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World Journal of Gastroenterology 2005年第13期11卷 2035-2038页

作者： Alfredo Guglielmi Francesca Fior Orsolya Halmos gian franco veraldi Lorenzo Rossaro Andrea Ruzzenente Claudio Cordiano First Department of General Surgery Department of Internal Medicine Claudio Cordiano

AIM: To present a case of acute mesenteric and portal vein thrombosis treated with thrombolytic therapy in a patient with ulcerative colitis in acute phase and to review the literature on thrombolytic therapy of mesenteric-portal system. Treatment of acute portal vein thrombosis has ranged from conservative treatment with thrombolysis and anticoagulation therapy to surgical treatment with thrombectomy and/or intestinal ***: We treated our patient with intraportal infusion of plasminogen activator and then heparin through a percutaneous transhepatic ***: Thrombus resolved despite premature interruption of the thrombolytic treatment for neurological complications, which subsequently ***: Conservative management with plasminogen activator, could be considered as a good treatment for patients with acute porto-mesenteric thrombosis.

关键词：纤维蛋白肠系膜血管栓塞大肠炎病例报告

Optimization of room-and-pillar dimensions using automated numerical models

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International Journal of Mining Science and Technology 2019年第5期29卷 797-801页

作者： gian franco Napa-García Tais Renata Camara Vidal Félix Navarro Torres Mining Instituto Tecnológico ValeSanta LuziaMG 33040-900Brazil Exploration and Mineral Projects VALE S.A.Santa LuziaMG 33040-900Brazil

This paper presents an optimization methodology for the geometric configuration of a room–and–pillar mining project,considering safety and operational restrictions while maximizing ore *** underground manganese mine was chosen as a case study to investigate the capabilities of the presented methodology.A software package(OPTIMINE)was implemented to address the computational demand in an automated ***–dimensional finite difference analyses were performed in FLAC3D and used as implicit functions to consider safety in terms of the factor of safety and room *** obtained results showed that recovery could be increased from 44%to more than 80%in a safe manner.

关键词： Optimization Safety Room and pillar mining Ore recovery 3D numerical modeling

My Beautiful Relationship with China

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Voice of Friendship 2014年第2期 34-37页

作者： gian franco Terenzi San Marino-China Friendship Association

The beautiful story of friendship began in 1987 when I served as Captain Regent(Head of State)of San *** then,I had some knowledge of China and decided to realize my dream of paying an offi cial visit there during my *** was my first trip,so I did not know what was awaiting ***,I was sure it would be something *** the head of a delegation,I arrived in China in February *** reception was meticulous and incom-

关键词： something delegation decided story visit dream wel

From bariatric to metabolic surgery:Looking for a"diseasemodifier"surgery for type 2 diabetes

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World Journal of Diabetes 2016年第2期7卷 27-33页

作者： Renzo Cordera gian franco Adami Department of Internal Medicine University of Genova16132 GenovaItaly Department of Surgery University of Genova16132 GenovaItaly

In this review the recent evolution of the comprehension of clinical and metabolic consequences of bariatric surgery is depicted. At the beginning bariatric surgery aim was a significant and durable weight loss. Later on, it became evident that bariatric surgery was associated with metabolic changes, activated by unknown pathways, partially or totally independent of weight loss. Paradigm of this "metabolic" surgery is its effects on type 2 diabetes mellitus(T2DM). In morbid obese subjects it was observed a dramatic metabolic response leading to decrease blood glucose, till diabetes remission, before the achievement of clinically significant weight loss, opening the avenue to search for putative antidiabetic "intestinal" factors. Both proximal duodenal(still unknown) and distal(GLP1) signals have been suggested as hormonal effectors of surgery on blood glucose decrease. Despite these findings T2 DM remission was never considered a primary indication for bariatric surgery but only a secondary one. Recently T2 DM remission in obese subjects with body mass index(BMI) greater than 35 has become a primary aim for surgery. This change supports the idea that "metabolic surgery" definition could more appropriate than bariatric, allowing to explore the possibility that metabolic surgery could represent a "disease modifier" for T2 DM. Therefore, several patients have undergone surgery with a primary aim of a definitive cure of T2 DM and today this surgery can be proposed as an alternative therapy. How much surgery can be considered truly metabolic is still unknown. To be truly "metabolic" it should be demonstrated that surgery could cause T2 DM remission not only in subjects with BMI > 35 but also with BMI < 35 or even < 30. Available evidence on this topic is discussed in this mini-review.

