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MicroRNAs as possible biomarkers for diagnosis and prognosis of hepatitis b- and c-related-hepatocellularcarcinoma

World Journal of Gastroenterology 2016年第15期22卷 3907-3936页

作者： Sirio Fiorino Maria Letizia Bacchi-Reggiani Michela Visani Giorgia Acquaviva Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Luca di Tommaso Arrigo Bondi Sergio Sabbatani Andrea Domanico carlo Fabbri Paolo Leandri Annalisa Pession Elio Jovine Dario de Biase unita operativa di medicina c Ospedale Maggiore 40133 Bologna Italy dipartimento di medicina Sperimentale Istituto di Cardiologia Policlinico S. Orsola-Malpighi Universita degli Studi di Bologna 40138 BolognaItaly dipartimento di Farmacia e Biotecnologie Universita di Bologna 40139 Bologna Italy dipartimento di medicina Sperimentale Universita di Bologna Ospedale Bellaria 40139 Bologna Italy Servizio di Anatomia Patologica Ospedale Maggiore 40133 Bologna Italy unita operativa di chirurgia A Ospedale Maggiore 40133 Bologna Italy cNR Institute of Neuroscience Padova Italy 35121 Padova Italy Humanitas clinical and Research center 20089 Rozzano Milano Italy Istituto di Malattie Infettive Policlinico S. Orsola-Malpighi Universita degli Studi di Bologna 40138 Bologna Italy unita operativa di medicina Interna A Ospedale Maggiore 40133 Bologna Italy unita operativa di Endoscopia digestiva Ospedale Maggiore 40133 Bologna Italy

Aim of the present review is to summarize the current knowledge about the potential relationship between mi RNAs and hepatitis B virus(HBV)-hepatitis c virus(HcV) related liver diseases. A systematic computerbased search of published articles, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis Statement, was performed to identify relevant studies on usefulness of serum/plasma/urine mi RNAs, as noninvasive biomarkers for early detection of HBV and HcV-induced hepatocellular carcinoma(Hcc) development, as well as for its prognostic evaluation. The used Medical Subject Headings terms and keywords were: "HBV", "HcV", "hepatocellular carcinoma", "micro RNAs", "mi RNAs", "diagnosis", "prognosis", "therapy", "treatment". Some serum/plasma mi RNAs, including mi R-21, mi R-122, mi-125a/b, mi R-199a/b, mi R-221, mi R-222, mi R-223, mi R-224 might serve as biomarkers for early diagnosis/prognosis of Hcc, but, to date, not definitive results or well-defined panels of mi RNAs have been obtained. More well-designed studies, focusing on populations of different geographical areas and involving larger series of patients, should be carried out to improve our knowledge on the potential role of mi RNAs for Hcc early detection and prognosis.

关键词： Hepatitis B virus Hepatitis c virus Hepatocellular carcinomas Liver diseases MicroRNAs Review

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HBV and HcV infection and pancreatic ductal adenocarcinoma

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Hepatobiliary & Pancreatic diseases International 2013年第6期12卷 570-574页

作者： Sirio Fiorino Unità operativa di medicina Interna Ospedale di Budrio

Introduction Pancreatic ductal adenocarcinoma(PDAc)is a highly lethal malignancy,with a poor overall fiveyear *** dismal prognosis,even after curative resection,depends on its advanced stage at diagnosis,early metastatic spread,aggressive biological behavior and inefficacy of available systemic therapies.[1]To date,epidemiological studies have identified some risk factors for this cancer,including cigarette smoking habit,family history as well as high dietary fat consumption,alcohol abuse,diabetes mellitus,metabolic syndrome and chronic pancreatitis history.[1]

关键词： PDAc HBcAb HBsAb HcV HBV and HcV infection and pancreatic ductal adenocarcinoma

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Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis:a systematic review and meta-analysis

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World Journal of Hepatology 2017年第6期9卷 333-342页

