激素，雌二醇，在病人的 prolactine 在六和 12 个月以后被测量抗病毒联合(interferon+ribavirin ) 治疗。结果：在治疗前的病人比控制象更低的抑制素 B 和免费睾丸激素层次一样显示出显著地更低的 nemaspermic 活动性和形态学。在情况中的抑制素 B 层次被改进在五个应答者的六和 12 瞬间术后疗法(161.9+/-52.8 pg/mL 对 101.7+/-47.0 pg/mL 和 143.4+/-46.1 pg/mL 对 95.4+/-55.6 pg/mL，分别地) 。病人的神经质的模式显著地没改变术后疗法，与有起始的减小和全面随后的增长(19.7+/-6.4 pg/mL 对 13.6+/-5.0 pg/mL 对 17.3+/-5.7 pg/mL ) 的雌二醇层次的例外。然而，在 1 年的应答者，免费睾丸激素(14.2+/-2.54 pg/mL 对 17.1+/-2.58 pg/mL ) 的重要增长发生了。nemaspermic 形态学的一个缺陷发生了，当另外的精液的参数没在抗病毒的治疗期间显著地变化时。结论：有 HCV 感染的病人比控制显示出更坏的精子的参数，建议精子发生上的病毒的可能的否定影响，与在抗病毒的治疗期间的进一步温和的缺陷。然而，治疗能改进精子的功能，由增加的抑制素 B 层次建议了并且在应答者改进了神经质的模式。进一步的研究被需要证实这些初步的吸引人的结果。

关键词：丙型病毒肝炎精液肝外表现病理机制

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Source, Triggers and Clinical Implications of Hyperlactemia in Patients Undergoing Mitral Valve Surgery Using Custodiol Cardioplegia

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World Journal of Cardiovascular Surgery 2013年第5期3卷 131-138页

作者： Raimondo Ascione Andrea Venturini Elvio Polesel Domenico Mangino Chiara Zanchettin giampaolo Zoffoli Gianni Angelini M.Saadeh Suleiman CSIRO Bristol Heart Institute University of Bristol Bristol UK U.O. di Cardiochirurgia Ospedale Civile “Umberto I” Venice Italy

Background: Postoperative blood hyperlactaemia is an indicator of organ anaerobic metabolism and is associated with morbidity after cardiac surgery. This prospective study aims to explore the source, triggers and clinical implications for hyperlactaemia in patients undergoing mitral valve surgery using Custodiol cardioplegia. Methods: Twenty consecutive elective patients undergoing open-heart surgery for mitral valve repair/replacement using Custodiol (based on Bretschneider’s HTK-solution) cardioplegia were recruited. A serial measurement of arterial blood lactate was performed. Pre-, intra-and post-operative clinical data were obtained and cardiac injury was determined by serial plasma measurement of postoperative release of CK-MB. Results: There were no in-hospital deaths. Most of the patients (n = 16) needed intraoperative direct current cardioversion to treat ventricular arrhythmias or post-operative vasopressors (n = 13) to treat vasoplegia. There was significant cardiac injury as determined by the marked increase of serum CK-MB (p 0.05). A significant (p 0.05) increase in blood lactate was found to follow a biphasic profile. The first peak (from 0.54 ± 0.03 to 1.3 ± 0.07 mM) was observed immediately following the release of the aortic cross-clamp and remained high for 1 hour. This was followed by a second peak at 12 hours post-operatively (1.9 ± 0.2 mM). The second rise in lactate was seen only in patients that required post-operative vasopressors (1.3 ± 0.2 vs 2.2 ±0.3 mM, p 0.05), in whom a significant late decrease in CVP was also observed (12.2 ± 1.0 to 7.7 ± 1.0 for 1 and 12 hours postoperative, respectively). Hyperlactaemia did not correlate with any other variables including CK-MB levels, cross-clamp or cardiopulmonary bypass time. Conclusions: In patients undergoing mitral valve surgery with Custodiol cardioplegia there is marked cardiac injury and a biphasic release of blood lactate. The initial peak in lactate occurs immediately following unclamping

