Giant bile duct dilatation in newborn:A case report

BACKGROUND Giant congenital biliary dilation(CBD)is a rare condition observed in clinical practice.Infants born with this condition often experience a poor overall health status,and the disease progresses rapidly,leading to severe biliary obstruction,infections,pressure exerted by the enlarged CBD on abdominal organs,disturbances in the internal environment,and multiple organ dysfunction.The treatment of giant CBD using laparoscopy is challenging due to the high degree of variation in the shape of the bile duct and other organs,making it difficult to separate the bile duct wall from adjacent tissues or to control bleeding.CASE SUMMARY Herein,we present the details of an 11-d-old male newborn who was diagnosed with giant CBD.The patient was admitted to the neonatal surgery department of our hospital due to a history of common bile duct cyst that was detected more than 3 mo ago,and also because the patient had been experiencing yellowish skin for the past 9 d.The abnormal echo in the fetal abdomen was first noticed by the patient’s mother during a routine ultrasound examination at a local hospital,when the patient was at 24 wk+6 d of pregnancy.This finding raised concerns about the possibility of congenital biliary dilatation(22 mm×21 mm).Subsequent ultrasound examinations at different hospitals consistently confirmed the presence of a congenital biliary dilatation.No specific treatment was administered for biliary dilatation during this period.A computed tomography scan conducted during the hospitalization revealed a large cystic mass in the right upper quadrant and pelvis,measuring approximately 9.2 cm×7.4 cm×11.3 cm.Based on the CONCLUSION The analysis reveals that prenatal imaging techniques,such as ultrasound and magnetic resonance imaging,play a crucial role in the early diagnosis,fetal prognosis,and treatment plan for giant CBD.Laparoscopic surgery for giant CBD presents certain challenges,including difficulties in separating the cyst wall,anastomosis,and hemostasis,as well as severe biliary system infection and ulceration.Consequently,there is a high likelihood of converting to laparotomy.The choice between surgical methods like hepaticojejunostomy(HJ)or hepaticoduodenostomy has not been standardized yet.However,we have achieved favorable outcomes using HJ.Preoperative management of inflammation,biliary drainage,liver function protection,and supportive treatment are particularly vital in improving children’s prognosis.After discharge,it is essential to conduct timely reexamination and close follow-up to identify potential complications.

Primary repair of esophageal atresia gross type C via thoracoscopic magnetic compression anastomosis:A case report

BACKGROUND Esophageal atresia(EA)is a life-threatening congenital malformation in newborns,and the traditional repair approaches pose technical challenges and are extremely invasive.Therefore,surgeons have been actively investigating new minimally invasive techniques to address this issue.Magnetic compression anastomosis has been reported in several studies for its potential in repairing EA.In this paper,the primary repair of EA with magnetic compression anastomosis under thoracoscopy was reported.CASE SUMMARY A full-term male weighing 3500 g was diagnosed with EA gross type C.The magnetic devices used in this procedure consisted of two magnetic rings and several catheters.Tracheoesophageal fistula ligation and two purse strings were performed.The magnetic compression anastomosis was then completed thoracoscopically.After the primary repair,no additional operation was conducted.A patent anastomosis was observed on the 15th day postoperatively,and the magnets were removed on the 23rd day.No leakage existed when the transoral feeding started.CONCLUSION Thoracoscopic magnetic compression anastomosis may be a promising minimally invasive approach for repairing EA.

A super resolution target separation and reconstruction approach for single channel sar against deceptive jamming

The excellent remote sensing ability of synthetic aperture radar(SAR)will be misled seriously when it encounters deceptive jamming which possesses high fidelity and fraudulence.In this paper,the dynamic synthetic aperture(DSA)scheme is used to extract the difference between the true and false targets.A simultaneous deceptive jamming suppression and target reconstruction method is proposed for a single channel SAR system to guarantee remote sensing ability.The system model is formulated as a sparse signal recovery problem with an unknown parametric dictionary to be estimated.An iterative reweighted method is employed to jointly handle the dictionary parameter learning and target reconstruction problem in an majorization-minimization framework,where a surrogate function majorizing the Gaussian entropy in the objective function is introduced to circumvent its non-convexity.After dictionary parameter learning,the grid mismatching problem in a fixed grid based method is avoided.Therefore,the proposed method can reap a super resolution result.Besides,a simple yet effective DSA section scheme is developed for the SAR data excerpting,in which only two DSAs are required.Experimental results about location error and reconstruction power error reveal that the proposed method is able to achieve a good performance in deceptive jamming suppression.

