内镜下抗反流黏膜切除术治疗难治性胃食管反流病初探

目的探讨内镜下抗反流黏膜切除术(ARMS)治疗难治性胃食管反流病(RGERD)的初步疗效及安全性。方法回顾性分析2017年6月-2019年1月宁波市第一医院6例行ARMS治疗的RGERD患者的临床资料,治疗前后行反流症状指数(RSI)、胃食管反流病健康相关生存质量量表(GERD-HRQL)及吞咽困难评分,评价治疗的疗效。结果全组6例患者均顺利完成内镜下ARMS术,无术中术后穿孔、出血等严重并发症。术后随访至少6个月,最长至26个月。术后1个月RSI评分及GERD-HRQL评分为(9.7±3.9)和(11.3±2.3)分,与术前比较,差异均有统计学意义(P<0.01);术后6个月RSI评分及GERD-HRQL评分为(2.8±1.5)和(3.2±1.9)分,与术前比较,差异均有统计学意义(P<0.01)。术后1个月吞咽困难症状改善尚不明显(P>0.05),术后6个月无1例患者存在吞咽困难[评分为(0.0±0.0)分],与术前比较,差异有统计学意义(P<0.05)。结论内镜下ARMS术治疗RGERD的短期疗效好,安全性高。

经支气管镜介入技术治疗气道平滑肌瘤的临床研究

目的探讨经支气管镜下联合荧光、氩离子束凝固术(APC)、二氧化碳冷冻术介入治疗气道平滑肌瘤的可行性及安全性,观察临床疗效。方法回顾性分析2014年6月-2019年12月该院8例确诊为气道平滑肌瘤所致的气道阻塞患者,在支气管镜下联合荧光进行圈套、电切、APC和二氧化碳冷冻术治疗,观察气道打通程度、临床症状改善情况、并发症的发生率及复发情况,术中监测患者心率、血压、呼吸和血氧饱和度,比较治疗前后患者的气道狭窄分级情况、气促分级和Karnofsky评分(KPS)。评估此技术的疗效和安全性。结果在8例平滑肌瘤中,行支气管镜下APC、电切和冷冻术共计21次,肿瘤切除后气道完全打通,临床症状完全缓解;无纵隔气肿、呼吸道穿孔及大出血等严重并发症;经随访,无复发。结论经支气管镜下联合荧光进行APC、高频电刀和二氧化碳冷冻术在治疗气道平滑肌瘤导致的气道阻塞中疗效显著,可达到临床根治,避免了开胸手术创伤,适合临床推广。

Relationship between brain—derived neurotrophic factor and cognitive function of obstructive sleep apnea/hypopnea syndrome patients

Objective:To determine the relationship between the blood serum brain-derived neurotrophic factor（BDNF） level and cognitive function deterioration in patients with obstructive sleep apnea/ hypopnea syndrome（OSAHS）,and to explore the possible mechanism of cognitive impairment. Methods:Twenty-eight male OSAHS patients and 14 normal males（as controls） were enrolled in the study.Polysomnography and the Montreal cognitive assessment（MoCA） were conducted. The blood serum BDNF levels were measured using ELISA.Results:The OSAHS group had significantly decreased blood serum BDNF levels compared with the control group（t=-10.912, P=0.000）.The blood serum BDNF level of the subjects was significantly positively associated with the MoCA score（r=0.544,P=0.000）,significantly negatively associated with the apneahypopnea index（AHI） and shallow sleep（S1+S2）（AHI:r=-0.607,P=0.000;S1+S2:r =-0.768,P= 0.000）,and significantly positively associated with the lowest SaO2（LSO）,slow wave sleep（S3+S4）, and rapid eye movement sleep（REM）（LSO:r=0.566,P = 0.000;S3+S4:r=0.778,P=0.000;REM: r=0.575,P=0.000）.Conclusions:OSAHS patients have significantly decreased blood serum BDNF levels compared with the control.Nocturnal hypoxia as well as the deprivation of slow wave sleep and REM may lead to the decreased serum BDNF level of OSAHS patients.This decreased blood serum BDNF level may contribute to the cognitive impairment in OSAHS.