关键词： Mitral Valve Blood Lactate Cardiac Injury Custodiol

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Effect of a Combination of Berberine and Monacolin on CYP Enzymes： An Oral Cocktail Interaction Study in Healthy Volunteers

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Journal of Pharmacy and Pharmacology 2014年第11期2卷 660-668页

作者： Stefano Persiani Federica Sala Carla Manzotti Milena Colovic Yves Donazzolo Beatrice Barbetta Cristina Vitalini giampaolo Giacovelli Claudio Benvenuti Lucio C. Rovati R&D Division Rottapharm | Madaus Monza 20900 Italy Eurofins|Optimed Gieres 38610 France

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Carboxytherapy and Platelet Rich Plasma： A New Therapy for Trigonitis, Abacterial and Interstitial Cystitis

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Journal of Pharmacy and Pharmacology 2015年第9期3卷 405-410页

作者： Muzi Fabrizio Delicato giampaolo D'Andria Daniele Baffigo Giulio Tartaglia Edoardo Tati Eleonora Corvese Francesco Signore Stefano Perla Alessandro Montagna Giuseppe Tati Gaetano Department of Urology and Oncologic Urology S. Eugenio Hospital Rome 00144 Rome Italy

Cystitis often appears even in absence of bacteria colonization. Trigonitis and interstitial inflammation are the most common morphological features of abacterial cystitis in young and post menopausal women. Arterial obstructive disease and bladder ischemia might play an important role in bladder dysfunction. Activated inflammatory cells produce ROS (radicals of oxygen), NF kB seems involved in ROS synthesis. Clinical studies have indicated that high CO2 levels can impact upon peripheral tissue, reducing ischaemia, responsible of recurrent inflammation and consequently reducing oxydative phenomena. PRP (platelet-rich plasma) is a volume of fractionated plasma from the patient"s own blood that contains platelet concentrate rich of alpha granules. PRP interacts tissue repair mechanisms by placing supra-physiological concentrations of autologous platelets at the site of tissue damage. This study proposes a single PRP transvaginal injection followed by 10 weekly applications of carboxytherapy, using subcutaneous injections of sterile CO2 gas. We have selected 6 Women (50-75 years), affected by recurrent abacterial cystitis with Pain and urge incontinence. All patients showed a subjective sensible reduction of symptoms. After 2 months all patients have neither inflammatory symptoms nor endoscopic evidence of trigonitis. Preliminary qualitative results could encourage the use of carboxytherapy and PRP in treatment of abacterial and interstitial cystitis.

关键词：药剂学药理学药学药典药方

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Effect of food on the Oral Bioavailability of Berberine and Monacolin Administered in Combination in Healthy Male Volunteers

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Journal of Pharmacy and Pharmacology 2014年第12期2卷 703-712页

作者： Stefano Persiani Federica Sala Monique Zangarini Carla Manzotti Milena Colovic Yves Donazzolo Beatrice Barbetta Cristina Vitalini giampaolo Giacovelli Claudio Benvenuti Lucio C. Rovati R&D Division Rottapharm Biotech S.r.l. Monza 20900 Italy Eurofins/Optimed Gieres 38610 France Medical Department RottapharmlMadaus Monza 20900 Italy

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Metastatic pancreatic cancer: Is there a light at the end of the tunnel?