关键词： Obesity Severe obesity Obesity relatedmetabolic co-morbidities Type 2 diabetes Type 2diabetes remission Type 2 diabetes control Bariatric/metabolic surgery

Multimodal treatment of gastric cancer in the west: Where are we going?

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World Journal of Gastroenterology 2015年第26期21卷 7954-7969页

作者： Daniele Marrelli Karol Polom Giovanni de Manzoni Paolo Morgagni gian Luca Baiocchi franco Roviello Department of Medicine Surgery and NeurosciencesUniversity of Siena Department of Surgery University of Verona Depertment of Surgery "Morgani-Pierantoni" Hospital Surgical Clinic University of Brescia

The incidence of gastric cancer(GC) is decreasing worldwide,especially for intestinal histotype of the distal third of the *** the contrary,proximal location and diffuse Lauren histotype have been reported to be generally stable over *** the west,no clear improvement in long-term results was observed in clinical and population-based *** of treatment in these neoplasms are strictly dependent on tumor *** surgery and extended lymphadenectomy are associated with good long-term outcome in early-stage cancer; however,results are still unsatisfactory for advanced stages(Ⅲ and Ⅳ),for which additional treatments could provide a survival *** implies a tailored approach to *** aim of this review was to summarize the main multimodal treatment options in advanced resectable *** or postoperative treatments,including chemotherapy,chemoradiotherapy,targeted therapies,and hyperthermic intraperitoneal chemotherapy have been reviewed,and the main ongoing and completed trials have been *** original tailored multimodal approach to non-cardia GC has been also proposed.

关键词： Epidemiology Hyperthermic intraperitonealchemotherapy Chemotherapy Radiotherapy Gastriccancer Targeted therapy

Follow-up after gastrectomy for cancer:results of an international web round table

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World Journal of Gastroenterology 2014年第34期20卷 11966-11971页

作者： gian Luca Baiocchi Yasuhiro Kodera Daniele Marrelli Fabio Pacelli Paolo Morgagni franco Roviello Giovanni De Manzoni Department of Medical and Surgical Sciences Surgical ClinicBrescia UniversityBrescia 25123Italy Department of Gastroenterological Surgery Surgery ⅡNagoya UniversityNagoya 452-0813Japan Department of Human Pathology and Oncology Surgical OncologySiena UniversitySiena 53011Italy Department of Surgical Sciences Digestive SurgeryCatholic UniversityRome 00118Italy Department of General Surgery MorgagniPierantoni HospitalForlì 47121Italy 1~(st) Department of General Surgery Borgo Trento HospitalUniversity of VeronaVerona 37121Italy

Oncological follow-up after radical gastrectomy for cancer still represents a discrepancy in the field,with many retrospective series demonstrating that early diagnosis of recurrence does not result in an improvement in patient survival;yet,many centers with high quality of care still provide routine patient follow-up after surgery by clinical and instrumental *** was the topic for a web round table entitled"Rationale and limits of oncological follow-up after gastrectomy for cancer"that was launched one year before the 10th International Gastric Cancer *** having specific expertise were invited to comment on their previous publications to provide the subject for an open *** a three-month-long discussion,32 authors from 12 countries participated,and 2299people visited the dedicated web *** differences emerged between the participants:authors from Japan,South Korea,Italy,Brazil,Germany and France currently engage in instrumental follow-up,whereas authors from Eastern Europe,Peru and India do not,and British and American surgeons practice it in a rather limited manner or in the context of experimental *** endoscopy is still considered useful by most authors,all the authors recognized that computed tomography scanning is the method of choice to detect recurrence;however,many limit follow-up to clinical and biochemical examinations,and acknowledge the lack of improved survival with early detection.

