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| 1 | Laparoscopic fundoplication for gastroesophageal reflux disease显示文摘Gastroesophageal reflux disease(GERD) is a condition that develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms and/or complications. Heartburn is the cardinal symptom, often associated with regurgitation. In patients with endoscopy-negative heartburn refractory to proton pump inhibitor(PPI) therapy and when the diagnosis of GERD is in question, direct reflux testing by impedance-pH monitoring is warranted. Laparoscopic fundoplication is the standard surgical treatment for GERD. It is highly effective in curing GERD with a 80% success rate at 20-year follow-up. The Nissen fundoplication, consisting of a total(360°) wrap, is the most commonly performed antireflux operation. To reduce postoperative dysphagia and gas bloating, partial fundoplications are also used, including the posterior(Toupet) fundoplication, and the anterior(Dor) fundoplication. Currently, there is consensus to advise laparoscopic fundoplication in PPI-responsive GERD only for those patients who develop untoward side-effects or complications from PPI therapy. PPI resistance is the real challenge in GERD. There is consensus that carefully selected GERD patients refractory to PPI therapy are eligible for laparoscopic fundoplication, provided that objective evidence of reflux as the cause of ongoing symptoms has been obtained. For this purpose, impedance-pH monitoring is regarded as the diagnostic gold standard. | Marzio Frazzoni Micaela Piccoli Rita Conigliaro Leonardo Frazzoni Gianluigi Melotti | 2014 | World Journal of Gastroenterology2014，20，39： | 10 |
| 2 | CEUS and Fibroscan in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis显示文摘AIM: To determine intra-hepatic blood flow and liver stiffness in patients with non-alcoholic fatty liver disease(NAFLD) and non-alcoholic steatohepatitis (NASH) using contrast-enhanced ultrasound and fibroscan.METHODS: This prospective study included 15 patients with NAFLD, 17 patients with NASH and 16 healthy controls.In each patient, real-time ultrasound was used to locate the portal vein (PV) and the right liver lobe, and 5 mL of SonoVue? was then injected intravenous in a peripheral vein of the left arm over a 4-s span. Digital recording was performed for 3 min thereafter. The recording was subsequently retrieved to identify an area of interest in the PV area and in the right liver parenchyma(LP) to assess the blood flow by processing the data using dedicated software (Qontrast?, Bracco, Italy).The following parameters were evaluated: percentage of maximal contrast activity (Peak%), time to peak (TTP, s), regional blood volume (RBV, cm3), regional blood flow (RBF, cm3/s) and mean transit time (MTT, s).At 24-48 h post-injection, liver stiffness was evaluated using Fibroscan and measured in kPa. The statistical evaluation was performed using Student’s t test.RESULTS: In the PV, the Peak%, RBV and RBF were significantly reduced in the NAFLD and NASH patientscompared with the controls (Peak%: NAFLD 26.3 ± 6.6,NASH 28.1 ± 7.3 vs controls 55.8 ± 9.9, P < 0.001;RBV: NAFLD 4202.3 ± 3519.7, NASH 3929.8 ± 1941.3vs controls 7473 ± 3281, P < 0.01; RBF: NAFLD 32.5± 10.8, NASH 32.7 ± 12.1 vs controls 73.1 ± 13.9, P< 0.001). The TTP in the PV was longer in both patient groups but reached statistical significance only in the NASH patients compared with the controls (NASH 79.5± 37.8 vs controls 43.2 ± 30, P < 0.01). In the LP,the Peak%, RBV and RBF were significantly reduced in the NAFLD and NASH patients compared with the controls (Peak%: NAFLD 43.2 ± 7.3, NASH 41.7 ± 7.7 vs controls 56.6 ± 6.3, P < 0.001; RBV: NAFLD 4851.5± 2009, NASH 5069.4 ± 2292.5 vs controls 6922.9 ±2461.5, P < 0.05; RBF: NAFLD 55.7 ± 10.1, NASH 54.5 ± 12.1 vs controls 75.9 ± 10.5, P < 0.001). The TTP was longer in both patient groups but did not reach statistical significance. The MTT in both the PV and LP in the NAFLD and NASH patients was not different from that in the controls. Liver stiffness was significantly increased relative to the controls only in the NASH patients(NASH: 6.4 ± 2.2 vs controls 4.6 ± 1.5, P < 0.05).CONCLUSION: Blood flow derangement within the liver present not only in NASH but also in NAFLD suggests that a vascular flow alteration precedes liver fibrosis development. | Sila Cocciolillo Giustino Parruti Leonardo Marzio | 2014 | World Journal of Hepatology2014，6，7： | 7 |
