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Role of osteoprotegerin/receptor activator of nuclear factor kappa B/receptor activator of nuclear factor kappa B ligand axis in nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2018年第19期24卷 2073-2082页

作者： Lucia Pacifico Gian Marco Andreoli Miriam D'Avanzo Delia De Mitri Pasquale Pierimarchi Policlinico Umberto I Hospital Sapienza University of Rome institute of Translational Pharmacology National Research Council

Concomitantly with the increase in the prevalences of overweight/obesity, nonalcoholic fatty liver disease(NAFLD) has worldwide become the main cause of chronic liver disease in both adults and children. Patients with fatty liver display features of metabolic syndrome(Met S), like insulin resistance(iR), glucose intolerance, hypertension and dyslipidemia. Recently, epidemiological studies have linked obesity, Met S, and NAFLD to decreased bone mineral density and osteoporosis, highlighting an intricate interplay among bone, adipose tissue, and liver. Osteoprotegerin(OPG), an important symbol of the receptor activator of nuclear factor-B ligand/receptor activator of nuclear factor kappa B/OPG system activation, typically considered for its role in bone metabolism, may also play critical roles in the initiation and perpetuation of obesityrelated comorbidities. Clinical data have indicated that OPG concentrations are associated with hypertension, left ventricular hypertrophy, vascular calcification, endothelial dysfunction, and severity of liver damage in chronic hepatitis C. Nonetheless, the relationship between circulating OPG and iR as a key feature of Met S as well as between OPG and NAFLD remains uncertain. Thus, the aims of the present review are to provide the existent knowledge on these associations and to discuss briefly the underlying mechanisms linking OPG and NAFLD.

关键词： Nonalcoholic fatty liver disease insulin resistance Metabolic syndrome Osteoprotegerin Receptor activator of nuclear factor kappa B Receptor activator of nuclear factor kappa B ligand

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Mediterranean diet and nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2018年第19期24卷 2083-2094页

作者： Caterina Anania Francesco Massimo Perla Francesca Olivero Lucia Pacifico Claudio Chiesa Policlinico Umberto I Hospital Sapienza University of Rome institute of Translational Pharmacology National Research Council

Nonalcoholic fatty liver disease(NAFLD) is emerging as the most common chronic liver disease, and is characterized by a wide spectrum of fat-liver disorders that can result in severe liver disease and cirrhosis. inflammation and oxidative stress are the major risk factors involved in the pathogenesis of NAFLD. Currently, there is no consensus concerning the pharmacological treatment of NAFLD. However, lifestyle interventions based on exercise and a balanced diet for quality and quantity, are considered the cornerstone of NAFLD management. Mediterranean diet(MD), rich in polyunsaturated fats, polyphenols, vitamins and carotenoids, with their anti-inflammatory and antioxidant effects, has been suggested to be effective in preventing cardiovascular risk factors. in adults, MD has also been demonstrated to be efficacious in reducing the risk of metabolic syndrome. However, few studies are available on the effects of the MD in both adult and pediatric subjects with NAFLD. Thus, the aims of the present narrative review are to analyze the current clinical evidence on the impact of MD in patients with NAFLD, and to summarize the main mechanisms of action of MD components on this condition.

关键词： Mediterranean diet children Nonalcoholic fatty liver disease adults

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Focus on limbal stem cell deficiency and limbal cell transplantation

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World Journal of Transplantation 2023年第6期13卷 321-330页

作者： Emanuele Tonti Gregorio Antonio Manco Leopoldo Spadea Marco Zeppieri Eye Clinic Policlinico Umberto I"Sapienza"University of RomeRome 00142Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy

Limbal stem cell deficiency(LSCD)causes severe vision impairment and can lead to blindness,representing one of the most challenging ocular surface disorders.Stem cell deficiency can be congenital or,more often,acquired.The categorization of ocular surface transplantation techniques is crucial to achieving treatment homogeneity and quality of care,according to the anatomic source of the tissue being transplanted,genetic source,autologous or allogenic transplantation(to reflect histocompatibility in the latter group),and cell culture and tissue engineering techniques.The aim of this minireview is to provide a summary of the management of LSCD,from clinical characteristics and therapeutic outcomes to the development of novel therapeutic approaches.The manuscript also briefly summarizes recent findings in the current literature and outlines the future challenges to overcome in the management of the major types of ocular surface failure.