关键词： Gastric cancer Recurrence Follow-up Diagnosis Prog

Hemodynamic changes acutely determined by primary PCI in STEMI patients evaluated with a minimally invasive method

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World Journal of Cardiovascular Diseases 2013年第4期3卷 69-72页

作者： Cristina Giglioli Omar Tujjar Emanuele Cecchi Daniele Landi Marco Chiostri Serafina Valente Giorgio Jacopo Baldereschi Francesco Meucci gian franco Gensini Salvatore Mario Romano Department of Critical Care and Surgery Unit of Internal Medicine and Cardiology University of Florence Italy Department of Heart and Vessels Azienda Ospedaliero-Universitaria Careggi Florence Italy

Objective: Few studies are available on the hemodynamic changes acutely determined by Primary Percutaneous Coronary Intervention (PCI) in ST-Elevation Myocardial Infarction (STEMI) patients, probably for the difficult evaluation of hemodynamic variables in this acute setting. Therefore, the paper is to evaluate the variations of several hemodynamic parameters determined by PCI using PRAM (Pressure Recording Analytical Method), minimally invasive hemodynamic monitoring. Methods: We analyzed in 20 STEMI patients submitted to PCI several hemodynamic variables, assessed with PRAM from radial/ femoral artery, 3-minute before PCI and at endprocedure. Variables measures were: systolic, diastolic, dicrotic and mean arterial pressures;heart rate (HR);stroke volume (SV);systemic vascular resistance (SVR);dP/dtmax;cardiac cycle efficiency (CCE). Results: In our patients HR, SVR and dP/dtmax decreased significantly (85 ± 6.3 to 77 ± 4.5, p = 0.002;1738 ± 241 to 1450 ± 253, p = 0.022;1.22 ± 0.11 to 1.11 ± 0.12, p = 0.007, respectively) while CCE and SV increased significantly (?0.25 ± 0.23 to ?0.01 ± 0.12,

关键词： STEMI Primary PCI Hemodynamic Monitoring Cardiac Output

Associations between y-glutamyl transferase, metabolic abnormalities and inflammation in healthy subjects from a population-based cohort: A possible implication for oxidative stress

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World Journal of Gastroenterology 2005年第45期11卷 7109-7117页

作者： Simona Bo Roberto Gambino Marilena Durazzo Sabrina Guidi Elisa Tiozzo Federica Ghione Luigi Gentile Maurizio Cassader gian franco Pagano Department of Internal Medicine Diabetic Clinic

AIM: To examine the relationships between γ -glutamyltransferase (GGT), alanine-aminotransferase (ALT),aspartate-aminotransferase (AST) and various metabolic parameters, C-reactive protein (CRP) and an oxidative stress marker (nitrotyrosine, NT) in subjects without any metabolic abnormalities from a population-based ***: Two hundred and five subjects with normal body mass index (BMI), glucose tolerance, and without any metabolic abnormality were studied out of 1339subjects, without known liver diseases, alcohol abuse or use of hepatotoxic drugs, who are representative of the 45-64 aged population of Asti (north-western Italy).RESULTS: In all patients metabolic parameters and hs-CRP levels linearly increase from the lowest to the highest ALT and GGT tertiles, while in subjects without metabolic abnormalities, there is a significant association between fasting glucose, uric acid, waist circumference,hs-CRP, triglyceride values, and GGT levels. In these subjects, male sex, higher hs-CRP and glucose levels are associated with GGT levels in a multiple regression model, after adjustments for multiple *** the same model, median NT levels are significantly associated with the increasing GGT tertile (β = 1.06;95%CI 0.67-1.45), but not with the AST and ALT *** a multiple regression model, after adjusting for age,sex, BMI, waist, smoking, and alcohol consumption, both NT (β = 0.05; 95%CI 0.02-0.08) and hs-CRP levels (β =0.09; 95%CI 0.03-0.15) are significantly associated with fasting ***: GGT, an easy, universally standardized and available measurement, could represent an early marker of sub-clinical inflammation and oxidative stress in otherwise healthy individuals. Prospective studies are needed to establish if GGT could predict future diabetes in these subjects.