作者： Sirio Fiorino Maria Letizia Bacchi-Reggiani Paolo Leandri Elisabetta Loggi Pietro Andreone Unità operativa di medicina Interna c Ospedale Maggiore Unità operativa Malattie cardiovascolari Azienda Ospedaliero Universitaria di BolognaPoliclinico Sant’Orsola-Malpighi dipartimento di Scienze Mediche e chirurgiche Azienda Ospedaliero Universitaria di BolognaPoliclinico Sant’Orsola-Malpighi

AIM To assess vitamin E efficacy,defined as its ability to induce hepatitis B e antigen(HBeAg) seroconversion,in children with HBeAg-positive persistent *** In July 2016,we extracted articles published in MEDLINE and the cochrane Library using the following search terms:"chronic hepatitis B","children","childhood","therapy","treatment","vitamin E","tocopherols","tocotrienols".Only randomized controlled trials(RcTs) published in English language were *** Three RcTs met inclusion criteria and were considered in the present ***,23/122 children in the treatment group underwent HBeAg seroconversion vs 3/74 in the control group(OR=3.96,95%cI:1.18-13.25,P=0.025).cONcLUSION Although our meta-analysis has several limits,including the very small number of available studies and enrolled children with HBeAg positivity-related hepatitis,it suggests that vitamin E use may enhance the probability to induce HBeAg seroconversion in these *** well designed and adequately sized trials are required to confirm or deny these very preliminary results.

关键词： Hepatitis B Pediatric hepatology Viral hepatitis Immunology

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Possible association between hepatitis c virus and malignancies different from hepatocellular carcinoma:A systematic review

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World Journal of Gastroenterology 2015年第45期21卷 12896-12953页

作者： Sirio Fiorino Letizia Bacchi-Reggiani Dario de Biase Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Giorgia Acquaviva Luca di Tommaso Arrigo Bondi Michela Visani Sergio Sabbatani Laura Pontoriero carlo Fabbri Andrea cuppini Annalisa Pession Elio Jovine Unità operativa di medicina Interna Ospedale di Budrio dipartimento di medicina Sperimentale Istituto di Cardiologia Policlinico S. Orsola-Malpighi Università degli Studi di Bologna dipartimento di medicina Sperimentale Università di Bologna Unità Operativa Biologia Molecolare Anatomia Patologica Ospedale Bellaria Servizio di Anatomia Patologica Ospedale Maggiore Unità operativa di chirurgia A Ospedale Maggiore Institute of Neuroscience National Research Council Humanitas clinical and Research center Rozzano dipartimento di Farmacia e Biotecnologie Università di Bologna Istituto di Malattie Infettive Policlinico S. Orsola-Malpighi Università degli Studi di Bologna Unità di cura Materno-Infantile Distretto Lametino U.O. Endoscopia Ospedale Maggiore

AIM: To summarize the current knowledge about the potential relationship between hepatitis c virus(HcV) infection and the risk of several extra-liver cancers. METHODS: We performed a systematic review of the literature, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) Statement. We extracted the pertinent articles, published in MEDLINE and the cochrane Library, using the following search terms: neoplasm/cancer/malignancy/tumor/carcinoma/adeno-carcinoma and non-Hodgkin lymphomas, kidney/renal-, cholangio-, pancreatic-, thyroid-, breast-,oral-, skin-, prostate-, lung-, colon-, stomach-, haematologic. case series, case-series with control-group, case-control, cohort-studies as well as meta-analyses, written in English were collected. Some of the main characteristics of retrieved trials, which were designed to investigate the prevalence of HcV infection in each type of the above-mentioned human malignancies were summarised. A main table was defined and included a short description in the text for each of these tumours, whether at least five studies about a specific neoplasm, meeting inclusion criteria, were available in literature. According to these criteria, we created the following sections and the corresponding tables and we indicated the number of included or excluded articles, as well as of meta-analyses and reviews:(1) HcV and haematopoietic malignancies;(2) HcV and cholangiocarcinoma;(3) HcV and pancreatic cancer;(4) HcV and breast cancer;(5) HcV and kidney cancer;(6) HcV and skin or oral cancer; and(7) HcV and thyroid cancer. RESULTS: According to available data, a clear correlation between regions of HcV prevalence and risk of extra-liver cancers has emerged only for a very small group of types and histological subtypes of malignancies. In particular, HcV infection has been associated with:(1) a higher incidence of some B-cell Non-HodgkinLymphoma types, in countries, where an elevated prevalence of this pathogen is de

