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Laparoscopic and robot-assisted laparoscopic digestivesurgery:Present and future directions

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World Journal of gastroenterology 2016年第6期22卷 1975-2004页

作者： Juan C Rodríguez-Sanjuán Marcos gómez-Ruiz Soledad Trugeda-Carrera Carlos Manuel-Palazuelos Antonio López-Useros Manuel gómez-fleitas department of general Surgery University Hospital Marqués de Valdecilla39008 SantanderSpain department of medical and surgical sciences University of Cantabria39010 SantanderSpain

Laparoscopic surgery is applied today worldwide to most digestive procedures. In some of them, such as cholecystectomy, Nissen's fundoplication or obesity surgery, laparoscopy has become the standard in practice. In others, such as colon or gastric resection, the laparoscopic approach is frequently used and its usefulness is unquestionable. More complex procedures, such as esophageal, liver or pancreatic resections are, however, more infrequently performed, due to the high grade of skill necessary. As a result, there is less clinical evidence to support its implementation. In the recent years, robot-assisted laparoscopic surgery has been increasingly applied, again with little evidence for comparison with the conventional laparoscopic approach. This review will focus on the complex digestive procedures as well as those whose use in standard practice could be more controversial. Also novel robot-assisted procedures will be updated.

关键词： Laparoscopy Robotic surgery Colectomy Esophagectomy gastrectomy Obesity surgery Liverresection Pancreatectomy Laparoscopic training

Hyperthermic intraperitoneal chemotherapy and colorectal cancer:from physiology to surgery

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World Journal of Clinical Cases 2022年第30期10卷 10852-10861页

作者： giorgio Ammerata Rosalinda filippo Carmelo Laface Riccardo Memeo Leonardo Solaini Davide Cavaliere giuseppe Navarra girolamo Ranieri giuseppe Currò Michele Ammendola department Digestive Surgery UnitUniversity“Magna Graecia”Medical SchoolCatanzaro 88100Italy Interventional Oncology Unit with Integrated Section of Translational medical Oncology National Cancer Research Centre“Giovanni Paolo Ⅱ”Bari 70124Italy Hepato-Biliary and Pancreatic surgical Unit “F.Miulli”HospitalAcquaviva delle FontiBari 70124Italy department of medical and surgical sciences University of BolognaForlì40126Italy department of general and Oncologic Surgery Morgagni-Pierantoni HospitalForlì47121Italy department of Human Pathology of Adult and Evolutive Age Surgical Oncology Division“G.Martino”HospitalUniversity of MessinaMessina 98122Italy

The pursuit of this paper is to collect principal reviews and systematic reviews about hyperthermic intraperitoneal chemotherapy(HIPEC) and cytoreductive surgery(CRS) used in colorectal cancer(CRC).We focus on principal biological aspects of CRC,hyperthermia effects,and surgical *** searched PubMed/MEDLINE for the principal reviews and systematic reviews published from 2010 to 2021 regarding the bimodal treatment(CRS + HIPEC) against local and advanced *** the literature,from several studies,it seems that the efficacy of bimodal treatment with an accurate CRS can extend overall *** these studies,there are not still any straight guidelines more detailed and scheduled about the use of combined treatment in patients with *** if the concept is still not very clear and shared,after a careful evaluation of the published data,and after some technical and pathophysiological descriptions,we concluded that it is possible to improve the overall survival and quality of life and to reduce the tumor relapse in patients affected by locally advanced(pT4) CRC with peritoneal metastases.

关键词： Hyperthermic intraperitoneal chemotherapy Colorectal cancer Peritoneum Cytoreductive surgery

g-CSf is a key modulator of MDSC and could be a potential therapeutic target in colitis-associated colorectal cancers

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Protein & Cell 2016年第2期7卷 130-140页

作者： Wenbin Li Xinghua Zhang Yongkang Chen Yibin Xie Jiancheng Liu Qiang feng Yi Wang Wei Yuan Jie Ma State Key Laboratory of Molecular Oncology Cancer Hospital Chinese Academy of Medical Sciences Peking Union MedicalCollege Beijing 100021 China department of Abdominal surgical Oncology Cancer Hospital Chinese Academy of Medical Sciences Peking UnionMedical College Beijing 100021 China department of VIP Cancer Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing 100021China

granulocyte colony-stimulating factor （g-CSf） is an essential regulator of neutrophil trafficking and is highly expressed in multiple tumors. Myeloid derived suppressor cells （MDSCs） promote neoplastic progression through multiple mechanisms by immune suppression. Despite the findings of g-CSf function in colon cancer progression, the precise mechanism of g-CSf on MDSCs regulation and its blockade effects on tumor growth remains a worthy area of investigation. In this study we observed an overexpression of g-CSf in a mouse colitis-associated cancer （CAC） model, which was consistent with the accumulation of MDSCs in mouse colon tissues. further in vitro studies demonstrated that g-CSf could promote MDSCs survival and activation through signal transducer and activator of transcription 3 （STAT3） signaling pathway. Moreover, compared with isotype control, anti-g-CSf mAb treatment demonstrated reduced MDSC accumulation, which led to a marked decrease in neoplasm size and number in mice. Our results indicated that g-CSf is a critical regulating molecule in the migration, proliferation and function maintenance of MDSCs, which could be a potential therapeutic target for cancer.