Numerical simulation of enhancing coalbed methane recovery by injecting CO_2 with heat injection

The technology used to enhance coalbed methane(CBM) recovery by injecting CO_2(CO_2-ECBM) with heat, combining heat injection with CO_2 injection, is still in its infancy; therefore, theoretical studies of this CO_2-ECBM technology should be perused. First, the coupling equations of the di usion–adsorption–seepage–heat transfer fields of gas are established. The displacement processes under di erent pressures and temperatures are simulated by COMSOL. Finally, the displacement effects, a comparison of the CO_2 storage capacity with the CH_4 output and the e ective influencing radius of CO_2 injection are analyzed and discussed. The results show that(1) the displacement pressure and temperature are two key factors influencing the CH_4 output and the CO_2 storage capacity, and the increase in the CO_2 storage capacity is more sensitive to temperature and pressure than the CH_4 output.(2) The gas flow direction is from the injection hole to the discharge hole during the displacement process, and the regions with high velocity are concentrated at the injection hole and the discharge hole.(3) A reduction in the CH_4 concentration and an increase in the CO_2 concentration are obvious during the displacement process.(4) The e ective influencing radius of injecting CO_2 with heat increases with the increase in time and pressure. The relationship between the e ective influencing radius and the injection time of CO_2 has a power exponential function, and there is a linear relationship between the functional coe cient and the injection pressure of CO_2. This numerical simulation study on enhancing CBM recovery by injecting CO_2 with heat can further promote the implementation of CO_2-ECBM project in deep coal seams.

Characteristics of high-rank coal structure parallel and perpendicular to the bedding plane via NMR and X-ray CT

Pores and fractures and their connectivity play a significant role in coalbed methane production.To investigate the growth characteristics and connectivity of pores and fractures in coal parallel and perpendicular to the bedding plane,the pores and fractures of high-rank coal samples collected from the southern Qinshui Basin were measured by low-field nuclear magnetic resonance,X-ray-computed tomography and field emission scanning electron microscopy.Then,the determinants of their connectivity were further discussed.The results show that the high-rank coal samples have similar pore size distributions both parallel and perpendicular to the bedding plane.They primarily contain mesopores(2-50 nm in width),followed by macrospores(> 50 nm in width).The research indicated that the high-rank coal connectivity parallel to the bedding plane is significantly better than that perpendicular to the bedding plane.The connectivity of high-rank coal is mainly determined by throats,and the orientation of the pores and fractures.The two connectivity modes in high-rank coal are "pore connectivity," in which the throats are mainly pores with a low coordination number,and "microfissure connectivity",in which the throats are mainly microfissures with a high coordination number.

Healing of Stoma After Magnetic Biliary-Enteric Anastomosis in Canine Peritonitis Models

Objective To assese the healing of stoma after magnetic anastomosis for the reconstruction of biliary-enteric continuity under severe inflammation. Methods Acute bile duct injury was constructed as a bile peritonitis model in mongrel dogs(n=32). Magnetic anastomosis(group A, n=16) and traditional suture anastomosis(group B, n=16) were performed to reconstruct the biliary-enteric continuity in one stage. Half of the dogs in each group were euthanized on the 30 th postoperative day, and the other half on the 90 th postoperative day to harvest the stoma region. The healing conditions of the stoma after the 2 anastomotic approaches were observed with naked eyes, under light microscope and scanning electron microscope. Results The stoma leakage rate(50% versus 0% on the 30 th postoperative day, 37.5% versus 12.5% on the 90 th postoperative day, both P<0.05) and stenosis degree(13.9%±0.3% versus 7.1%±0.3% on the 30 th postoperative day, 17.2%±0.4% versus 9.4%±0.4% on the 90 th postoperative day, both P<0.01) were significantly higher in group B than in group A. Compared with traditional manual anastomoses, the histological analysis under light and electron microscope showed a more continuous stoma with more regular epithelium proliferation and collagen arrangement, less inflammation in group A. Conclusions Magnetic anastomosis stent ensures better healing of the stoma even under the circumstance of severe inflammation.

A new veno-venous bypass type for ex-vivo liver resection in dogs

Ex-vivo liver resection is a procedure in which the liver is completely removed, perfused and after bench surgery, the liver is autotransplanted to the original site. Ex vivo liver resection is an important treatment for unresectable liver tumors. This surgical procedure requires long operation time, during which blood flow must be carefully maintained to avoid venous congestion. An effective veno-venous bypass (VVB) may meet this requirement. The present study was to test our new designed VVB device which comprised one heparinized polyvinylchloride tube and three magnetic rings The efficacy of this device was tested in five dogs. A VVB was established in 6-10 minutes. There was no leakage during the procedure. Hemodynamics was stable at anhepatic phase, which indicated that the bypass was successful. This newly-developed VVB device maintained circulation stability during ex-vivo liver resection in our dog model and thus, this VVB device significantly shortened the operation time.