关键词： Neoplasm cancer Hepatitis c virus Risk factors Ext

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diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy

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World Journal of Gastroenterology 2014年第37期20卷 13382-13401页

作者： Renato costi Alessandro Gnocchi Francesco di Mario Leopoldo Sarli dipartimento di Scienze chirurgiche Università di ParmaAzienda Ospedaliero-Universitaria di Parma dipartimento Materno Infantile Unità Operativa di Gastroenterologia ed Endoscopia DigestivaAzienda Ospedaliero-Universitaria di Parma dipartimento di medicina clinica e Sperimentale Università di ParmaAzienda Ospedaliero-Universitaria di Parma

Biliary lithiasis is an endemic condition in both Western and Eastern countries, in some studies affecting 20% of the general population. In up to 20% of cases, gallbladder stones are associated with common bile duct stones (cBDS), which are asymptomatic in up to one half of cases. Despite the wide variety of examinations and techniques available nowadays, two main open issues remain without a clear answer: how to cost-effectively diagnose cBDS and, when they are finally found, how to deal with them. cBDS diagnosis and management has radically changed over the last 30 years, following the dramatic diffusion of imaging, including endoscopic ultrasound (EUS) and magnetic resonance cholangiography (MRc), endoscopy and laparoscopy. Since accuracy, invasiveness, potential therapeutic use and cost-effectiveness of imaging techniques used to identify cBDS increase together in a parallel way, the concept of “risk of carrying cBDS” has become pivotal to identifying the most appropriate management of a specific patient in order to avoid the risk of “under-studying” by poor diagnostic work up or “over-studying” by excessively invasive examinations. The risk of carrying cBDS is deduced by symptoms, liver/pancreas serology and ultrasound. “Low risk” patients do not require further examination before laparoscopic cholecystectomy. Two main “philosophical approaches” face each other for patients with an “intermediate to high risk” of carrying cBDS: on one hand, the “laparoscopy-first” approach, which mainly relies on intraoperative cholangiography for diagnosis and laparoscopic common bile duct exploration for treatment, and, on the other hand, the “endoscopy-first” attitude, variously referring to MRc, EUS and/or endoscopic retrograde cholangiography for diagnosis and endoscopic sphincterotomy for management. concerning cBDS diagnosis, intraoperative chol

关键词： Biliary lithiasis choledocholithiasis Laparoscopy Endoscopy diagnosis Management

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When sepsis affects the heart: A case report and literature review

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World Journal of clinical cases 2015年第8期3卷 743-750页

作者： Giuseppe clemente Antonino Tuttolomondo Daniela colomba Rosaria Pecoraro chiara Renda Vittoriano Della corte carlo Maida Irene Simonetta Antonio Pinto U.O.c.di medicina Interna e cardioangiologia University of Palermo

A 59-year-old nursing home patient with Down syndrome was brought to the internal medicine department of our hospital due to fever, cough without expectorate, and dyspnea. A thoracic computed tomography revealed the presence of bilateral basal parenchymal opacities. Her condition deteriorated after admission and troponin reached a peak serum concentration of 16.9 ng/m L. The patient was in cardiogenic shock. In addition to fluid resuscitation, vaso-active amine infusion was administered to achieve hemodynamic stabilization. The differential diagnosis investigated possible pulmonary embolism, myocardial infarction, and myocarditis. Furthermore, a second transthoracic echocardiogram suggested Tako-Tsubo syndrome. This is a septic patient. The purpose of this manuscript is to review studies which formerly examined the possible association between high levels of troponin and mortality to see if it can be considered a positive predictive factor of fatal prognosis as the case of thrombocytopenia, already a positive independent predictive factor of multiple organ failure syndrome, and generally to characterize risk profile in a septic patient.