关键词： inflammation cancer granulocyte colony-stimulating factor myeloid derived suppressor cells

Portugal's first major forensic case and the genesis of forensic toxicology:10 years of research to reconstruct the event

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forensic sciences Research 2019年第1期4卷 69-81页

作者： Ricardo Jorge Dinis-Oliveira department of sciences IINFACTS–Institute of Research and Advanced Training in Health Sciences and TechnologiesUniversity Institute of Health Sciences(IUCS)CESPUCRLGandraPortugal UCIBIO-REQUIMTE Laboratory of ToxicologyDepartment of Biological SciencesFaculty of PharmacyUniversity of PortoPortoPortugal department of Public Health and forensic sciences and Medical EducationFaculty of MedicineUniversity of PortoPortoPortugal

The"Crime of flores Street"is one of the most famous cases of poisoning to divide public opinion in Portugal in the late 19th century, and it also demonstrated the weaknesses of the Portuguese medicolegal system and attested to the importance of toxicological analysis. Vicente Urbino de freitas was a prominent doctor, graduating from the faculty of Medicine of the University of Coimbra in 1875. He later became Professor of Physiology at the Porto medical-surgical School and author of a number of books on leprosy. In 1877, he married Maria das Dores Basto Sampaio freitas, and this was followed by the death of a number of her close relatives in suspicious circumstances, notably her brother José António Sampaio Junior and nephew Mário guilherme Augusto de Sampaio. This review aims to retell the story of Portugal's first significant medicolegal case as well as the accompanying judicial drama that gave birth to forensic Toxicology in Portugal and prompted the medicolegal organization that exists today. This research was carried out over a 10-year period and repre-sents undeniable historical value given the rarity of the facts compiled. At the heart of this forensic case was the use of toxicological analyses in court for which the Chemist Antònio Joaquim ferreira da Silva played a key role. This toxicological report revealed high concen-trations of morphine, delphinine and narceine in viscera and in Mario's urine. The Mario's cause of death was attributed to poisoning by opium alkaloids. Despite the strong judicial evidence, doubts still remains as to whether Vicente Urbino de freitas was a"monster"or a victim of circumstances and a hapless martyr.

关键词： forensic sciences forensic toxicology Vicente Urbino de freitas António Joaquim ferreira da Silva medical-surgical School Mário guilherme Augusto de Sampaio

genetic analysis of Italian patients with congenital tufting enteropathy

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世界儿科杂志:英文版 2016年第2期12卷 219-224页

作者： Maria d'Apolito Daniela Pisanelli flavio faletra Ida giardino Maddalena gigante Massimo Pettoello-Mantovani Olivier goulet Paolo gasparini Angelo Campanozzi Unit of Pediatrics Department of Medical and Surgical SciencesUniversity of FoggiaItaly Institute for Maternal and Child Health-IRCCS"Burlogarofolo" TriesteItaly Laboratory Medicine Department of Clinical and Experimental MedicineUniversity of FoggiaFoggiaItaly department of medical and surgical sciences University of FoggiaFoggiaItaly department of Pediatric gastroenterology-Hepatology and Nutrition and Reference Center for Rare Digestive Disease Hopital Necker-EnfantsMaladesParisFrance

Background:Congenital tufting enteropathy(CTE),an inherited autosomal recessive rare disease,is a severe diarrhea of infancy which is clinically characterized by absence of infl ammation and presence of intestinal villous *** in the EpCAM gene were identified to cause *** cases of syndromic tufting enteropathy harboring the SPINT2(19q13.2)mutation were ***:four CTE Italian patients were clinically and immunohistochemically *** DNA sequencing of EpCAM and SPINT2 genes was ***:All patients were of Italian *** different mutations were detected(***219Metfs*15,Tyr186Phefs*6 and ***146Asn)in the EpCAM gene;one of them is novel(***146Asn).Two patients(P1 and P2)showed compound heterozygosity revealing two mutations in separate alleles.A third patient(P3)was heterozygous for only one novel EpCAM missense mutation(***146Asn).In a syndromic patient(P4),no deleterious EpCAM mutation was *** SPINT2 mutational analysis was performed.P4 showed a homozygous SPINT2 mutation(p.Y163C).No SPINT2 mutation was found in ***7 was also evaluated as a candidate gene by mutational screening in P3 but no mutation was identifi ***:This study presented a molecular characterization of CTE Italian patients,and identified three mutations in the EpCAM gene and one in the SPINT2 *** of EpCAM mutations was novel,therefore increasing the mutational spectrum of allelic variants of the EpCAM *** analysis of the SPINT2 gene also allowed us to identify a SPINT2 substitution mutation(c.488A>g)recently found to be associated with syndromic CTE subjects.