关键词： γ-谷氨酸转移酶代谢异常氧化反应炎症

Clinical significance of lactate in acute cardiac patients

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World Journal of Cardiology 2015年第8期7卷 483-489页

作者： Chiara Lazzeri Serafina Valente Marco Chiostri gian franco Gensini Intensive Cardiac Care Unit Heart and Vessel Department Azienda Ospedaliero-Universitaria Careggi Department of Experimental and Clinical Medicine University of Florence

Lactate, as a metabolite of easy and quick assessment, has been studied over time in critically ill patients in order to evaluate its prognostic ability. The present review is focused on the prognostic role of lactate levels in acute cardiac patients(that is with acute coronary syndrome, cardiogenic shock, cardiac arrest, non including post cardiac surgery patients). In patients with STelevation myocardial infarction treated with mechanical revascularization, hyperlactatemia identified a subset of patients at higher risk for early death and in-hospital complications, being strictly related mainly to hemodynamic derangement. The prognostic impact of hyperlactatemia on mortality has been documented in patients with cardiogenic shock and in those with cardiac arrest even if there is no cut-off value of lactate to be associated with worse outcome or to guide resuscitation or hemodynamic management. Therapeutic hypothermia seems to affect per se lactate values which have been shown to progressively decrease during hypothermia. The mechanism(s) accounting for lactate levels during hypothemia seem to be multiple ranging from the metabolic effects of reduced temperatures to the hemodynamic effects of hypothermia(i.e., reduced need of vasopressor agents). Serial lactate measurements over time, or lactate clearance, have been reported to be clinically more reliable than lactate absolute value also in acute cardiac patients. Despite differences in study design, timing of lactate measurements and type of acute cardiac conditions(i.e., cardiogenic shock, cardiac arrest, refractory cardiac arrest), available evidence strongly suggests that higher lactate levels can be observed on admission in non-survivors and that higher lactate clearance is associated with better outcome.

关键词： Lactate Acute coronary syndrome Cardio-genic shock Cardiac arrest Therapeutic hypothermia Extracorporeal membrane oxygenation Prognosis

在姿势的挑战以后的肝脏硬化症的病人的非侵略的连续血液动力学的评估

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World Journal of Hepatology 2012年第4期4卷 149-153页

作者： Roberto Tarquini gianluigi Mazzoccoli Fulvio Fusi Giacomo Laffi gian franco Gensini Salvatore Mario Romano Department of Internal Medicine School of Medicine 50134 Florence Italy Department of Internal Medicine and Chronobiology Unit Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza 71013 San Giovanni Rotondo (FG) Italy Heart and Vessel Department School of Medicine 50134 Florence Italy

AIM: To assess whether Most Care is able to detect the cardiovascular alterations in response to physiological stress (posture). METHODS: Non invasive hemodynamic was assessed in 26 cirrhotic patients compared to healthy subjects, both in the supine and standing positions. RESULTS: In baseline conditions, when compared to healthy subjects, cirrhotic patients showed significantly lower values of dicrotic and diastolic pressures and systemic vascular resistance. While in the standing position, cirrhotic patients showed higher values of cardiac index, stroke volume index and cardiac cycle efficiency. When returning to the supine position, cirrhotic patients exhibited lower values of dicrotic and diastolic pressures and systemic vascular resistance in the presence of higher values of cardiac index, stroke volume index and cardiac cycle efficiency.

关键词： Liver cirrhosis Non-invasive hemodynamic Pressure recording analytical method Posture