关键词： Limbal stem cell deficiency Conjunctival limbal autograft Conjunctival limbal allograft Keratolimbal allograft Cultivated limbal epithelial transplantation Simple limbal epithelial transplantation

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Ascending aorta disruption after thoracic blunt trauma

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Chinese Journal of Traumatology 2020年第1期23卷 32-33页

作者： Francesco Giosue irace Valentina Rico Domenico Ciuffetta Fabio Miraldi “Paride Stefanini”Department policlinico“umberto i” Sapienza UniversityRomeItaly Cardiac Department Sapienza UniversityRomeItaly SS Trinita hospital SoraItaly

Blunt traumatic aortic injury is the second leading cause of death after motor vehicle accidents.The most frequent localisation of aortic lesion is the isthmus,especially in those who survived the accident.Here we report a case of blunt traumatic aortic injury with unusual localisation and modality.A 31 years old man sustained a motorcycle accident,being run over by a car.Computed tomography scan showed an atypical ascending aorta lesion,confirmed by intraoperative finding.The patient underwent emergency ascending aorta replacement with Dacron tubular graft.The patient was discharged uneventfully on 35th postoperative day,after multiple maxillofacial surgeries for concomitant injuries.

关键词： Ascending aorta Blunt injury Aortic dissection

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A two-choice strategy through a medial tibial approach for the treatment of pilon fractures with posterior or anterior fragmentation

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Chinese Journal of Traumatology 2013年第5期16卷 272-276页

作者： Luigi Di Giorgio Georgios Touloupakis Emmanouil Theodorakis Luca Sodano Dipartimento di Scienze dell' Apparato Locomotore Policlinico Umberto I University Sapienza Rome Italy Orthopaedic Consultant Aurelia Hospital Rome Italy

胫骨的 ObjectiveThe 在前面偏一边的途径为胫骨的 pilon 破裂的管理被推广了。为复杂破裂模式，一条联合 anterolateral/anteromedial 途径合适，但是复杂并发症的高率被报导了。在我们的回顾的学习，采用一条中间的胫骨的途径的二选... 详细信息

胫骨的 ObjectiveThe 在前面偏一边的途径为胫骨的 pilon 破裂的管理被推广了。为复杂破裂模式，一条联合 anterolateral/anteromedial 途径合适，但是复杂并发症的高率被报导了。在我们的回顾的学习，采用一条中间的胫骨的途径的二选择的策略在胫骨的 pilon 破裂的解剖研究上与前面或以后的 fragmentation.MethodsBased 为 pilon 破裂的处理被建议，我们回顾地分析了破裂与主要以后、以后侧面或前面，前面侧面( Tillaux-Chaput )远侧的胫骨的参与。这回顾的研究与关上的胫骨的天花板破裂由 18 个病人组成了。包括标准是：( 1 )前面/在前面偏一边的类型碎片的存在或一以后( Volkmann )打碎片包含>25%关节的表面，( 2 ) 12 个月的最小的后续，( 3 )腓骨破裂与远侧的胫骨的中间的列破裂联系了，并且( 4 )软组织在没损害外科的存取的选择的操作的时候调节(为关上的破裂的 Tscherne 分类：分级 0 和等级 1 ) 。胫骨的天花板破裂被分类进二个组：有以后的边界(Volkmann ) 的前面的介绍的和其它 fragments.ResultsMost 病人以运动和 Olerud-Molander 规模分数的范围完成了好临床的恢复。仅仅三个病人介绍了一个等级在是的二选择的策略热点概念以前在文学辩论了并且描述的 12 月 follow-up.ConclusionOur 的 2 骨关节炎。但是为远侧的胫骨的外科的途径的一个新扩大协议，包括更多的破裂模式和他们的协会应该进一步被调查。

关键词：骨折胫骨治疗外科手术选择策略时间相关发生率并发症

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Non-alcoholic fatty liver disease connections with fat-free tissues: A focus on bone and skeletal muscle

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World Journal of Gastroenterology 2017年第10期23卷 1747-1757页

作者： Eleonora Poggiogalle Lorenzo Maria Donini Andrea Lenzi Claudio Chiesa Lucia Pacifico Department of Experimental Medicine-Medical Pathophysiology Food Science and Endocrinology SectionSapienza University of Rome institute of Translational Pharmacology National Research Council Policlinico Umberto I Hospital Sapienza University of Rome

The estimates of global incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) are worrisome, due to the parallel burden of obesity and its metabolic complications. indeed, excess adiposity and insulin resistance represent two of the major risk factors for NAFLD; interestingly, in the last years a growing body of evidence tended to support a novel mechanistic perspective, in which the liver is at the center of a complex interplay involving organs and systems, other than adipose tissue and glucose homeostasis. Bone and the skeletal muscle are fat- free tissues which appeared to be independently associated with NAFLD in several cross-sectional studies. The deterioration of bone mineral density and lean body mass, leading to osteoporosis and sarcopenia, respectively, are age-related processes. The prevalence of NAFLD also increases with age. Beyond physiological aging, the three conditions share some common underlying mechanisms, and their elucidations could be of paramount importance to design more effective treatment strategies for the management of NAFLD. in this review, we provide an overview on epidemiological data as well as on potential contributors to the connections of NAFLD with bone and skeletal muscle.