关键词： diarrhea gastroenterology gene mutation

Detection of ALK translocation in non-small cell lung carcinoma(NSCLC) and its clinicopathological significance using the Ventana immunohistochemical staining method: a single-center large-scale investigation of 1,504 Chinese Han patients

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Chinese Journal of Cancer Research 2016年第5期28卷 495-502页

作者： Lin Yang Yun Ling Lei guo Di Ma Xuemin Xue Bingning Wang Junling Li Jianming Ying department of Pathology Cancer HospitalChinese Academy of Medical Sciences Internal department Cancer HospitalChinese Academy of Medical Sciences

Objective： The novel fully automated immunohistochemistry （IHC） assay-Ventana anaplastic lymphoma kinase （ALK）-DSf3 for screening ALK rearrangements has been approved by China＇s food and Drug Administration in 2013, our previous study disclosed a highly specificity and sensitivity nearly 100%, and its efficacy needs to be evaluated in a large cohort of primary lung adenocarcinoma patients, and to compare clinicopathological features with ALK （＋） and ALK （-） lung ***： A total of 1,504 consecutive surgical lung adenocareinoma eases of Chinese Han population were collected and re-diagnosed according to the 2011 multidisciplinary classification of lung adenocarcinoma. fully automated Ventana ALK-D5f3 IHC staining with a binary scoring was adopted to evaluate staining and correlated with dinieopathologieal characters, including age, sex, differentiation degree, histological subtype, lymph node metastasis, and clinical staging. ALK （＋） patients were followed-up, and targeted therapy of ALKinhibitors was adopted and observed in patients with stage IV according to the NCCN ***： ALK positive adenocarcinomas were identified in 6.6% of the surgically resected 1,504 NSCLCs, and significantly younger than the negative group （P〈0.05）.Mucinous adenocarcinoma （28.2%） was determined to be predominant in ALK （＋） cases, followed by the solid type （11.7%）, specific type （6.8%）, papillary type （5.6%）, acinar type （5.5%）, and lepidic type （3.1%）, and the differences were statistically significant （χ2=42.01 1, P〈0.05）. ALK （＋） adenocarcinoma with lymph node metastasis （10.8%） were significantly higher than that without lymph node metastasis （4.5%）（g2=19.809, P〈0.05）; and ALK （＋） in phase Ⅳ （20%） was significantly higher than phaseⅢ （12.9%）, phase Ⅱ （4.2%）, phase Ⅰ （4.5%）, and phase 0 （0）（g2=36.068, P〈0.05）. Multivariate logistic regression disclosed that patient age, AJCC staging, and histological mucinous subtype were correlated with ALK positive staini

关键词： Anaplastic lymphoma kinase (ALK) rearrangements fully automated immunohistochemistry (IHC) clinicopathological analysis targeted therapy

gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?

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World Journal of gastroenterology 2017年第13期23卷 2269-2275页

作者： fabrizio Rebecchi Marco E Allaix Marco g Patti francisco Schlottmann Mario Morino department of surgical sciences University of Torino Center for Esophageal Diseases and Swallowing University of North Carolina

Laparoscopic sleeve gastrectomy(LSg) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight loss results and effects on comorbid conditions. However, there are concerns regarding the effects of LSg on gastroesophageal reflux disease(gERD). The interpretation of the current evidence is challenged by the fact that the LSg technique is not standardized, and most studies investigate the presence of gERD by assessing symptoms and the use of acid reducing medications only. A few studies objectively investigated gastroesophageal function and the reflux profile by esophageal manometry and 24-h p H monitoring, reporting postoperative normalization of esophageal acid exposure in up to 85% of patients with preoperative gERD, and occurrence of de novo gERD in about 5% of cases. There is increasing evidence showing the key role of the surgical technique on the incidence of postoperative gERD. Main technical issues are a relative narrowing of the mid portion of the gastric sleeve, a redundant upper part of the sleeve(both depending on the angle under which the sleeve is stapled), and the presence of a hiatal hernia. Concomitant hiatal hernia repair is recommended. To date, either medical therapy with proton pump inhibitors or conversion of LSg to laparoscopic Rouxen-Y gastric bypass are the available options for the management of gERD after LSg. Recently, new minimally invasive approaches have been proposed in patients with gERD and hypotensive LES: the LINX? Reflux Management System procedure and the Stretta? procedure. Large studies are needed to assess the safety and long-term efficacy of these new approaches. In conclusion, the recent publication of p H monitoring data and the new insights in the association between sleeve morphology and gERD control have led to a wider acceptance of LSg as bariatric procedure also in obese patients with gERD, as recently stated in the 5^(th) International Consensus Con

