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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. The patients 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 surgery

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Intraductal papillary neoplasm of the bile duct:The new frontier of biliary pathology

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World Journal of Gastroenterology 2023年第38期29卷 5361-5373页

作者： Federico Mocchegiani paolo Vincenzi Grazia Conte Daniele Nicolini Roberta Rossi andrea Benedetti Cacciaguerra Marco Vivarelli Department of Experimental and Clinical Medicine Polytechnic University of MarcheAncona 60126Italy Department of Gastroenterology and Transplant United Hospital of MarcheAncona 60126Italy

Intraductal papillary neoplasms of the bile duct(IPNBs)represent a rare variant of biliary tumors characterized by a papillary growth within the bile duct *** their first description in 2001,several classifications have been proposed,mainly based on histopathological,radiological and clinical features,although no specific guidelines addressing their management have been *** duct neoplasms generally develop through a multistep process,involving different precursor pathways,ranging from the initial lesion,detectable only microscopically,*** intraepithelial neoplasia,to the distinctive grades of IPNB until the final stage represented by invasive *** and advanced investigations,mainly relying on magnetic resonance imaging(MRI)and cholangioscopy,are required to reach a correct diagnosis and to define an adequate bile duct mapping,which supports proper *** recently introduced subclassifications of types 1 and 2 highlight the histopathological and clinical aspects of IPNB,as well as their natural evolution with a particular focus on prognosis and *** surgical resection,including hepatectomy,pancreaticoduodenectomy or both,represents the treatment of choice,yielding optimal results in terms of survival,although several endoscopic approaches have been *** are newly recognized preinvasive neoplasms of the bile duct with high malignant *** novel subclassification of types 1 and 2 defines the histological and clinical aspects,prognosis and *** is mainly based on MRI and *** resection represents the mainstay of treatment,although endoscopic resection is currently applied to nonsurgically fit *** frontiers in genetic research have identified the processes underlying the carcinogenesis of IPNB,to identify targeted therapies.

关键词： Intraductal neoplasm of the bile duct Bile duct neoplasms Cholangiocarcinoma Intraductal papilloma Classification Treatment

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In Vivo Toxicity Assessment of Gold Nanoparticles in Drosophila melanogaster

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Nano Research 2011年第4期4卷 405-413页

作者： Pier paolo Pompa Giuseppe Vecchio Antonio Galeone Virgilio Brunetti Stefania Sabella Gabriele Maiorano andrea Falqui GiovanniBertoni Roberto Cingolani Italian Institute of Technology Center for Bio-Molecular Nanotechnology Via Barsanti 1-73010 Arnesano （Lecce） Italy Italian Institute of Technology Central Research Laboratories Via Morego 30-16136 Genova Italy

The growing use of nanomaterials in commercial goods and novel technologies is generating increasing questions about possible risks for human health and environment, due to the lack of an in-depth assessment of their potential toxicity. In this context, we investigated the effects of citrate-capped gold nanoparticles （AuNPs） on the model system Drosophila melanogaster upon ingestion. We observed a significant in vivo toxicity of AuNPs, which elicited clear adverse effects in treated organisms, such as a strong reduction of their life span and fertility, presence of DNA fragmentation, as well as a significant overexpression of the stress proteins. Transmission electron microscopy demonstrated the localization of the nanoparticles in tissues of Drosophila. The experimental evidence of high in vivo toxicity of a nanoscale material, which is widely considered to be safe and biocompatible in its bulk form, opens up important questions in many fields, including nanomedicine, material science, health, drug delivery and risk assessment.

关键词： Nanoparticles nanotoxicology gold in vivo studies

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Proton pump inhibitors in cirrhosis:Tradition or evidence based practice?

