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| 1 | Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis显示文摘AIM: To evaluate acute cholecystitis, complicated by peritonitis, acute phase response and immunological status in patients treated by laparoscopic or open approach. METHODS: From January 2002 to May 2012, we conducted a prospective randomized study on 45 consecutive patients (27 women, 18 men; mean age 58 years). These subjects were taken from a total of 681 patients who were hospitalised presenting similar preoperative findings: acute upper abdominal pain with tenderness, involuntary guarding under the right hypochondrium and/or in the flank; fever higher than 38 ℃, leukocytosis greater than 10 × 10 9 /L or both, and ultrasonographic evidence of calculous cholecystitis possibly complicated by peritonitis. These patients had undergone cholecystectomy for acute calculous cholecystitis,complicated by bile peritonitis. Randomly, 23 patients were assigned to laparoscopic cholecystectomy (LC), and 22 patients to open cholecystectomy (OC). Blood samples were collected from all patients before operation and at days 1, 3 and 6 after surgery. Serum bacteraemia, endotoxaemia, white blood cells (WBCs), WBC subpopulations, human leukocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin-1 (IL-1) and IL-6, and C-reactive protein (CRP) were measured at 0, 30, 60, 90, 120 and 180 min, at 4, 6, 12, 24 h, and then daily (8 A.M.) until post-operative day 6.RESULTS: The two groups were comparable in the severity of peritoneal contamination as indicated by the viable bacterial count (open group = 90% of positive cultures vs laparoscopic group = 87%) and endotoxin level (open group = 33.21 ± 6.32 pg/mL vs laparoscopic group = 35.02 ± 7.23 pg/mL). Four subjects in the OC group (18.1%) and 1 subject (4.3%) in the LC group (P < 0.05) developed intra-abdominal abscess. Severe leukocytosis (range 15.8-19.6/mL) was observed only after OC but not after LC, mostly due to an increase in neutrophils (days 1 and 3, P < 0.05). This value returned to the normal range within 3-4 d after LC and 5-7 d after OC. Other WBC types and lymphocyte subpopulations showed no significant variation. On the first day after surgery, a statistically significant difference was observed in HLA-DR expression between LC (13.0 ± 5.2) and OC (6.0 ± 4.2) (P < 0.05). A statistically significant change in plasma elastase concentration was recorded post-operatively at days 1, 3, and 6 in patients from the OC group when compared to the LC group (P < 0.05). In the OC group, the serum levels of IL-1 and IL-6 began to increase considerably from the first to the sixth hour after surgery. In the LC group, the increase of serum IL-1 and IL-6 levels was delayed and the peak values were notably lower than those in the OC group. Significant differences between the groups, for these two cytokines, were observed from the second to the twenty-fourth hour (P < 0.05) after surgery. The mean values of serum CRP in the LC group on post-operative days (1 and 3) were also lower than those in the OC group (P < 0.05). Systemic concentration of endotoxin was higher in the OC group at all intra-operative sampling times, but reached significance only when the gallbladder was removed (OC group = 36.81 ± 6.4 ρg/mLvs LC group = 16.74 ± 4.1 ρg/mL, P < 0.05). One hour after surgery, microbiological analysis of blood cultures detected 7 different bacterial species after laparotomy, and 4 species after laparoscopy (P < 0.05). CONCLUSION: OC increased the incidence of bacteraemia, endotoxaemia and systemic inflammation compared with LC and caused lower transient immunological defense, leading to enhanced sepsis in the patients examined. | Federico Sista Mario Schietroma Giuseppe De Santis Antonella Mattei Emanuela Marina Cecilia Federica Piccione Sergio Leardi Francesco Carlei Gianfranco Amicucci | 2013 | World Journal of Gastrointestinal Surgery2013，5，4： | 23 |