关键词：非酒精的脂肪肝疾病骨头骨胳的肌肉骨质疏松症 Sarcopenia

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is proliferative colonic disease presentation changing?

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World Journal of Gastroenterology 2012年第45期18卷 6614-6619页

作者： Vito D Corleto Cristiano Pagnini Maria Sofia Cattaruzza Ermira Zykaj Emilio Di Giulio Giovanna Margagnoni Emanuela Pilozzi Giancarlo D'Ambra Antonietta Lamazza Enrico Fiori Mario Ferri Luigi Masoni Vincenzo Ziparo Bruno Annibale Gianfranco Delle Fave Department of Medical and Surgical Sciences and Translational Medicine Faculty of Medicine and PsychologySant'Andrea Hospital"Sapienza" University00189 RomeItaly Department of Public Health and inf.Diseases Faculty of MedicinePoliclinico Umberto I"Sapienza" University00189 RomeItaly Department of Pathology Faculty of Medicine and PsychologySant'Andrea Hospital"Sapienza" University00189 RomeItaly Department of Surgery Faculty of MedicinePoliclinico Umberto I"Sapienza" University00189 RomeItaly

AiM:To compare the site,age and gender of cases of colorectal cancer(CRC) and polyps in a single referral center in Rome,italy,during two periods.METHODS:CRC data were collected from surgery/pathology registers,and polyp data from colonoscopy reports.Patients who met the criteria for familial adenomatous polyposis,hereditary non-polyposis colorectal cancer syndrome or inflammatory bowel disease were excluded from the study.Overlap of patients between the two groups(cancers and polyps) was carefully avoided.Theχ 2 statistical test and a regression analysis were performed.RESULTS:Data from a total of 768 patients(352 and 416 patients,respectively,in periods A and B) who underwent surgery for cancer were collected.During the same time periods,a total of 1693 polyps were analyzed from 978 patients with complete colonoscopies(428 polyps from 273 patients during period A and 1265 polyps from 705 patients during period B).A proximal shift in cancer occurred during the latter years for both sexes,but particularly in males.Proximal cancer increased > 3-fold in period B compared to period A in males [odds ratio(OR) 3.31,95%Ci:2.00-5.47;P imilar proximal shift was observed for polyps,particularly in males(OR 1.87,95%Ci:1.23-2.87;P in females(OR 1.62,95%Ci:0.96-2.73;P iON:The prevalence of proximal proliferative colonic lesions seems to have increased over the last decade,particularly in males.

关键词：结肠疾病增生性癌症患者结直肠癌数据收集肠道疾病统计检验回归分析

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Current trends in management of hepatitis B virus reactivation in the biologic therapy era

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World Journal of Gastroenterology 2011年第34期17卷 3881-3887页

作者： Claudio M Mastroianni Miriam Lichtner Rita Citton Cosmo Del Borgo Angela Rago Helene Martini Giuseppe Cimino Vincenzo Vullo infectious Diseases Unit Fondazione Eleonora Lorillard Spencer Cenci Sapienza University SM Goretti Hospital Hematology Unit Sapienza University SM Goretti Hospital Department of Public Health and infectious Diseases Sapienza University Policlinico Umberto I

Hepatitis B virus (HBV) reactivation represents an emerging cause of liver disease in patients undergoing treatment with biologic agents. in particular, the risk ofHBV reactivation is heightened by the use monoclonalantibodies, such as rituximab (anti-CD20) and alemtuzumab (anti-CD52) that cause profound and longlasting immunosuppression. Emerging data indicatethat HBV reactivation could also develop following theuse of other biologic agents, such as tumor necrosis factor (TNF)-α inhibitors. When HBV reactivation is di-agnosed, it is mandatory to suspend biologic treatmentand start antiviral agents immediately. However, preemptive antiviral therapy prior to monoclonal antibodyadministration is crucial in preventing HBV reactivationand its clinical consequences. Several lines of evidencehave shown that risk of HBV reactivation is greatlyreduced by the identifi cation of high-risk patients andthe use of prophylactic antiviral therapy. in this article, we discuss current trends in the management of HBV reactivation in immunosuppressed patients receiving biologic therapy, such as rituximab, alemtuzumab and TNF-α antagonists.