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World Journal of Gastroenterology 2008年第19期14卷 2980-2985页

作者： Francesca Lodato Francesco Azzaroli Maria Di Girolamo Valentina Feletti paolo Cecinato andrea Lisotti Davide Festi Enrico Roda Giuseppe Mazzella Department of Internal Medicine and Gastroenterology Gastroenterology UnitUniversity of Bologna

Proton Pump Inhibitors (PPI) are very effective in inhibiting acid secretion and are extensively used in many acid related diseases. They are also often used in patients with cirrhosis sometimes in the absence of a specific acid related disease, with the aim of preventing peptic complications in patients with variceal or hypertensive gastropathic bleeding receiving multidrug treatment. Contradicting reports support their use in cirrhosis and evidence of their efficacy in this condition is poor. Moreover there are convincing papers suggesting that acid secretion is reduced in patients with liver cirrhosis. With regard to Helicobacter pylori (H pylori) infection, its prevalence in patients with cirrhosis is largely variable among different studies, and it seems that H pylori eradication does not prevent gastro-duodenal ulcer formation and bleeding. With regard to the prevention and treatment of oesophageal complications after banding or sclerotherapy of oesophageal varices, there is little evidence for a protective role of PPI. Moreover, due to liver metabolism of PPI, the dose of most available PPIs should be reduced in cirrhotics. In conclusion, the use of this class of drugs seems more habit related than evidence- based eventually leading to an increase in health costs.

关键词： Proton pump inhibitors Cirrhosis H pylori Peptic ulcer CYP P450

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The treatment of nerve defects

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Plastic and Aesthetic Research 2023年第1期10卷 430-442页

作者： paolo Titolo andrea Fanecco Department of Hand Surgery Azienda Ospedaliero-Universitaria Cittàdella Salute e della Scienza di TorinoTurin 10126Italy

Among the many challenges that the hand surgeon has to face in his daily work,nerve defects of the hand represent one of the hardest;unsatisfactory results in their treatment may cause severe limitations for the patient’s social and working *** advances have been made over the years in the treatment of such conditions,and at the current state,surgical treatment can achieve satisfactory *** article aims to review the current concepts in hand innervation and nerve pathophysiology and to describe traditional and novel surgical techniques currently employed to correct these defects.

关键词： Peripheral nerve nerve injury hand surgery microsurgery

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Robotic liver surgery is the optimal approach as bridge to transplantation

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World Journal of Hepatology 2017年第4期9卷 224-226页

作者： paolo Magistri Giuseppe Tarantino Roberto Ballarin andrea Coratti Fabrizio Di Benedetto Department of Medical and Surgical Sciences and Translational Medicine Sapienza - University of Rome Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit University of Modena and Reggio Emilia Department of Oncology Division of Oncological and Robotic General Surgery Careggi University Hospital

The role of minimally invasive liver surgery as a bridge to transplantation is very promising but still underestimated. However, it should be noted that surgical approach for hepatocellular carcinomas(HCC) is not merely a technical or technological issue. Nowadays, the epidemiology of HCC is evolving due to the increasing role of non-alcoholic fatty-liver-disease, and the emerging concerns on direct-acting antivirals against hepatitis C virus in terms of HCC incidence. Therefore, a fully multidisciplinary study of the cirrhotic patient is currently more important than ever before, and the management of those patients should be reserved to tertiary referral hepatobiliary centers. In particular, minimally invasive approach to the liver showed several advantages compared to the classical open procedure, in terms of:(1) the small impact on abdominal wall;(2) the gentle manipulation on the liver;(3) the limited surgical trauma; and(4) the respect of venous shunts. Therefore, more direct indications should be outlined also in the Barcelona Clinic Liver Cancer model. We believe that treatment of HCC in cirrhotic patients should be reserved to tertiary referral hepatobiliary centers, that should offer patient-tailored approaches to the liver disease, in order to provide the best care for each case, according to the individual comorbidities, risk factors, and personal quality of life expectations.