| 2 | 第三十二指肠的部分的腺癌: 案例报告和文学的评论显示文摘We focus on the diagnostic and therapeutic problemsof duodenal adenocarcinoma,reporting a case and reviewing the literature.A 65-year old man with adenocarcinoma in the third duodenal portion was successfully treated with a segmental resection of the third part of the duodenum,avoiding a duodeno-cephalo-pancreatectomy.This tumor is very rare and frequently affects the Ⅲ and Ⅳduodenal portion.A precocious diagnosis and the exact localization of this neoplasia are crucial factors in order to decide the surgical strategy.Given a non-specificity of symptoms,endoscopy with biopsy is the diagnostic gold standard.Duodeno-ceph-alo-pancreatectomy(DCP) and segmental resection of the duodenum(SRD) are the two surgical options,with overlapping morbidity(27% vs 18%) and post operative mortality(3% vs 1%).The average incidence of postoperative long-term survival is 100%,73.3% and31.6% of cases after 1,3 and 5 years from surgery,respectively.Long-term survival is made worse by two factors:the presence of metastatic lymph nodes and tumor localization in the proximal duodenum.The two surgical options are radical:DCP should be used only for proximal localizations while SRD should be chosen for distal | Federico Sista Giuseppe De Santis Antonio Giuliani Emanuela Marina Cecilia Federica Piccione Laura Lancione Sergio Leardi Gianfranco Amicucci | 2012 | World Journal of Gastrointestinal Surgery2012，4，1： | 2 |
| 3 | Unsupervised video segmentation and object tracking 显示文摘 | Srinivas Sista Rangasami L Kashyap | 2000 | Computers in Industry2000，42，23： | 1 |
| 4 | Highly Efficient Tandem Polymer Photovohaic Cells 显示文摘 | SRINIVAS SISTA MI-HYAE PARK ZIRUO HONG | 2009 | Adv Mater2009，，22： | 1 |
| 5 | Single-dose study to compare the pharmacokinetics of HFA flunisolide and CFC flunisolide显示文摘 | Nolting A Sista S Abramowitx W | 2002 | J Pbarra Sci2002，91，2： | 1 |
| 6 | Palliative procedures in lung cancer 显示文摘 | Masuda E Sista AK Pua BB | 2013 | Semin Intervent Radio12013，30，2： | 1 |
| 7 | Three dimensional Monte Carlo simulation of grain growth during GTA welding of titanium显示文摘 | Yang Z Sista S Elmer J W | 2000 | Aeta Mater2000，48，： | 1 |
| 8 | Paradoxical movements of abdominal contents indicating a congenital diaphragmatic hemia显示文摘 | Sista AK Filly RA | 2008 | J Ultrasound Med2008，27，3： | 1 |
| 9 | Synthesis and Electronic Properties of Semiconducting Polymers ContainingBenzodithiophene with Alkyl Phenylethynyl Substituents 显示文摘 | SISTA P NGUYEN H MURPHY J W | 2010 | Macromolecules2010，43，19： | 1 |
| 10 | THREE DIMENSIONAL MONTE CARLO SIMULATION OF GRAIN GROWTH DURING GTA WELDING OF TITANIUM显示文摘 | YANG Z SISTA S ELMER J W | 2000 | Acta mater2000，48，8： | 1 |
| 11 | The growth of single F% B phase on low carbon steel via phase homogenization in electrochemical boriding ( PHEB ) 显示文摘 | Kartal G Timur S Sista V | 2011 | Surface and Coatings Technology2011，206，7： | 1 |
| 12 | Heptad-repeat regions of respiratory syncytial virus Fl protein form a sixmembered coiled-coil complex显示文摘 | Lawless Delmedico MK Sista P Sen R | 2000 | Biochemistry2000，39，11： | 1 |
| 13 | Electro- chemical boriding and characterization of AISI D2 tool steet显示文摘 | Sista V Kahvecioglu O Eryilmaz O L | 2011 | Thin Solid Films2011，520，5： | 1 |
| 14 | Unsupervised video segmentation and object tracking显示文摘 | Srinivas Sista Rangassami L Kashyap | 2000 | Computer in Industry2000，，42： | 1 |
| 15 | Friction and wear behaviour of boron based surface treatment and nano-particle lubricant additives for wind turbine gearbox applications显示文摘 | Greco A Mistry K Sista V | 2011 | Wear2011，，6： | 1 |
| 16 | Twist beam suspension design and analysis for ve- hicle handling and rollover behavior显示文摘 | SISTA P KANG H T | 2010 | SAE Technical Paper2010，，4： | 1 |
| 17 | High-concentration supplemental perioperative oxygen and surgical site infection following elective colorectal surgery for rectal cancer:aprospective,randomized,double-blind,controlled,single-site trial显示文摘 | Schietroma M Cecilia EM Sista F | 2014 | Am J Surg2014，208，5： | 1 |
| 18 | The growth of single Fe 2 B phase on low carbon steel via phase homogenization in electrochemical boriding (PHEB)显示文摘 | G. Kartal S. Timur V. Sista O.L. Eryilmaz A. Erdemir | 2011 | Surface & Coatings Technology2011，，7： | 1 |
| 19 | Highly efficient tandem polymer photovoltaic cells显示文摘 | Sista S Park M Hong Z | 2010 | Advanced Materials2010，22，3： | 1 |
| 20 | CDKN1B/p27 expression in peripheral T cell lymphoma not otherwise specified 显示文摘 | Gazzola A Sista MT Agostinelli C | 2011 | J Clin Pathol2011，64，1： | 1 |
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