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Assessing risks for gastric cancer: New tools for pathologists

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World Journal of Gastroenterology 2006年第35期12卷 5622-5627页

作者： Robert M Genta Massimo Rugge Department of Pathology University of Texas Southwestern Medical Center at Dallas Texas United states Department of oncological and Surgical Sciences University of Padova Italy

Although the Sydney Systems (original and updated) for the classification of gastritis have contributed substantially to the uniformity of the reporting of gastric conditions, they lack immediacy in conveying to the user information about gastric cancer risk. In this review, we summarize the current understanding of the gastric lesions associated with an increased risk for cancer, and present the rationale for a proposal for new ways of reporting gastritis. In addition to the traditional histopathological data gathered and evaluated according to the Sydney System rules, pathologists could add an assessment expressed as grading and staging of the gastric inflammatory and atrophic lesions and integrate these findings with pertinent laboratory information on pepsinogens and gastrin levels. Such an integrated report could facilitate clinicians’ approach to the management of patients with gastric conditions.

关键词： Gastritis Staging and grading Gastritis Histology

Ginsenoside Rd inhibits apoptosis following spinal cord ischemia/reperfusion injury

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Neural Regeneration Research 2014年第18期9卷 1678-1687页

作者： Baogang Wang Qingsan Zhu Xiaxia Man Li Guo Liming Hao Department of Cardiac surgery First Hospital of Jilin University Department of Orthopedics China-Japan Union Hospital of Jilin University Department of oncological Gynecology First Hospital of Jilin University Department of Toxicology School of Public HealthJilin University Department of Histology and Embryology College of Basic Medical SciencesJilin University

Ginsenoside Rd has a clear neuroprotective effect against ischemic stroke. We aimed to verify the neuroprotective effect of ginsenoside Rd in spinal cord ischemia/reperfusion injury and explore its anti-apoptotic mechanisms. We established a spinal cord ischemia/reperfusion injury model in rats through the occlusion of the abdominal aorta below the level of the renal artery for 1 hour. Successfully established models were injected intraperitoneally with 6.25, 12.5, 25 or 50 mg/kg per day ginsenoside Rd. Spinal cord morphology was observed at 1, 3, 5 and 7 days after spinal cord ischemia/reperfusion injury. Intraperitoneal injection of ginsenoside Rd in ischemia/reperfusion injury rats not only improved hindlimb motor function and the morphology of motor neurons in the anterior horn of the spinal cord, but it also reduced neuronal apoptosis. The optimal dose of ginsenoside Rd was 25 mg/kg per day and the optimal time point was 5 days after ischemia/ reperfusion. Immunohistochemistry and western blot analysis showed ginsenoside Rd dose-de- pendently inhibited expression of pro-apoptotic Caspase 3 and down-regulated the expression of the apoptotic proteins ASK1 and JNK in the spinal cord of rats with spinal cord ischemia/reper- fusion injury. These findings indicate that ginsenoside Rd exerts neuroprotective effects against spinal cord ischemia/reperfusion injury and the underlying mechanisms are achieved through the inhibition of ASK1-JNK pathway and the down-regulation of Caspase 3 expression.

关键词： nerve regeneration spinal cord injury ginsenoside Rd ischemia/reperfusion injury apoptosis ASKI INK Caspase 3 neural regeneration

SSIs in Italy: Prevention and Surveillance during the Last Five Years

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Surgical Science 2015年第8期6卷 383-394页

作者： Carlo de Werra Sergio Aloia Rosa di Micco Roberto del Giudice Roberto Tramontano Francesco Mangani Ludovica Maria Esposito Gabriele di Filippo General surgery Oncological Geriatric Endocrine and Advanced Technology Department University of Naples “Federico II” Naples Italy

Surgical site infections (SSIs) are recognized as a common surgical complication, occurring in about 2% - 5% of all surgical procedures. For this reason, it is the second most common nosocomial infection, representing the 19.6% of all infections observed in hospitalized patients and 38% of those observed among surgical patients. Among SSIs prevention strategies, surveillance has been proved to be very incisive. The most recent surveillance study carried out at a national level in Italy is SNICh protocol (National Surveillance System of Surgical Site Infections), which analyses data received from 127 Italian hospitals, from the 2009 to 2011 and the entire 2013. The only application of a surveillance strategy, observing the recommended prophylaxis protocols, brought to a reduction of SSIs: their incidence has been shown to be comparable to European or American one. Furthermore, recent studies have brought strong evidence that the development of new devices, such as dressings impregnated with silver nanoparticles or triclosan-coated sutures, is strongly connected with the reduction of incidence of SSIs. In conclusion, if common preventive techniques were applied to all surgical procedures performed in the country, about 14,000 SSIs per year could be avoided with a possible savings after three years between 50 million and EUR 175 million euro.