关键词：生物治疗乙肝病毒激活管理抗病毒治疗乙型肝炎病毒肿瘤坏死因子生物制剂

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Safety and efficacy of DEM-TACE performed with drug-eluting microspheres smaller than 300μm in patients with HCC and TiPS

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Hepatoma Research 2022年第1期8卷 193-206页

作者： Pierleone Lucatelli Simone Zilahi De Gyurgyokai Gianluca De Rubeis Renato Argirò Simone Ciaglia Bianca Rocco Flaminia Ferri Simona Parisse Mariana Forlino Alessandro Cannavale FabrizioBasilico Pier Giorgio Nardis Mario Corona Vito Cantisani Carlo Catalano Vascular and interventional Radiology Unit Department of Radiological Oncological and Anatomo-Pathological SciencesPoliclinico Umberto I Sapienza University of RomeViale Regina Elena 324Rome 00161Italy Department of interventional Radiology San Camillo Forlanini HospitalCirconvallazione Gianicolense 87Rome 00152Italy Department of imaging and interventional Radiology Azienda Ospedaliera Universitaria Policlinico Tor VergataViale Oxford 81Rome 00133Italy Department of Translational and Precision Medicine Sapienza University of RomeViale Regina Elena 324Rome 00161Italy Department of Radiology Policlinico Umberto I Sapienza University of RomeViale Regina Elena 324Rome 00161Italy

Aim:Safety and efficacy evidence of drug-eluting-microspheres trans-arterial chemoembolization(DEM-TACE)in patients with hepatocellular carcinoma(HCC)and trans-jugular intrahepatic portosystemic shunt(TiPS)is lacking.The aim of this retrospective study was to report the safety and efficacy of DEM-TACE procedures performed with microspheres smaller than 300μm in patients with HCC and TiPS in a high-volume transplant center.Methods:Embolization was standardized by initiating DEM-TACE with microspheres smaller than 100μm,and if stasis was not achieved,adjunctive embolization with 100-300 or 200μm microspheres was administered.With regards to efficacy,the oncological response was evaluated and categorized according to mRECiST criteria at 1,3-6,9-12,and 15-18 months.Reporting the safety profile,detailed laboratory analysis was performed before,at 36-48 h,and 30-60 days after the procedure.Adverse events(AEs)were recorded;post-embolic syndrome was defined as the onset of fever/nausea/pain after the procedure.Late onset hepatobiliary complications were evaluated by follow-up imaging with computed tomography or magnetic resonance(CT/MR).Results:From December 2007 to November 2020,17 HCC patients(25 HCC nodules)with patent TiPS underwent 20 DEM-TACE.Embolization was performed only with microspheres smaller than 100μm in 3/20 DEM-TACE(15%);adjunctive embolization with 100-300 or 200μm microspheres was required in 17/20 DEMTACE(85%).Reported early AEs were post-embolic syndrome(9/20;45%)all of grade 1-2,late AEs were asymptomatic acute liver bile duct injury(2/20;10%),and in one case we observed hepatic abscess(1/20;5%)resulting in death due to sepsis.With regards to efficacy,the oncological response was evaluated and categorized according to mRECiST criteria.Complete response(CR)at 1,3-6,9-12,and 15-18 months was 52%,50%,50%,and 50%,respectively.Objective response(CR+partial response)at 1,3-6,9-12,and 15-18 months was 95%,71%,70%,and 50%,respectively.Conclusion:DEM-TACE with drug-eluting-microspheres smaller than 300μm can

关键词： HCC TiPS DEM-TACE CT MR

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Cytoreductive surgery after recurrent epithelial ovarian cancer and at other timepoints

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World Journal of Obstetrics and Gynecology 2013年第4期2卷 101-107页

作者： Paolo Sammartino Tommaso Cornali Marialuisa Framarino dei Malatesta Pompiliu Piso Department of Surgery Pietro Valdoni Policlinico Umberto I 00161 Rome Italy Department of Gynecological Obstetrical and Urological Sciences Policlinico Umberto I 00161 Rome Italy Department of General Surgery Barmherzige Brüder Hospital 93049 Regensburg Germany

in this descriptive review we look at the role of surgery for advanced ovarian cancer at other timepoints apart from the initial cytoreduction for front-line therapy or interval cytoreductive surgery after neoadjuvant chemotherapy. The chief surgical problem to face after primary treatment is recurrent ovarian cancer. Of far more marginal concern are the second-look surgical procedures or the palliative efforts intended to resolve the patient's symptoms with no curative intent. The role of surgery in recurrent ovarian cancer remains poorly defi ned. Current data, albeit from non-randomized studies, nevertheless clearly support surgical cytoreduction in selected patients, a rarely curative expedient that invariably yields a marked survival advantage over chemotherapy alone. Despite these fi ndings, some consider it too early to adopt secondary cytoreduction as the standard care for patients with recurrent ovarian cancer and a randomized study is needed. Two ongoing randomized trials(Arbeitsgemeinschaft Gynkologische Onkologie-Desktop Ⅲ and Gynecologic Oncology Group 213) intend to verify the role of secondary cytoreduction for platinum-sensitive ovarian cancer compared with chemotherapy considered as standard care for these patients. We await the results of these two trials for a defi nitive answer to the matter.

关键词：晚期卵巢癌手术治疗治疗方法临床分析

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