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World Journal of Gastroenterology 2015年第16期21卷 4788-4801页

作者： Vanja Vaccaro Isabella Sperduti Sabrina Vari Emilio Bria Davide Melisi Carlo Garufi Carmen Nuzzo Aldo Scarpa giampaolo Tortora Francesco Cognetti Michele Reni Michele Milella Medical Oncology A Regina Elena National Cancer Institute Medical Oncology A and Biostatistics Regina Elena National Cancer Institute Medical Oncology University of VeronaAzienda Ospedaliera Universitaria Integrata ARC-Net Research Centre and Department of Pathology Diagnostics and SurgeryUniversity of Verona Medical Oncology Unit Department of OncologySan Raffaele Scientific Institute

Due to extremely poor prognosis,pancreatic cancer(PDAC)represents the fourth leading cause of cancerrelated death in Western *** more than a decade,gemcitabine(Gem)has been the mainstay of first-line PDAC *** efforts aimed at improving single-agent Gem efficacy by either combining it with a second cytotoxic/molecularly targeted agent or pharmacokinetic modulation provided disappointing ***,the field of systemic therapy of advanced PDAC is finally moving *** has shown promise over single-agent Gem:regimens like PEFG-PEXG-PDXG and GTX provide significant potential advantages in terms of survival and/or disease control,although sometimes at the cost of poor *** PRODIGE 4/ACCORD 11 was the first phaseⅢtrial to provide unequivocal benefit using the polychemotherapy regimen FOLFIRINOX;however the less favorable safety profile and the characteristics of the enrolled population,restrict the use of FOLFIRINOX to young and fit PDAC *** nanoparticle albumin-bound paclitaxel(nab-Paclitaxel)formulation was developed to overcome resistance due to the desmoplastic stroma surrounding pancreatic cancer *** of whether or not this is its main mechanisms of action,the combination of nabPaclitaxel plus Gem showed a statistically and clinically significant survival advantage over single agent Gem and significantly improved all the secondary ***,recent findings on maintenance therapy are opening up potential new avenues in the treatment of advanced PDAC,particularly in a new era in which highly effective first-line regimens allow patients to experience prolonged disease ***,we provide an overview of recent advances in the systemic treatment of advanced PDAC,mostly focusing on recent findings that have set new standards in metastatic *** avenues for further development in the metastatic setting and current efforts to integratenew effective chemotherapy regimens

关键词： Pancreatic cancer Metastatic disease Chemotherapy Folfirinox nab -Paclitaxel

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Internet of Things for Demand Side Management

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Journal of Energy and Power Engineering 2015年第5期9卷 500-503页

作者： giampaolo Fiorentino Antonello Corsi lo T (Internet of Things) R & D (Research and DevelopmenO Lab Engineering Ingegneria Informatica S.p.A Rome 00185 Italy

The introduction of new kinds of energy mixes to the electricity grid is a challenging environmental task for present and future generations as they fight the pollution and global warming issues associated with urbanization. Individual appliances and whole buildings that continuously incorporate local intelligence which originates from the new technologies of Internet of Things are the new infrastructure that this integration is based on. Smart Electricity Grids are becoming more intensively integrated with tertiary building energy management systems and distributed energy generators such as wind and solar. This new smart network type harnesses the IoT (Internet of Things) principles by generating a new network made of active elements combined with the necessary control and distributed coordination mechanisms. This new self-organized overlay network of connected DER (distributed energy resources) allows for the seamless management and control of the active grid as well as the efficient coordination and exploration of single and aggregated technical prosumer potential (generation and consumption) to participate in energy balancing and other distributed grid related services, applying energy management strategies based on control and predict of the DERs behavior for facing demand side management issues.

关键词：需求侧管理物联网分布式能源智能型网络 lnternet 能源管理系统全球变暖问题有源电网

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Evaluation of the prognostic value of liver stiffness in patients with hepatitis C virus treated with triple or dual antiviral therapy:A prospective pilot study

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World Journal of Gastroenterology 2015年第10期21卷 3013-3019页

作者： Cristina Stasi Alessia Piluso Umberto Arena Elena Salomoni Paolo Montalto Monica Monti Barbara Boldrini giampaolo Corti Fabio Marra Giacomo Laffi Stefano Milani Anna Linda Zignego Department of Experimental and Clinical Medicine University of Florence Health Agency of Tuscany Gastrointestinal Endoscopy Unit Ospedale SS Cosma e Damiano Department of Biomedical Experimental and Clinical sciencesUniversity of Florence