Esophageal Helicobacter pylori colonization aggravates esophageal injury caused by reflux

AIM: To investigate esophageal Helicobacter pylori (H. pylori) colonization on esophageal injury caused by reflux and the related mechanisms.

Survivin and pancreatic cancer

Pancreatic cancer is estimated to be the fourth most common cancer in men and fifth in women in the world and has poor prognosis.In recent years,more and more effort has been put on the relationship between pancreatic cancer and apoptosis.As a newly discovered inhibitor of apoptosis,survivin has drawn more attention.Strong evidence has shown that survivin is expressed in pancreatic cancer cells on frozen sections.Survivin increases in the development of pancreatic ductal adenocarcinoma and its expression can be a marker in evaluating the prognosis of pancreatic cancer patients.Survivin itself may be a new target in the treatment of pancreatic cancer and a survivin DNA vaccine could generate specific antitumor effects in pancreatic carcinoma models.

Development of unconventional gas and technologies adopted in China

This study analyses the geological characteristics and development progress of unconventional gas in China,summarizes the development theories and technologies,discusses the prospects and challenges of unconventional gas development,and puts forward the future trends of development technologies.Various technologies of unconventional gas development are available in China.Shale gas development technologies include comprehensive geological evaluation,volume fracturing of cluster horizontal wells under complex stress conditions,and factory-like operation of horizontal wells in complex mountainous area et al.Tight gas development technologies include fluid identification and quantitative prediction,optimization of well patterns,multi-layer fracturing in vertical well,staged fracturing in horizontal well,and drainage gas recovery.Coalbed methane(CBM)development technologies include the prediction of medium-high-and medium-low-rank CBM enrichment areas,rate-variable hydraulic fracturing,and quantitative drainage recovery with five stages,three pressures,and four controls.For economic and effective development of unconventional gas,further efforts should be made.First,intensified studies should be conducted on high-precision prediction and fine characterization technologies of high-quality shale reservoirs in deep marine,continental,and transitional facies.Second,key theories and technologies such as fast drilling and completion of wells with long laterals as well as large-scale volume fracturing should be developed to improve well productivity.Third,new technologies such as multiple well-type development,fluid injection,and nano-flooding should be developed to enhance the recovery.Fourth,effort should be made to identify the accumulation mechanism and large-scale effective development technologies for CBM.Fifth,the application of large amounts of data and artificial intelligence in the entire process of unconventional gas development should be considered to reduce the development cost.

Hybrid absorbing boundary condition based on transmitting boundary and its application in 3D fractional viscoacoustic modeling

An accurate numerical simulation for wave equations is essential for understanding of wave propagation in the earth's interior as well as full waveform inversion and reverse time migration. However, due to computational cost and hardware capability limitations, numerical simulations are often performed within a finite domain. Thus, an adequate absorbing boundary condition (ABC) is indispensable for obtaining accurate numerical simulation results. In this study, we develop a hybrid ABC based on a transmitting boundary, which is referred to as THABC, to eliminate artificial boundary reflections in 3D second-order fractional viscoacoustic numerical simulations. Furthermore, we propose an adaptive weighted coefficient to reconcile the transmitting and viscoacoustic wavefields in THABC. Through several numerical examples, we determine that the proposed THABC approach is characterized by the following benefits. First, with the same number of absorbing layers, THABC exhibits a better ability in eliminating boundary reflection than traditional ABC schemes. Second, THABC is more effective in computation, since it only requires the wavefields at the current and last time steps to solve the transmitting formula within the absorbing layers. Benefiting from a simple but effective combination between the transmitting equation and the second-order wave equation, our scheme performs well in the 3D fractional Laplacian viscoacoustic numerical simulation.