Three-dimensional spatial structure of the macro-pores and flow simulation in anthracite coal based on X-ray μ-CT scanning data

The three-dimensional(3 D) structures of pores directly affect the CH4 flow.Therefore,it is very important to analyze the3 D spatial structure of pores and to simulate the CH4 flow with the connected pores as the carrier.The result shows that the equivalent radius of pores and throats are 1-16 μm and 1.03-8.9 μm,respectively,and the throat length is 3.28-231.25 μm.The coordination number of pores concentrates around three,and the intersection point between the connectivity function and the X-axis is 3-4 μm,which indicate the macro-pores have good connectivity.During the single-channel flow,the pressure decreases along the direction of CH4 flow,and the flow velocity of CH4 decreases from the pore center to the wall.Under the dual-channel and the multi-channel flows,the pressure also decreases along the CH4 flow direction,while the velocity increases.The mean flow pressure gradually decreases with the increase of the distance from the inlet slice.The change of mean flow pressure is relatively stable in the direction horizontal to the bedding plane,while it is relatively large in the direction perpendicular to the bedding plane.The mean flow velocity in the direction horizontal to the bedding plane(Y-axis) is the largest,followed by that in the direction horizontal to the bedding plane(X-axis),and the mean flow velocity in the direction perpendicular to the bedding plane is the smallest.

One-bit splitting deceptive jamming against SAR

One-bit quantization is a promising technique due to its performance retention and complexity reduction in a deceptive jammer against synthetic aperture radar(SAR).In this paper,the 1-bit quantization technology is utilized to agilely generate split false targets in the SAR imagery once the radar signal is intercepted,which reduces the complexity of the jammer significantly with guaranteed focusing quality.A single-frequency threshold is used to decompose harmonics incurred by the 1-bit quantization,and its parameters are adjusted through different pulse repetition intervals to provide steerable modulations.In this way,the SAR signal is split into coupled false scatterers during the 1-bit interception.By further deploying amplitude,time-delay,and Doppler frequency modulations on the 1-bit intercepted signal,the split false targets are created.The proposed approach is compared with different deceptive jamming methods to show its validity in effectiveness and cost,and numerical experiments are also presented for verification.

Esophageal magnetic compression anastomosis in dogs

BACKGROUND Magnetic compression anastomosis(MCA)is a novel suture-free reconstruction of the digestive tract.It has been used in gastrointestinal anastomosis,jejunal anastomosis,cholangioenteric anastomosis and so on.The traditional operative outcomes of congenital esophageal atresia and benign esophageal stricture are poor,and there are too many complications postoperatively.AIM To test MCA technology to reconstruct the esophagus in dogs,prior to studying the feasibility and safety of MCA in humans.METHODS Thirty-six dogs were randomized into either the study or control group(n=18 per group).The dogs in the study group were subjected to end-to-end esophageal anastomosis with the magnetic compression device,while those in the control group underwent hand-sewn anastomosis with 4-0 absorbable multifilament Vicryl.We used interrupted single-layer inverting sutures.The anastomosis time,gross appearance,weight and pathology of the anastomosis were evaluated at one month,three months and six months postoperatively.RESULTS The anastomosis time of the MCA group was shorter than that of the hand-sewn group(7.5±1.0 min vs 12.5±1.8 min,P<0.01).In the MCA group,X-ray examination was performed every day to locate the magnetic device in the esophagus before the magnetic device fell off from the esophagus.In the hand-sewn group,dogs did not undergo X-ray examination.One month after the surgeries,the mean weight of the dogs in the hand-sewn group had decreased more than that of the dogs in the MCA group(11.63±0.71 kg vs 12.73±0.80 kg,P<0.05).At 3 mo and 6 mo after the operation,the dogs’weights were similar between the two groups(13.75±0.84 kg vs 14.03±0.82 kg,14.93±0.80 kg vs 15.44±0.47 kg).The number of inflammatory cells in MCA group was lower than that in hand-sewn group on 1 mo after operation.CONCLUSION MCA is an effective and safe method for esophageal reconstruction.The anastomosis time of the MCA group was less than that of the hand-sewn group.This study shows that MCA technology may be applied to human esophageal reconstruction,provided these favorable results are confirmed by more publications.

Endoscopic magnetic compression stricturoplasty for congenital esophageal stenosis:A case report

BACKGROUND Congenital esophageal stenosis(CES)is a rare malformation of the digestive tract.Endoscopic dilation and thoracotomy have been the main treatments for CES.However,there is no well-defined management protocol.Magnetic compression stricturoplasty(MCS)has been used in refractory esophageal stricture in children after esophageal atresia.CASE SUMMARY We describe the first case of MCS for CES in one female child patient.The child(aged 3 years and 1 mo)was admitted due to frequent vomiting and choking after eating complementary food since 7 mo old.Esophagography and gastroendoscopy showed that there was stenosis in the lower esophagus,suggesting a diagnosis of CES.The patient did not receive any treatment for esophageal stricture including surgery or endoscopic dilation procedures before MCS.MCS procedure was smoothly conducted without complications.At 24 mo after MCS,durable esophageal patency without dysphagia was achieved.CONCLUSION MCS may serve as an alternative and efficient method for patients with CES.