关键词： Surgical Site Infections (SSIs) General surgery Infections Antibiotic Prophylaxis Prevention Surveillance

Influence of dietary isoflavone intake on gastrointestinal symptoms in ulcerative colitis individuals in remission

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World Journal of Gastroenterology 2017年第29期23卷 5356-5363页

作者： Dominika Glabska Dominika Guzek Dominika Grudzińska Gustaw Lech Department of Dietetics Faculty of Human Nutrition and Consumer SciencesWarsaw University of Life Sciences(WULS-SGGW) Department of Organization and Consumption Economics Faculty of Human Nutrition and Consumer SciencesWarsaw University of Life Sciences(WULS-SGGW) Department of General Gastroenterological and Oncological SurgeryMedical University of Warsaw

To analyse the association between isoflavone intake and ulcerative colitis motility symptoms in individuals in remission. METHODSCross-sectional study was conducted in a group of ulcerative colitis remission individuals, in sub-groups characterised by various intestinal motility and functioning characteristics (abdominal pain, flatulence, constipations, tenesmus). Total of 56 individuals with ulcerative colitis in remission (19 males and 37 females) were recruited for the study. Assessment of diet was based on self-reported data from each patient’s dietary records taken over a period of three typical, random days (2 weekdays and 1 d of the weekend). The daily isoflavone intake (daidzein, genistein, glycitein and total isoflavones) and daily isoflavone intake per 1000 kcal of diet were assessed. RESULTSNo correlations between isoflavone intake levels and number of bowel movements per day were observed both in the case of intake and intake per 1000 kcal of diet. In the group of individuals declaring lack of abdominal pain, the higher intakes of daidzein (P = 0.0075), daidzein per 1000 kcal of diet (P = 0.0358) and total isoflavone (P = 0.0358) were stated, than in the group of individuals declaring abdominal pain. In the group of individuals declaring lack of constipations, the lower intakes of glycitein (P = 0.0213) and glycitein per 1000 kcal of diet (P = 0.0213) were stated, than in the group of individuals declaring presence of constipations. No differences were observed in isoflavone intake between groups of ulcerative colitis individuals declaring lack of flatulence and declaring presence of flatulence, as well as between groups declaring lack of tenesmus and declaring presence of tenesmus. CONCLUSIONThe moderate dietary isoflavone intake may be beneficial for individuals with ulcerative colitis in remission, however, before including it into recommendations, further prospective studies are needed.

关键词： Abdominal pain Constipations ulcerative colitis Daidzein Genistein Glycitein Isoflavone

Monosegment ALPPS hepatectomy preserving segment 4 for colorectal liver metastases:literature review and our experience

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Hepatobiliary surgery and Nutrition 2018年第2期7卷 105-115页

作者： Fiammetta Soggiu Francesco Giovinazzo Jack Straiton Giulia Turri Jim Phillips Bassam Al-Kari Irfan Ahmed Mohammad Habib Hepatobiliary and Pancreatic surgery unit NHS GrampianAberdeenUK Department of Radiology NHS GrampianAberdeenUK

Monosegment 4±1 Associating Liver Partition and Portal Vein ligation for Staged hepatectomy(ALPPS)for bilateral colorectal liver metastases decreases the risk of drop-out of two stage hepatectomy,triggering a rapid and significant increase in future liver remnant(FLR)with promising oncological *** report two cases of segment 4+1 monosegment ALPPS for multiple colorectal liver metastases performed at our *** the literature,seven similar cases have been *** and long term outcomes of our two patients were reported along with a review of data from the *** patients showed a FLR increase from 13%to 37%and from 14%to 41%of total liver volume,*** was compared to a median growth from 19%at baseline to 34%before stage 2,in the *** 20 and 27 months since resection both patients are alive and *** the literature,median overall survival and disease free survival were 13 months(range,5–24 months)and 5 months(range,3–23 months),*** 4±1 ALPPS is associated with promising oncological outcomes and a significant FLR *** may be safely performed in selected patients as a salvage procedure,reducing the risk of the dropout of two-stage hepatectomy.