关键词： Sepsis Shock Hypotension Troponin Myocardial dysfunction

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diabetic foot syndrome:Immune-inflammatory features as possible cardiovascular markers in diabetes

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World Journal of Orthopedics 2015年第1期6卷 62-76页

作者： Antonino Tuttolomondo carlo Maida Antonio Pinto dipartimento Biomedico di medicina Interna e Specialistica U.O.C di Medicina Interna e CardioangiologiaUniversità degli Studi di Palermo

diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality. diabetic foot syndrome(DFS), as defined by the World Health Organization, is an "ulceration of the foot(distally from the ankle and including the ankle) associated with neuropathy and different grades of ischemia and infection". Pathogenic events able to cause diabetic foot ulcers are *** the commonest causes of this pathogenic pathway it's possible to consider peripheral neuropathy, foot deformity, abnormal foot pressures, abnormal joint mobility, trauma, peripheral artery disease. Several studies reported how diabetic patients show a higher mortality rate compared to patients without diabetes and in particular these studies under filled how cardiovascular mortality and morbidity is 2-4 times higher among patients affected by type 2 diabetes mellitus. This higher degree of cardiovascular morbidity has been explained as due to the observed higher prevalence of major cardiovascular risk factor, of asymptomatic findings of cardiovascular diseases, and of prevalence and incidence of cardiovascular and cerebrovascular events in diabetic patients with foot complications. In diabetes a fundamental pathogenic pathway of most of vascular complications has been reported as linked to a complex interplay of inflammatory, metabolic and procoagulant variables. These pathogenetic aspects have a direct interplay with an insulin resistance, subsequent obesity, diabetes, hypertension, prothrombotic state and blood lipid disorder. Involvement of inflammatory markers such as IL-6 plasma levels and resistin in diabetic subjects as reported by Tuttolomondo et al confirmed the pathogenetic issue of the a "adipo-vascular" axis that may contribute to cardiovascular risk in patients with type 2 diabetes. This "adipo-vascular axis" in patients with type 2 diabetes has been reported as characterized by lower plasma l

关键词： diabetic foot syndrome Inflammation cytokines cardiovascular risk Marker

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Serum chromogranin-A in hepatocellular carcinoma: diagnostic utility and limits

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World Journal of Gastroenterology 2005年第13期11卷 1987-1990页

作者： Aldo Spadaro Antonino Ajello carmela Morace Agata Zirilli Graziella D'arrigo carmelo Luigiano Francesco Martino Anna Bene Domenico Migliorato Santi Turiano Oscar Ferraù Maria Antonietta Freni dipartimento clinico Sperimentale di medicina e Farmacologia dipartimento di Statistica dipartimento di Scienze Radiologiche Unità operativa di Gastroenterologia

AIM: The utility of serum alpha-fetoprotein (α-FP) for the detection of hepatocellular carcinoma (Hcc) is questionable. High serum levels of chromogranin-A (cgA) have recently been reported in Hcc. Impaired hepatic, renal, and heart functions influence circulating cgA. The aim of this study was to assess sensitivity and specificity of serum cgA as a marker of Hcc in patients with liver cirrhosis (Lc). METHODS: Serum cgA levels were measured by RIA in 339 patients of which 54 Hcc, 132 Lc, 45 chronic hepatitis (cH), 27 chronic heart failure (cHF), 36 chronic renal failure (cRF), 45 chronic inflammatory bowel disease (IBD) as disease controls and in 75 healthy controls. Patients with liver disease or IBD and concomitant renal and/or heart failure were excluded. Pearson correlation, non-parametric combination test and confidence interval analysis were used for statistical analysis. RESULTS: Serum cgA above normal values (100 ng/mL) were found in 83% of Hcc patients, in 48% of Lc patients, in 20% of cH patients, in 33% of IBD patients, in 92% of cRF patients, in 100% of cHF patients, and in none of the healthy controls. The mean cgA values in Hcc (769±1046), in Lc (249±369), in cH (87±94), in cRF (1390±1401), in cHF (577±539), in IBD (146±287) were significantly higher than those in healthy controls (48±18). Hcc patients had higher cgA values (Pc, cH, and IBD patients but did not differ from those with cRF or cHF. The 95% cI for the mean (250-1289 ng/mL) in Hcc patients was selected as a cgA range and the lower value of such range was assumed as cut-off. Sensitivity and specificity of cgA, calculated in relation to the cut-off in patients with cirrhosis and Hcc, were respectively 61% (cI 48-73%) and 82% (cI 75-88%). Serum a-FP values were >200 ng/mL in 21% of the Hcc patients and in none of the Lc patients. No significant correlation was found between a-FP and cgA in patients with Hcc and in patients with cirrhosis. cONcLUSION: When Hcc is suspected and a-FP