| 3 | Quadruple therapy with moxifloxacin and bismuth for first-line treatment ofHelicobacter pylori显示文摘AIM:To compare triple therapy vs quadruple therapy for 10 d as first-line treatment ofHelicobacter pylori(H.pylori) infection.METHODS:Consecutive H.pylori positive patients never treated in the past for this infection were randomly treated with triple therapy of pantoprazole(PAN) 20 mg bid,amoxicillin(AMO) 1 g bid and moxifloxacin(MOX) 400 mg bid for 10 d(PAM) or with quadruple therapy of PAN 20 mg bid,AMO 1 g bid,MOX 400 mg bid and bismuth subcitrate 240 mg bid for 10 d(PAMB).All patients were found positive at 13 C-Urea breath test(UBT) performed within ten days prior to the start of the study.A successful outcome was confirmed with an UBT performed 8 wk after the end of treatment.χ 2 analysis was used for statistical comparison.Per protocol(PP) and intention-to-treat(ITT) values were also calculated.RESULTS:Fifty-seven patients were enrolled in the PAM group and 50 in the PAMB group.One patient in each group did not return for further assessment.Eradication was higher in the PAMB group(negative:46 and positive:3) vs the PAM group(negative:44 and positive:12).The H.pylori eradication rate was statistically significantly higher in the PAMB group vs the PAM group,both with the PP and ITT analyses(PP:PAMB 93.8%,PAM 78.5%,P < 0.02;ITT:PAMB 92%,PAM 77.1 %,P <0.03).CONCLUSION:The addition of bismuth subcitrate can be considered a valuable adjuvant to triple therapy in those areas where H.pylori shows a high resistance to fluoroquinolones. | Antonio Francesco Ciccaglione Luigina Cellini Laurino Grossi Leonardo Marzio | 2012 | World Journal of Gastroenterology2012，18，32： | 5 |
| 4 | Dopamine interrupts gastrointestinal fed motility pattern in humans显示文摘 | Prof. Leonardo Marzio MD Matteo Neri MD Oreste Pieramico MD Mauro Delle Donne MD Theo L. Peeters MD Franco Cuccurullo MD | 1990 | Digestive Diseases and Sciences1990，，3： | 1 |
| 5 | A Triple and Quadruple Therapy with Doxycycline and Bismuth for First‐Line Treatment of H elicobacter pylori Infection: A Pilot Study显示文摘 | Antonio Francesco Ciccaglione Luigina Cellini Laurino Grossi Lamberto Manzoli Leonardo Marzio | 2015 | Helicobacter2015，，5： | 1 |
| 6 | Relationship between gastric and gallbladder emptying and refilling in normal subjects and patients withH. pylori-positive and-negative idiopathic dyspepsia and correlation with symptoms显示文摘 | Dr. Leonardo Marzio MD Mariassunta Falcucci MD Antonio Francesco Ciccaglione MD Maria Grazia Malatesta MD Domenico Lapenna MD Enzo Ballone MD Carlo Antonelli MD Laurino Grossi MD | 1996 | Digestive Diseases and Sciences1996，，1： | 1 |
| 7 | Gallbladder hypokinesia and normal gastric emptying of liquids in patients with dyspeptic symptoms显示文摘 | Prof Leonardo Marzio MD Franca DiFelice MD Maria Grazia Laico MD Bruno Imbimbo PharmD Domenico Lapenna MD Franco Cuccurullo MD | 1992 | Digestive Diseases and Sciences1992，，2： | 1 |
| 8 | Relationship between gastric and gallbladder emptying and refilling in normal subjects and patients withH. pylori-positive and-negative idiopathic dyspepsia and correlation with symptoms显示文摘 | Dr. Leonardo Marzio MD Mariassunta Falcucci MD Antonio Francesco Ciccaglione MD Maria Grazia Malatesta MD Domenico Lapenna MD Enzo Ballone MD Carlo Antonelli MD Laurino Grossi MD | 1996 | Digestive Diseases and Sciences1996，，1： | 1 |
| 9 | Analysis of genetic variability, antimicrobial susceptibility and virulence markers in Helicobacter pylori identified in Central Italy显示文摘 | Luigina Cellini Rossella Grande Emanuela Di Campli Soraya Di Bartolomeo Simona Capodicasa Leonardo Marzio | 2006 | Scandinavian Journal of Gastroenterology2006，，3： | 1 |
| 10 | Helicobacter pylori isolates from proximal and distal stomach of patients never treated and already treated show genetic variability and discordant antibiotic resistance显示文摘 | Leonardo Marzio Lugina Cellini Maria Amitrano Rossella Grande Mariaelena Serio Giorgio Cappello Laurino Grossi | 2011 | European Journal of Gastroenterology & Hepatology2011，，6： | 1 |