关键词： Associating Liver Partition and Portal Vein ligation for Staged hepatectomy(ALPPS) liver resection colorectal liver metastases

Pancreatectomy with concomitant portal vein resection in the current neoadjuvant era

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Hepatobiliary surgery and Nutrition 2022年第2期11卷 295-298页

作者： Benedetto Ielpo Fernando Burdio Ana Martinez Patricia Sanchez-Velazquez Hepato-Biliary and Pancreatic surgery unit Hospital del MarUniversitat Pompeu FabraBarcelonaSpain

I’ve read with great interest the paper of Machairas et al.(1)which is of great interest for the oncological and surgical *** adenocarcinoma(PDAC)is still considered a malignancy with an extremely poor prognosis,being currently the 4th cause of death for cancer and,according to the Global Cancer Statistics in the next decade,it may ascend up to the third cause of death(2).During the last decades,there have been great efforts to improve survival of potentially resectable pancreatic cancer through several ***,the selection of patients:newer preoperative studies have been able to select those patients that might really benefit from ***,the surgical procedure itself improved its outcome:proper mesopancreatic dissection and lymphadenectomy,superior mesenteric artery approach and vascular resection have been able to enhance the R0 resection rate with acceptable morbidity(3).Finally,newer chemotherapies regimens have been introduced,as well,with relevant survival improvement(4).

关键词： resection death

Partial pancreatic tail preserving subtotal pancreatectomy forpancreatic cancer: Improving glycemic control and quality of lifewithout compromising oncological outcomes

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World Journal of Gastrointestinal surgery 2020年第12期12卷 491-506页

作者： Li You Lie Yao Yi-Shen Mao Cai-Feng Zou Chen Jin De-Liang Fu Department of Pancreatic surgery Huashan HospitalShanghai 200040China Department of Pancreatic surgery Huashan HospitalFudan UniversityShanghai 200040China Department of Pancreatic surgery Pancreatic Disease InstituteHuashan HospitalShanghai 200040China

BACKGROUND Total pancreatectomy (TP) is usually considered a therapeutic option forpancreatic cancer in which Whipple surgery and distal pancreatectomy areundesirable, but brittle diabetes and poor quality of life (QoL) remain majorconcerns. A subset of patients who underwent TP even died due to severehypoglycemia. For pancreatic cancer involving the pancreatic head and proximalbody but without invasion to the pancreatic tail, we performed partial pancreatictail preserving subtotal pancreatectomy (PPTP-SP) in selected patients, in order toimprove postoperative glycemic control and QoL without compromisingoncological *** To evaluate the efficacy of PPTP-SP for patients with pancreatic *** We retrospectively reviewed 56 patients with pancreatic ductal adenocarcinomawho underwent PPTP-SP (n = 18) or TP (n = 38) at our institution from May 2014to January 2019. Clinical outcomes were compared between the two groups, withan emphasis on oncological outcomes, postoperative glycemic control, and *** was evaluated using the European Organization for Research and Treatmentof Cancer Quality of Life Questionnaire (EORTC QLQ-C30 and EORTC PAN26).All patients were followed until May 2019 or until *** A total of 56 consecutive patients were enrolled in this study. Perioperativeoutcomes, recurrence-free survival, and overall survival were comparablebetween the two groups. No patients in the PPTP-SP group developed cancerrecurrence in the pancreatic tail stump or splenic hilum, or a clinical pancreaticfistula. Patients who underwent PPTP-SP had significantly better glycemiccontrol, based on their higher rate of insulin-independence (P = 0.014), lowerhemoglobin A1c (HbA1c) level (P = 0.046), lower daily insulin dosage (P < 0.001),and less frequent hypoglycemic episodes (P < 0.001). Global health was similar inthe two groups, but patients who underwent PPTP-SP had better functional status(P = 0.036), milder symptoms (P = 0.013), less severe diet restri