AIM:To evaluate the association between liver stiffness(LS) prior to the initiation of dual/triple therapy and viral ***:LS was measured in all patients before treatment was *** therapeutic approach was based on hepatic,virological,and immunological evaluations and considered the fact that patients with severe fibrosis(F3)or compensated cirrhosis(F4)in Child-Pugh class A are the primary candidates for triple *** total,65 hepatitis C virus(HCV)patients were treated with Peg-interferon/ribavirin(Peg-IFN/RBV);24patients were classified as genotypes 1/4(36.92%),and41 patients were classified as genotypes 2/3(63.08%)(dual therapy).In addition,20 HCV treatment-experienced genotype 1 patients were treated with Peg IFN-RBV and boceprevir(triple therapy).Wilcoxon rank-sum tests were used to compare the ***:LS significantly differed between dual therapy and triple therapy(P=0.002).The mean LS value before dual therapy treatment was 8.61±5.79k Pa and was significantly different between patients achieving a sustained virologic response(SVR)24weeks after therapy and those who did not(7.23±5.18 k Pa vs 11.72±5.99 k Pa,respectively,P=0.0003).The relative risk of non-response to therapy was 4.45(95%CI:2.32-8.55).The attributable risk of non-response to therapy was 49%.The mean LSvalue before triple therapy treatment was 13.29±8.57k Pa and was significantly different between patients achieving and not achieving SVR24(9.41±5.05 vs19.11±9.74,respectively;P=0.008).The relative risk of non-response to therapy was 5.57%(95%CI:1.50-20.65).The attributable risk of non-response to therapy(70%)was increased compared with dual therapy ***-treatment stiffness>12 k Pa was significantly associated with non-SVR(P<0.025)in both ***:Pre-treatment liver stiffness may be useful for predicting the response to treatment in patients treated with either dual or triple anti-HCV therapy.

关键词： Antiviral therapy Chronic hepatitis C Fibrosis Liv

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Prognostication and response assessment in liver and pancreatic tumors:The new imaging

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World Journal of Gastroenterology 2015年第22期21卷 6794-6808页

作者： Riccardo De Robertis Paolo Tinazzi Martini Emanuele Demozzi Gino Puntel Silvia Ortolani Sara Cingarlini Andrea Ruzzenente Alfredo Guglielmi giampaolo Tortora Claudio Bassi Paolo Pederzoli Mirko D'Onofrio Department of Radiology Verona Comprehensive Cancer Network G.B. Rossi Hospital University of Verona Department of Radiology Casa di Cura Pederzoli Department of Oncology Verona Comprehensive Cancer Network G.B.Rossi Hospital University of Verona Department of Hepato-Biliary Surgery Verona Comprehensive Cancer NetworkG.B. Rossi Hospital University of Verona Department of Pancreatic Surgery Verona Comprehensive Cancer Network G.B. Rossi Hospital University of Verona Department of Pancreatic Surgery Casa di Cura Pederzoli

Diffusion-weighted imaging(DWI), dynamic contrastenhanced magnetic resonance imaging(DCE-MRI) and perfusion computed tomography(CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT ***, the term "functional imaging" is commonly used to describe molecular imaging techniques, as positron emission tomography(PET)CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive "one-step" morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging,therefore these techniques could be used also for posttreatment assessment, even at an early stage. The aim of this editorial is to describe possible applications of new functional imaging techniques apart frommolecular imaging to hepatic and pancreatic tumors through a review of up-to-date literature data, with a particular emphasis on pathological correlations,prognostic stratification and post-treatment monitoring.

关键词： Diffusion magnetic resonance imaging Perfusion imaging Hepatocellular carcinoma Liverneoplasms Pancreatic neoplasms

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