Impact of cap-assisted colonoscopy during transendoscopic enteral tubing:A randomized controlled trial

BACKGROUND Colonic transendoscopic enteral tubing(TET)requires double cecal intubation,raising a common concern of how to save cecal intubation time and make the tube stable.We hypothesized that cap-assisted colonoscopy(CC)might reduce the second cecal intubation time and bring potential benefits during the TET procedure.AIM To investigate if CC can decrease the second cecal intubation time compared with regular colonoscopy(RC).METHODS This prospective multicenter,randomized controlled trial was performed at four centers.Subjects≥7 years needing colonic TET were recruited from August 2018 to January 2020.All subjects were randomly assigned to two groups.The primary outcome was the second cecal intubation time.Secondary outcomes included success rate,insertion pain score,single clip fixation time,purpose and retention time of TET tube,length of TET tube inserted into the colon,and all procedurerelated(serious)adverse events.RESULTS A total of 331 subjects were randomized to the RC(n=165)or CC(n=166)group.The median time of the second cecal intubation was significantly shorter for CC than RC(2.2 min vs 2.8 min,P<0.001).In patients with constipation,the median time of second cecal intubation in the CC group(n=50)was shorter than that in the RC group(n=43)(2.6 min vs 3.8 min,P=0.004).However,no difference was observed in the CC(n=42)and RC(n=46)groups of ulcerative colitis patients(2.0 min vs 2.5 min,P=0.152).The insertion pain score during the procedure in CC(n=14)was lower than that in RC(n=19)in unsedated colonoscopy(3.8±1.7 vs 5.4±1.9;P=0.015).Multivariate analysis revealed that only CC(odds ratio[OR]:2.250,95%confidence interval[CI]:1.161-4.360;P=0.016)was an independent factor affecting the second cecal intubation time in difficult colonoscopy.CC did not affect the colonic TET tube’s retention time and length of the tube inserted into the colon.Moreover,multivariate analysis found that only endoscopic clip number(OR:2.201,95%CI:1.541-3.143;P<0.001)was an independent factor affecting the retention time.Multiple regression analysis showed that height(OR:1.144,95%CI:1.027-1.275;P=0.014)was the only independent factor influencing the length of TET tube inserted into the colon in adults.CONCLUSION CC for colonic TET procedure is a safe and less painful technique,which can reduce cecal intubation time.

Distributed Optimization Algorithm for Multi-Robot Formation with Virtual Reference Center

Dear editor,In this letter,we use a distributed optimization approach to solve a class of multi-robot formation problem with virtual reference center.We investigate the design and analysis of the constrained consensus algorithm to solve the optimization problem with a sum of objective functions with some local constraints.In the multi-robot system with virtual reference center,each robot has messages on its own constraints and objective function,as well as the message about the formation that interacts with the virtual reference center.At the same time,all the robots collaborate to find the minimum value of the function defined by the formation.To find the optimal formation,we propose an algorithm with fixed step size with better performance.In addition,we use a combination of the Hungarian assignment algorithm and the proposed formation algorithm to get the optimal matching formation of the multi-robot system.

朴心五色 匠心筑梦——记紫砂艺术家刘军华

宜兴的紫砂艺术历经数百年的传承与流变,在中国乃至世界陶瓷文化史上占有极为重要的地位。古往今来,众多艺术家为了紫砂艺术的发展孜孜不倦、接续前行,生于陶都宜兴丁蜀的刘军华,就是这样一位对紫砂有着与生俱来的偏爱且凭着厚实的功底在紫砂艺术领域默默耕耘、独树一帜的艺术家。70后的刘军华,现为中国民间文艺家协会会员,宜兴市工艺美术学会理事。他师从中国陶瓷艺术大师、正高级工艺美术师张红华,擅长全手工紫砂壶制作.

芳华绽放 妙艺传承--记紫砂艺术家董亚芳

"茗注莫妙于砂,壶之精者又莫过于阳羡"。宜兴之紫砂文化源远流长,闻名千载。太湖之滨璀璨而耀眼的明珠宜兴,亦可谓物华天宝,人杰地灵,紫砂艺术家董亚芳便出生在这里,因自幼受着浓郁的紫砂文化熏陶,使得紫砂艺术早已深入到她的心灵之中。时至今日,董亚芳从事紫砂壶创制已有三十余个春秋,她尊师勤研,博采众长并以独特的创作视角脱颖而出、卓然群芳。