关键词： Hepatocellular carcinomas Liver transplant Robotic surgery Bridge to transplantation Da vinci Barcelona Clinic Liver Cancer Patient safety

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Heavy cigarette smoking and alcohol consumption are associated with impaired sperm parameters in primary infertile men

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Asian Journal of Andrology 2019年第5期21卷 478-485页

作者： Luca Boeri paolo Capogrosso Eugenio Ventimiglia Filippo Pederzoli Walter Cazzaniga Francesco Chierigo Federico Deho Emanuele Montanari Francesco Montorsi andrea Salonia Division of Experimental Oncology/Unit of Urology URIIRCCS San Raffaele HospitalMilan 20132Italy Department of Urology Foundation IRCCS Ca'Granda Maggiore Policlinico HospitalUniversity of MilanMilan 20122Italy University Vita-Salute San Raffaele Milan 20132Italy

We assessed the concomitant impact of cigarette smoking and alcohol con sumption in men presenting for primary couple's *** from 189 in fertile men were an a *** analysis,serum hormones,and sperm DNA fragmentation(SDF)were *** status was categorized as follows:current nonsmoker(-S),moderate smoker(+MS),and heavy smoker(+HS).Alcohol consumption was categorized as follows:abstainer(-D),moderate drinker(+MD),and heavy drinker(+HD).Descriptive statistics and logistic regression models were *** all the participants,132(69.8%),30(15.9%),and 27(14.3%)patients were-S,+MS,and+HS,*** addition,67(35.4%),77(40.7%)and 45(23.8%)men were-D,+MD and+HD,*** concomitant habits,52(27.5%)patients were nonsmokers and abstainers(-S/-D:Group 1),91(48.1%)had at least one recreational habit(-S/+D or+S/-D:Group 2),and 46(24.3%)were both smokers and drinkers(+S/+D:Group 3).Sperm concentration and progressive motility were lower in+HS and+HD,compared with-S and-D(all P<0.05),***,both parameters were significantly lower in Group 3 than Groups 1 and 2(all P<0.05).SDF values were higher in Group 3 than Groups 1 and 2(both P<0.05).In multivariate analysis,follicle-stimulating hormone(FSH)levels and concomitant+S/+D status were independent predictors of impaired sperm concentration and progressive motility(all P<0.05).Heavy smoking and heavy drinking were associated with worse seminal parameters than moderate smoking/drinking and nonsmoking/*** concomitant,+S/+D status has an even greater detrimental effect on semen parameters.

关键词： alcohol con sumption cigarette smoki ng in fertility risk factors seme n an alysis

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Impact of seed amplification assay and surface-enhanced Raman spectroscopy combined approach on the clinical diagnosis of Alzheimer’s disease

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Translational Neurodegeneration 2023年第1期12卷 416-427页

作者： Cristiano D’andrea Federico Angelo Cazzaniga Edoardo Bistaffa andrea Barucci Marella de Angelis Martina Banchelli Edoardo Farnesi Panagis Polykretis Chiara Marzi Antonio Indaco Pietro Tiraboschi Giorgio Giaccone paolo Matteini Fabio Moda Institute of Applied Physics“Nello Carrara” National Research Council50019 Sesto FiorentinoItaly Division of Neurology 5 and Neuropathology Fondazione IRCCS Istituto Neurologico Carlo Besta20133 MilanItaly Institute of Physical Chemistry(IPC)and Abbe Center of Photonics(ACP) Friedrich Schiller University Jena07743 JenaGermany Leibniz Institute of Photonic Technology 07745 JenaGermany

Background The current diagnosis of Alzheimer’s disease(AD)is based on a series of analyses which involve clinical,instrumental and laboratory ***,signs,symptoms and biomarker alterations observed in AD might overlap with other dementias,resulting in *** Here we describe a new diagnostic approach for AD which takes advantage of the boosted sensitivity in biomolecular detection,as allowed by seed amplification assay(SAA),combined with the unique specificity in biomolecular recognition,as provided by surface-enhanced Raman spectroscopy(SERS).Results The SAA-SERS approach supported by machine learning data analysis allowed efficient identification of pathological Aβoligomers in the cerebrospinal fluid of patients with a clinical diagnosis of AD or mild cognitive impairment due to *** Such analytical approach can be used to recognize disease features,thus allowing early stratification and selection of patients,which is fundamental in clinical treatments and pharmacological trials.