关键词： Sleeve gastrectomy gastroesophageal reflux Morbid obesity Ambulatory p H monitoring Esophageal manometry

Wingless/It/β-catenin signaling in liver metastasis from colorectal cancer:A focus on biological mechanisms and therapeutic opportunities

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World Journal of gastroenterology 2023年第18期29卷 2764-2783页

作者： federico Selvaggi Teresa Catalano Rossano Lattanzio Roberto Cotellese gitana Maria Aceto department of surgical ASL2 Lanciano-Vasto-ChietiOspedale Clinicizzato SS Annunziata of ChietiChieti 66100Italy department of Clinical and Experimental Medicine University of MessinaMessina 98125Italy department of Innovative technologies in Medicine&Dentistry University“G.d’Annunzio”Chieti-PescaraChieti 66100Italy department of medical Oral and Biotechnological SciencesUniversity“G.d’Annunzio”Chieti-PescaraChieti 66100Italy Villa Serena foundation for Research Villa Serena-Del Dott.L.PetruzziCittàSant’Angelo 65013PescaraItaly department of medical Oral and Biotechnological Sciences“G.d’Annunzio”University of Chieti-PescaraChieti 66100Italy

The liver is the most common site of metastases in patients with colorectal *** liver metastases(CRLMs)are the result of molecular mechanisms that involve different cells of the liver *** aberrant activation of Wingless/It(Wnt)/β-catenin signals downstream of Wnt ligands initially drives the oncogenic transformation of the colon epithelium,but also the progression of metastatization through the epithelial-mesenchymal transition/mesenchymalepithelial transition *** liver microenvironment,metastatic cells can also survive and adapt through dormancy,which makes them less susceptible to pro-apoptotic signals and *** of CRLMs is challenging due to its variability and *** in surgery and oncology have been made in the last decade and a pivotal role for Wnt/β-catenin pathway has been recognized in *** the state of art,there is a lack of clear understanding of why and how this occurs and thus where exactly the opportunities for developing anti-CRLMs therapies may *** this review,current knowledge on the involvement of Wnt signaling in the development of CRLMs was *** addition,an overview of useful biomarkers with a revision of surgical and non-surgical therapies currently accepted in the clinical practice for colorectal liver metastasis patients were provided.

关键词： Wingless/It/β-catenin signaling Colorectal cancer Epithelial-mesenchymal transition/mesenchymal-epithelial transition Liver metastasis Markers surgical and non-surgical therapies

Circulating tumor DNAs and non-coding RNAs as potential biomarkers for hepatocellular carcinoma diagnosis, prognosis and response to therapy

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Hepatoma Research 2019年第2期5卷 12-33页

作者： Paola guerriero farzaneh Moshiri Laura Lupini Silvia Sabbioni Massimo Negrini Elisa Callegari department of Morphology Surgery and Experimental MedicineUniversity of FerraraFerrara 44121Italy department of Molecular Medicine School of Advanced Technologies in MedicineTehran University of Medical SciencesTehran 11369Iran department of Life sciences and Biotechnologies University of FerraraFerrara 44121Italy

Hepatocellular carcinoma(HCC)is the second leading cause of cancer-related deaths worldwide and despite improvement in therapeutic approaches,prognosis remains *** can be partly attributed to the fact that the majority of HCCs are diagnosed at intermediate or advanced *** of circulating biomarkers able to detect HCC at early stages could improve patients'*** present,however,alpha fetoprotein or des-g-carboxyprothrombin are unable to reliably detect HCC at early stages and better circulating biomarkers are *** tumor DNA(ctDNA)and non-coding RNAs(ncRNAs)are emerging as promising biomarkers to achieve the *** and epigenetic alterations in ctDNA allow to pinpoint tumor-specific biomarkers,reveal tumor heterogeneity,help monitor tumor evolution over time and assess therapy *** remains to be fully evaluated the possibility of detecting these biomarkers at early tumor *** ncRNAs are quantitative biomarkers with potential use in diagnostic,prognostic and predictive clinical *** may help to reveal HCC at early ***,because of heterogeneous and sometimes conflicting reported results,they still require validation and standardization of pre-analytical and analytical approaches before clinical applications could be envisaged.

关键词： Liquid biopsy hepatocellular carcinoma circulating tumor DNA non-coding RNA diagnosis prognosis therapy response