| 11 | Esophagitis and its causes:Who is “guilty” when acid is found “not guilty”?显示文摘Esophagitis is mainly a consequence of gastroesophageal reflux disease, one of the most common diseases affecting the upper digestive tract. However the esophageal mucosa can also be targeted by some infectious, systemic or chemical conditions. Eosinophilic esophagitis(Eo E) is an immune-mediated inflammatory disease, characterized by eosinophilic infiltration in the mucosa. Esophageal localization of Crohn's disease is not very common, but it should always be considered in patients with inflammatory bowel disease complaining of upper digestive tract symptoms. There are also forms of infectious esophagitis(e.g., Herpes simplex virus or Candida albicans) occurring in patients with a compromised immune system, either because of specific diseases or immunosuppressive therapies. Another kind of damage to esophageal mucosa is due to drug use(including oncologic chemotherapeutic regimens and radiotherapy) or caustic ingestion, usually of alkaline liquids, with colliquative necrosis and destruction of mucosa within a few seconds. Dysphagia is a predominant symptom in Eo E, while infectious, drug-induced and caustic damages usually cause chest pain and odynophagia. Endoscopy can be useful for diagnosing esophagitis, although no specific pattern can be identified. In conclusion when a patient refers upper gastrointestinal tract symptoms and the diagnosis of gastro-esophageal reflux disease is not convincing we should always carefully investigate the patient's clinical history to consider possibilities other than the gastric refluxate. | laurino grossi antonio francesco ciccaglione leonardo marzio | 2017 | World Journal of Gastroenterology2017，23，17： | 0 |
| 12 | Typical and atypical symptoms of gastro esophageal reflux disease: Does Helicobacter pylori infection matter?显示文摘AIM: To analyze whether the presence of Helicobacter pylori(H. pylori) infection could affect the quality of symptoms in gastro-esophageal reflux disease(GERD) patients. METHODS: one hundred and forty-four consecutive patients referred to our Unit for suspected GERD were recruited for the study. All patients underwent esophageal p H-metric recording. For those with a positive test, C13 urea breath test was then performed to assess the H. pylori status. GERD patients were stratified according to the quality of their symptoms and classified as typical, if affected by heartburn and regurgitation, and atypical if complaining of chest pain, respiratory and ears, nose, and throat features. H. pylori-negative patients were also asked whether they had a previous diagnosis of H. pylori infection. If a positive response was given, on the basis of the time period after successful eradication, patients were considered as 'eradicated'(E) if H. pylori eradication occurred more than six months earlier or 'recently eradicated' if the therapy had been administered within the last six months. Patients without history of infection were identified as 'negative'(N). χ2 test was performed by combining the clinical aspects with the H. pylori status.RESULTS: one hundred and twenty-nine of the 144 patients, including 44 H. pylori-positive and 85 H. pylori-negative(41 negative, 21 recently eradicated, 23 eradicated more than 6 mo before), were eligible for the analysis. No difference has been found between H. pylori status and either the number of reflux episodes(138 ± 23 vs 146 ± 36, respectively, P = 0.2, not significant) or the percentage of time with pH values < 4(6.8 ± 1.2 vs 7.4 ± 2.1, respectively, P = 0.3, not significant). The distribution of symptoms was as follows: 13 typical(30%) and 31 atypical(70%) among the 44 H. pylori-positive cases; 44 typical(52%) and 41 atypical(48%) among the 85 H. pylori-negative cases,(P = 0.017 vs H. pylori +; OR = 2.55, 95%CI: 1.17-5.55). Furthermore, clinical signs in patients with recent H. pylori eradication were similar to those of H. pylori-positive(P = 0.49; OR = 1.46, 95%CI: 0.49-4.37); on the other hand, patients with ancient H. pylori eradication showed a clinical behavior similar to that of H. pylori-negative subjects(P = 0.13; OR = 0.89, 95%CI: 0.77-6.51) but different as compared to the H. pylori-positive group(P < 0.05; OR = 3.71, 95%CI: 0.83-16.47).CONCLUSION: Atypical symptoms of GERD occur more frequently in H. pylori-positive patients than in H. pylori-negative subjects. In addition, atypical symptoms tend to decrease after H. pylori eradication. | Laurino Grossi Antonio Francesco Ciccaglione Leonardo Marzio | 2015 | World Journal of Gastrointestinal Pharmacology and Therapeutics2015，6，4： | 0 |
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