关键词： Alzheimer’s disease Amyloid-βprotein Seed amplification assay Surface-enhanced Raman spectroscopy

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***-term recovery of normal sexual function in lesticular cancer survivors

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Asian Journal of Andrology 2016年第1期18卷 85-89页

作者： paolo Capogrosso Luca Boeri Matteo Ferrari Eugenio Ventimiglia Giovanni La Croce Umberto Capitanio Alberto Briganti Rocco Damiano Francesco Montorsi andrea Salonia Universita Vita-Salute San Raffaele Milan Italy Division of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele Milan Italy Research Doctorate Program in Urology Magna Graecia University Catanzaro Italy

Testicular cancer （TC） is the most common solid cancer in men between the third and fourth decade of life. Due to successful treatment approaches, TC survivors （TCSs） have long life expectancy, but with numerous potential long-term sequelae, including sexual dysfunction. We investigated predictors of long-term normal sexual function （SF） recovery in TCSs. Sociodemographic, medical, and psychometric data were analyzed in 143 Caucasian-European TCSs, who underwent orchiectomy at a single institution. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI）. Patients completed the International Index of Erectile Function （IIEF）. Statistical models tested the association between predictors （including age at surgery, body mass index, CCI, and adjuvant therapy： radiotherapy [RT], chemotherapy [CT], CT followed by retroperitoneal lymph node dissection [RPLND] and RPLND alone） and the long-term recovery of normal SF （defined as IIEF-erectile function [EF] ≥26, and sexual desire [SD], intercourse satisfaction [IS] orgasmic function [OF], and overall satisfaction [OS] domain scores in the upper tertiles）. At a mean follow-up of 86 months, 35 （25.5%） TCSs had erectile dysfunction （ED）, with 16 （11.2%） experiencing severe ED. Median time of EF recovery was 60, 60, and 70 months after CT, RT, and RPLND, respectively. Only adjuvant RT emerged as an independent predictor of nonrecovery of normal EF （HR： 0.55, P = 0.01）. Neither adjuvant CT nor CT plus RPLND or RPLND alone significantly impaired the recovery of normal erections. Adjuvant therapy was not associated with impaired recovery of normal sexuality as a whole, considering the IIEF-SD, -OF, -IS, and OS domains.

关键词： chemotherapy erectile dysfunction radiotherapy retroperitoneal lymph node dissection survivors testicular cancer

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Metabolic syndrome in White-European men presenting for secondary couple＇s infertility： an investigation of the clinical and reproductive burden

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Asian Journal of Andrology 2017年第3期19卷 368-373页

作者： Eugenio Ventimiglia paolo Capogrosso Alessandro Serino Luca Boeri Michele Colicchia Giovanni La Croce Roberta Scano Enrico Papaleo Rocco Damiano Francesco Montorsi andrea Salonia Division of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele 20132 Milan Italy University Vita-Salute San Raffaele 20132 Milan Italy Infertility Unit Unit of Obstetrics/Gynecology IRCCS Ospedale San Raffaele 20132 Milan Italy Research Doctorate Program in Urology Magna Graecia University 88020 Catanzaro Italy.

We aimed to determine the impact of metabolic syndrome （MetS） on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demographic, clinical, and laboratory data from 167 consecutive secondary infertile men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI; categorised 0 vs I vs 2 or higher）. NCEP-ATP III criteria were used to define MetS. Semen analysis values were assessed based on the 2010 World Health Organization （WHO） reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. MetS was found in 20 （12%） of 167 men. Patients with MetS were older （P 〈 0.001） and had a greater BMI （P 〈 0.001） compared with those without MetS. MetS patients had lower levels of total testosterone （P = 0.001）, sex hormone-binding globulin, inhibin B, and anti-MOIlerian hormone （all P 〈 0.03）, and they were hypogonadal at a higher prevalence （P = 0.01） than patients without MetS. Moreover, MetS patients presented lower values of semen volume, sperm concentration, and sperm normal morphology （all P≤0.03）. At multivariate logistic regression analysis, no parameters predicted sperm concentration, normal sperm morphology, and total progressive motility. Our data show that almost 1 of 8 White-European men presenting for secondary couple＇s infertility is diagnosed with MetS. MetS was found to be associated with a higher prevalence of hypogonadism, decreased semen volume, decreased sperm concentration, and normal morphology in a specific cohort of White-European men.

关键词： infertility metabolic syndrome sperm count

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