关键词： chromogranin-A Hepatocellular carcinoma Liver cirrhosis chronic hepatitis diagnosis

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Stem cells for end stage liver disease: How far have we got?

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World Journal of Gastroenterology 2008年第29期14卷 4593-4599页

作者： Stefania Lorenzini Stefano Gitto Elena Grandini Pietro Andreone Mauro Bernardi dipartimento di medicina clinica. Unità operativa di Semeiotica Medica. University of Bologna Italy

End stage liver disease (ESLD) is a health problem worldwide. Liver transplantation is currently the only effective therapy, but its many drawbacks include a shortage of donors, operative damage, risk of rejection and in some cases recidivism of the pre-transplant disease. These factors account for the recent growing interest in regenerative medicine. Experiments have sought to identify an optimal source of stem cells, sufficient to generate large amounts of hepatocytes to be used in bioartificial livers or injected in vivo to repair the diseased organ. This update aims to give non-stem cell specialists an overview of the results obtained to date in this fascinating field of biomedical research.

关键词： End stage liver disease Liver failuretreatment Stem cells Regenerative medicine

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Orphan patients with inflammatory bowel disease-when we treat beyond evidence

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World Journal of Gastroenterology 2021年第47期27卷 8047-8057页

作者： Giuseppe Privitera Daniela Pugliese Loris Riccardo Lopetuso Franco Scaldaferri Alfredo Papa GianLodovico Rapaccini Antonio Gasbarrini Alessandro Armuzzi dipartimento Universitario di medicina e chirurgia Traslazionale UniversitàCattolica del Sacro CuoreRome 00168Italy cEMAD–IBD UNIT-Unitàoperativa complessa di medicina Interna e Gastroenterologia Dipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario"A.Gemelli"IRCCSRome 00168Italy cEMAD–IBD UNIT-Unitàoperativa complessa di medicina Interna e Gastroenterologia Dipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario“A.Gemelli”IRCCSRome 00168Italy Department of Medicine and Ageing Sciences “G.d’Annunzio”University of Chieti-PescaraChieti 66100Italy center for Advanced Studies and Technology(cAST) “G.d’Annunzio”University of Chieti-PescaraChieti 66100Italy

Inflammatory bowel disease(IBD)is a chronic condition that requires continuous medical *** date,the medical management of patients with moderatelyto-severely active IBD who develop dependence or resistance to corticosteroids is based on immunomodulator *** therapies are licenced after passing through three phases of randomized controlled trials(RcTs),and are subsequently adopted in clinical ***,the real-life population of IBD patients who require these therapies can significantly differ from those included in *** a matter of fact,there is a number of exclusion criteria–nearly ubiquitous in all RcTs–that prevent the enrolment of specific patients:chronic refractory pouchitis or isolated proctitis in ulcerative colitis,short-bowel syndrome and stomas in crohn’s disease,ileorectal anastomosis in both ulcerative colitis and crohn’s disease,and elderly age are some representative *** this frontier article,we aim to give an overview of current literature on this topic,in order to address the main knowledge gaps that need to be filled in the upcoming years.

关键词： Pouchitis Proctitis Stoma Short-bowel Ileo-rectal anastomosis Biologics

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