An improved method for internal multiple elimination using the theory of virtual events

Compared with first-order surface-related multiples from marine data,the onshore internal multiples are weaker and are always combined with a hazy and occasionally strong interference pattern.It is usually difficult to discriminate these events from complex targets and highly scattering overburdens,especially when the primary energy from deep layers is weaker than that from shallow layers.The internal multiple elimination is even more challenging due to the fact that the velocity and energy difference between primary reflections and internal multiples is tiny.In this study,we propose an improved method which formulates the elimination of the internal multiples as an optimization problem and develops a convolution factor T.The generated internal multiples at all interfaces are obtained using the convolution factor T through iterative inversion of the initial multiple model.The predicted internal multiples are removed from seismic data through subtraction.Finally,several synthetic experiments are conducted to validate the effectiveness of our approach.The results of our study indicate that compared with the traditional virtual events method,the improved method simplifies the multiple prediction process in which internal multiples generated from each interface are built through iterative inversion,thus reducing the calculation cost,improving the accuracy,and enhancing the adaptability of field data.

Analysis of the expression and prognostic value of ENO1 in ovarian cancer based on Oncomine database

Objective:Ovarian cancer is one of the leading causes of death in women,because of late diagnosis,recurrence and resistance to chemotherapy.Therefore,it's necessary to design a novel sensitive and specific maker to diagnose and treat patients of ovarian cancer.However,this study intends to explore the expression and prognostic value of ENO1 in ovarian cancer.Method:ENO1 data were collected from Oncomine database,and then were performed subgroup analysis and systematic analysis.Meanwhile,the prognostic significance of ENO1 was analyzed by an online survival analysis tool"Kaplan-Meier Plotter"(KM plotter)database.Results:In Oncomine database,a total of 14 studies were involved ENO1 in ovarian cancer tissues and normal tissues,including a total of 1001 samples.Comparing with normal tissues,ENO1 expression is higher(P<0.05).Moreover,the overall survival of ENO1 high expression in ovarian cancer is closely related with high survival(P<0.05).Further study indicated that ENO1 expression showed negative relation to the prognosis of serous ovarian cancer patients while ENO1 expression showed no effects on the prognosis of endometrioid ovarian cancer patients.Conclusion:Through exploration of tumor gene information in Oncomine database,ENO1 was found highly expressed in ovarian cancer and related to the prognosis of ovarian cancer,which might be a new marker for ovarian cancer prognosis and alternative drug therapy.

Study on the flow structure in curved open channels with suspended vegetation using multi relaxation time lattice Boltzmann method

Suspended vegetation in rivers,lakes,reservoirs and canals can change flow structure,which will in turn affect the sediment transport and cause the variation of water ecological environment.In order to study the characteristics of bend flow through suspended vegetation,three-dimensional numerical simulations are carried out by using the multi-relaxation-time lattice Boltzmann method(MRT-LBM).The drag force induced by vegetation is added in the velocity correction in the equilibrium distribution and a hybrid format combined bounce and specular reflection scheme is applied in the solid-fluid boundaries.After the validation of this model,six cases are designed to conduct the numerical simulations according to the root depth and the arrangement of vegetation.The simulated results show that the suspended vegetation can redistribute the flow structure in curved open channels.After the arrangement of suspended vegetation,the main flow moves to the side without vegetation,and the distribution of velocity tends to be balanced when vegetation is arranged on the entire cross section,the range of circulating current is reduced from the whole cross section to the local position without vegetation,however,the circulating current can still exist in the curve where the suspended vegetation enters less than half of the water depth.In addition,it can also be concluded that the suspended vegetation can affect the lateral gradient of flow velocity,and the bed shear stress in the curved channel.

Investigation of open channel flow with unsubmerged rigid vegetation by the lattice Boltzmann method

The aquatic vegetation can significantly affect the flow structure,the sediment transport,the bed scour and the water quality in rivers,lakes,reservoirs and open channels.In this study,the lattice Boltzmann method(LBM)is applied in the two-dimensional numerical simulation of the flow structure in a flume with rigid vegetation.A multi-relaxation time model is applied to improve the stability of the numerical scheme for flows with a high Reynolds number.The vegetation induced drag force is added in the lattice Boltzmann equation model in order to improve the simulation accuracy and an algorithm of the multi-relaxation time is developed.Numerical simulations are performed for a wide range of flow and vegetation conditions and are validated by comparing with the laboratory experiments.Analysis of the simulated and experimentally measured flow Helds shows that the numerical simulation can satisfactorily reproduce the laboratory experiments,indicating that the proposed lattice Boltzmann model enjoys a high accuracy for simulating the flow-vegetation interaction in open channels.