Morphology and photocatalytic performance of nano-sized TiO_2 prepared by simple hydrothermal method with different pH values

pH value is a key factor in the preparation of nano-sized TiO2 with hydrothermal method. Using Ti（SO4）2 as the titanium source, H2O2 as the complexing agent, NaOH and HCl as the pH value regulator, nano- sized TiO2 powder with various morphologies and sizes was synthesized. Changes in morphology, size and phase type with pH values of samples were characterized by X-ray diffraction （XRD） and transmission electron micro- scopy （TEM） measurements. Results show that under the present preparation conditions, TiO2 powder is an anatase phase with pH value less than 11, but is more likely to be a brookite phase with pH value more than 11. With the increase in pH value from 1 to 11 in hydrothermal envi- ronment, nano-sized anatase TiO2 gradually grows up in all directions. {001 }, { 101 } and { 100} groups of crystal plane are the exposed crystal planes of nano-sized anatase TiO2 for the （004）, （101） and （200） facets found in high-reso- lution TEM image. The photocatalytic performance of nano-sized TiO2 with different morphologies was com- pared by measuring their photocatalytic degradation rates for methylene blue under ultraviolet light. Results show that anatase TiO2 prepared under the alkalescenthydrothermal environment （pH = 9, 11） has a better pho- tocatalytic degrading performance. Different sizes and phases of nanoscaled TiO2 powders with different photo- catalytic performances can be prepared by the control of pH value of hydrothermal solutions.

Antimicrobial Properties and Application of Polysaccharides and Their Derivatives

With the quick emergence of antibiotic resistance and multi-drug resistant microbes,more and more attention has been paid to the development of new antimicrobial agents that have potential to take the challenge.Polysaccharides,as one of the major classes of biopolymers,were explored for their antimicrobial properties and applications,owing to their easy accessibility,biocompatibility and easy modification.Polysaccharides and their derivatives have variable demonstrations and applications as antimicrobial agents and antimicrobial biomaterials.A variety of polysaccharides,such as chitosan,dextran,hyaluronic acid,cellulose,other plant/animal-derived polysaccharides and their derivatives have been explored for antimicrobial applications.We expect that this review can summarize the important progress of this field and inspire new concepts,which will contribute to the development of novel antimicrobial agents in combating antibiotic resistance and drug-resistant antimicrobial infections.

Surgical management of newborns with combined tracheoesophageal fistula, esophageal atresia, and duodenal obstruction

To the Editor: The incidence of esophageal atresia (EA) along with tracheoesophageal fistula (TEF) is approximately 1/3000 in newborns.[1] A large population study revealed that 46% of patients with TEF/EA had at least one of the other vertebral, anal, cardiac, tracheal, esophageal, renal, and limb (VACTERL) malformations.[2] Duodenal obstruction has an incidence of 1/7000 live births and can be caused by duodenal atresia (DA) or annular pancreas (AP).[3] AP is an uncommon congenital anomaly, and duodenal obstruction most commonly presents in the infancy or early childhood of patients.[4] The incidence of DA combined with EA varies between 3% and 6%,[5] and DA combined with EA is often associated with significant morbidity and mortality.[6]

Research Progress of Qiweibaizhu Powder in Treating Digestive System Diseases

Diarrhea is a common clinical problem that can lead to health complications,including death.It is the second-most common cause of death in children.The World Health Organization introduced a program to encourage the development and use of traditional herbal medicines in the treatment of diarrhea.Qiweibaizhu Powder(QWBZP)is a well-known pediatric prescription in China that is commonly used to treat digestive system diseases,such as diarrhea,which is also a type of syndrome in traditional Chinese medicine.Many studies have examined the clinical effects and mechanisms of QWBZP,and innovative and improved formulations have been developed.Recent studies on the effects of QWBZP on diarrhea caused by human rotavirus,antibiotic-associated diarrhea,and mesenteric lymphadenitis in experimental models and clinical trials with diarrhea patients have been reviewed.We conducted a literature search of several databases,including PubMed,China National Knowledge Infrastructure,Chongqing VIP Information Co.,Ltd.,and Wanfang.A short background of the QWBZP is also provided.The collective findings highlight the curative effects of QWBZP on diarrhea caused by viral infection,antibiotic use,and mesenteric lymphadenitis.Furthermore,QWBZP can regulate the balance of the gastrointestinal microbiota and protect and repair the intestinal mucosal barrier.This review will provide a reference for further studies on QWBZP.