关键词： Partial pancreatic tail preserving subtotal pancreatectomy Total pancreatectomy Pancreatic cancer Treatment outcome Diabetes mellitus Quality of life

Differential diagnosis of pancreatic cancer by single-shot echo-planar imaging diffusion-weighted imaging

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World Journal of Gastroenterology 2015年第20期21卷 6374-6380页

作者： Ben-Zu Hong Xin-Feng Li Jian-Qing Lin Department of General surgery Second Affiliated Hospital of Fujian Medical University Department of oncological surgery Second Affiliated Hospital of Fujian Medical University

AIM: To investigate the diagnostic ability of single-shot echo-planar imaging(EPI) diffusion-weighted imaging (DWI) to differentiate between malignant and benign pancreatic lesions. METHODS: A computerized search was performed on Pub Med, MEDLINE and EMBASE up to August 2014. Nine studies(10 sets of data) with a total of 304 malignant pancreatic lesions and 188 benign pancreatic lesions were included. The characteristics of each study included the study name, year of publication, magnetic resonance modalities used, patient population, strength of field, pulse time, repetition time, echo time(TE), maximum b factor, mean age, mean body weight, fat suppression, number of benign and malignant lesions, and true positive, true negative, false positive and false negative results. All analyses were performed using Meta-Di Sc and Stata ***: The pooled sensitivity and specificity of singleshot EPI DWI were 0.83(95%CI: 0.79-0.87) and 0.77(95%CI: 0.70-0.83), respectively. The positive likelihood ratio and negative likelihood ratio were 5.09(95%CI: 2.19-11.84) and 0.23(95%CI: 0.15-0.36), respectively. The P value for the χ2 heterogeneity for all pooled estimates was 0.05). CONCLUSION: Single-shot EPI DWI is useful to differentiate between malignant and benign pancreatic lesions. Lesion size ≥ 2 cm is the limit for the diagnosis of early lesions.

关键词： Meta-analysis Single-shot echo-planarimaging Diffusion-weighted imaging Pancreatic cancer Differential diagnosis

Testicular fine needle aspiration as a diagnostic tool in nonobstructive azoospermia

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Asian Journal of Andrology 2005年第3期7卷 289-294,页

作者： A.Bettella A.Ferlin M.Menegazzo M.Ferigo I.M.Tavolini P.F.Bassi C.Foresta Department of Histology Microbiology and Medical BiotechnologiesCentre for Male Gamete Cryopreservation Department of Surgical and oncological Sciences Clinical UrologyUniversity of PadovaPadova 35121Italy

Aim： To report the fine needle aspiration cytology （FNAC） of the testes used as a diagnostic tool in non-obstructive azoospermic patients. Methods： One hundred and twenty-five non-obstructive azoospermic male candidates to intracytoplasmic sperm injetion （ICSI） were analysed for follicle stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone and inhibin B plasma levels. They were classified into three groups on the basis of FNAC： 1） Sertoli cell-only syndrome （SCOS）（70）; 2） severe hypospermatogenesis （42）; and 3） maturation arrest （13）, Then, all men underwent testicular sperm extraction （TESE） for sperm recovery for ICSI. Results： Mature spermatozoa were detected by FNAC in 24 of 42 men with severe hypospermatogenesis and nine of 13 men with maturation arrest; while they were retrieved by TESE in 29 of 70 men with SCOS, 35 of 42 men with severe hypospermatogenesis （including the 24 by FNAC） and 10 of 13 men with maturation arrest （including the nine by FNAC）. The sensitivity and specificity of FNAC were 44.6 % and 100 %, respectively. There was no difference on testicular volume and hormonal parameters in men with and without sperm retrieved. Conclusion： These findings suggest that FNAC may be a simple and valid diagnostic parameter in non-obstructive azoospermic men and it may represent a valid positive prognostic parameter for sperm recovery at TESE, （Asian J Androl 2005 Sep; 7： 289-294）

关键词： oligospermia fine needle aspiration diagnosis ICSI