Molecular characterization,spatial-temporal expression and magnetic response patterns of iron-sulfur cluster assembly1(IscA1)in the rice planthopper,Nilaparvata lugens

The mechanisms of magnetoreception have been proposed as the magnetitebased, the chemical radical-pair and biocompass model, in which magnetite particles, the cryptochrome (Cry) or iron-sulfur cluster assembly 1 (IscA1) may be involved. However, little is known about the association among the molecules. Here we investigated the molecular characterization and the mRNA expression of IscA1 in different developmental stages, tissues and magnetic fields in the migratory brown planthopper (BPH), Nilaparvata lugens. NlIscA1 contains an open reading frame of 390 bp, encoding amino acids of 129, with the predicted molecular weight of 14.0 kDa and the isoelectric point of 9.10. Well-conserved Fe-S cluster binding sites were observed in the predicted protein. Phylogenetic analysis demonstrated NlIscA1 to be clustered into the insect's IscA1. NlIscA1 showed up-regulated mRNA expression during the period of migration. The mRNA expression of NlIscA1 could be detected in all the three tissues of head, thorax and abdomen, with the highest expression level in the abdomen. For the macropterous migratory Nilaparvata lugens, mRNA expression of NlIscA1 and N. lugens cryptochromel (Nlcry1) were up-regulated under the magnetic fields of 5 Gauss and 10 Gauss in strength (vs. local geomagnetic field), while N. lugens cryptochrome 2 (Nlcry2) remained stable. For the brachyterous non-migratory Nilaparvata lugens, no significant changes were found in mRNA expression of NlIscA1, Nlcry1 and Nlcry2 among different magnetic fields. These findings preliminarily reveal that the expression of NlIscA1 and Nlcry1 exhibited coordinated responses to the magnetic field. It suggests some potential associations among the putative magneto-sensitive molecules of cryptochrome and iron-sulfur cluster assembly.

Enhancement of the geomagnetic field reduces the phototaxis of rice brown planthopper Nilaparvata lugens associated with frataxin down-regulation

The geomagnetic field(GMF)is an environmental cue that provides directional information for animals.The intensity of GMF is varied over space and time.Variations in the GMF intensity afect the navigation of animals and their physiology.In this study,the phototaxis of the migratory insect rice planthopper Nilaparvata lugens(N.lugens)and frataxin in N.lugens(NI-fh),which is a mitochondrial protein required for cellular iron homeostasis and iron-sulfur cluster assembly,were investigated by using different intensities of magnetic field.From the results,individuals of N.lugens showed decreased phototaxis when reared and tested in a behavioral arena under a strong magnetic field.Besides the reduction in performance,an accompanying ffect of the strong magnetic field condition was a reduced level of Nl-fh-messenger RNA,and a NI-fh knockdown indeed impaired the phototactic behavior in a tested sample of insects.This leads to the conclusion that the expression of frataxin is dependent on the strength of the surrounding magnetic field and that functional frataxin facilitates phototactic behavior in N.lugens.

Soluble CD4 effectively prevents excessive TLR activation of resident macrophages in the onset of sepsis

T lymphopenia,occurring in the early phase of sepsis in response to systemic inflammation,is commonly associated with morbidity and mortality of septic infections.We have previously shown that a sufficient number of T cells is required to constrain Toll-like receptors(TLRs)mediated hyperinflammation.However,the underlying mechanisms remains unsolved.Herein,we unveil that CD4^(+)T cells engage with MHC II of macrophages to downregulate TLR pro-inflammatory signaling.