Applications of gastric peroral endoscopic myotomy in the treatment of upper gastrointestinal tract disease

Gastric peroral endoscopic myotomy(G-POME)is an emerging minimally invasive endoscopic technique involving the establishment of a submucosal tun-nel around the pyloric sphincter.In 2013,Khashab et al used G-POME for the first time in the treatment of gastroparesis with enhanced therapeutic efficacy,prov-iding a new direction for the treatment of gastroparesis.With the recent and rapid development of G-POME therapy technology,progress has been made in the treatment of gastroparesis and other upper digestive tract diseases,such as congenital hypertrophic pyloric stenosis and gastric sleeve stricture,with G-POME.This article reviews the research progress and future prospects of G-POME for the treatment of upper digestive tract gastrointestinal diseases.

A reliability-oriented genetic algorithm-levenberg marquardt model for leak risk assessment based on time-frequency features

Since leaks in high-pressure pipelines transporting crude oil can cause severe economic losses,a reliable leak risk assessment can assist in developing an effective pipeline maintenance plan and avoiding unexpected incidents.The fast and accurate leak detection methods are essential for maintaining pipeline safety in pipeline reliability engineering.Current oil pipeline leakage signals are insufficient for feature extraction,while the training time for traditional leakage prediction models is too long.A new leak detection method is proposed based on time-frequency features and the Genetic Algorithm-Levenberg Marquardt(GA-LM)classification model for predicting the leakage status of oil pipelines.The signal that has been processed is transformed to the time and frequency domain,allowing full expression of the original signal.The traditional Back Propagation(BP)neural network is optimized by the Genetic Algorithm(GA)and Levenberg Marquardt(LM)algorithms.The results show that the recognition effect of a combined feature parameter is superior to that of a single feature parameter.The Accuracy,Precision,Recall,and F1score of the GA-LM model is 95%,93.5%,96.7%,and 95.1%,respectively,which proves that the GA-LM model has a good predictive effect and excellent stability for positive and negative samples.The proposed GA-LM model can obviously reduce training time and improve recognition efficiency.In addition,considering that a large number of samples are required for model training,a wavelet threshold method is proposed to generate sample data with higher reliability.The research results can provide an effective theoretical and technical reference for the leakage risk assessment of the actual oil pipelines.

Importance of accurate diagnosis of congenital agenesis of the gallbladder from atypical gallbladder stone presentations:A case report

BACKGROUND Congenital agenesis of the gallbladder(CAGB)is a rare condition often misdiagnosed as cholecystolithiasis,leading to unnecessary surgeries.Accurate diagnosis and surgical exploration are crucial in patients with suspected CAGB or atypical gallbladder stone symptoms.Preoperative imaging,such as magnetic resonance cholangiopancreatography(MRCP),plays a vital role in confirming the diagnosis.Careful intraoperative dissection is necessary to avoid iatrogenic injuries and misdiagnosis.Multidisciplinary consultations and collaboration,along with the use of various diagnostic methods,can minimize associated risks.CASE SUMMARY We present the case of a 34-year-old female with suspected gallbladder stones,ultimately diagnosed with CAGB through surgical exploration.The patient underwent laparoscopic examination followed by open exploratory surgery,which confirmed absence of the gallbladder.Subsequent imaging studies supported the diagnosis.The patient received appropriate postoperative care and experienced a successful recovery.CONCLUSION This case highlights the rarity of CAGB and the importance of considering this condition in the differential diagnosis of patients with gallbladder stone symptoms.Accurate diagnosis using preoperative imaging,such as MRCP,is crucial to prevent unnecessary surgeries.Surgeons should exercise caution and conduct meticulous dissection during surgery to avoid iatrogenic injuries and ensure accurate diagnosis.Multidisciplinary collaboration and utilization of various diagnostic methods are essential to minimize the risk of misdiagnosis.Selection of the optimal treatment strategy should prioritize minimizing trauma and maintaining open communication with the patient and their family members.

Silencing of signal transducer and activator of transcription 3 expression by RNA interference suppresses growth of human hepatocellular carcinoma in tumor-bearing nude mice

AIM： To explore the effect of silencing of signal transducer and activator of transcription 3 （STAT3） expression by RNA interference （RNAi） on growth of human hepatocellular carcinoma （HCC） in tumorbearing nude mice in vivo.METHODS： To construct the recombinant plasmid of pSilencer 3.0-H1-STAT3-siRNA-GFP （pSHI-siRNA- STAT3） and establish the tumor-bearing nude mouse model of the HCC cell line SMMC7721, we used intratumoral injection together with electroblotting to transfect the recombinant plasmid pSHI-siRNA- STAT3 into the transplanted tumor. The weight of the nude mice and tumor volumes were recorded. STAT3 gene transcription was detected by semi-quantitative reverse transcription polymerase chain reaction （RT- PCR）. Level of protein expression and location of STAT3 were determined by Western blotting and immunohistochemical staining. STAT3-related genes such as survivin, c-myc, VEGF, p53 and caspase3 mRNA and protein expression were detected in tumor tissues at the same time. The terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling （TUNEL） assay was used to detect apoptosis of tumor cells.RESULTS： The weight of the treated nude mice increased, and the tumor volume decreased markedly compared with those of the mock-treated and negative control groups （P 〈 0.01）. The results of RT-PCR and Western blotting showed that mRNA and protein levels of STAT3 declined markedly in the treated group. The change in STAT3-related gene expression in tumor tissues at the mRNA and protein level also varied, the expression of survivin, VEGF and c-myc were obviously reduced, and expression of p53 and caspase3 increased （P 〈 0.01）. Most of the tumor tissue ceils in the treated group developed apoptosis that was detected by TUNEL assay.CONCLUSION： Silencing of STAT3 expression by RNAi significantly inhibits expression of STAT3 mRNA and protein, and suppresses growth of human HCC in tumor-bearing nude mice. The mechanism may be related to down-regulation of survivin, VEGF and c-myc and up-regulation of p53 and caspase3 expression. Accordingly, the STAT3 gene may act as an important and effective target in gene therapy of HCC.

Effect of Actual Cooling Rate of Ladle Stream on Persistent Metallurgical Performance of a Given Tundish

To evaluate the effect of actual cooling rate of liquid steel in the ladle on the metallurgical performances of a tundish, a transient and coupled computational model was developed to reveal the flow fields, temperature fields, residence time distribution of the molten steel and the inclusion removal efficiency in a typical single-strand tundish with given geometry and process parameters. The results showed that, with the decrease of the ladle stream cooling rate, the temperature difference of bulk flow at the outlet of tundish over a normal casting period decreased from 11.3 to 2.6 K, and the dead volume fraction of the tundish decreased from 17.58% to 14. 35%, while the inclusion removal efficiency was increased especially for the inclusions with the diameter less than 50 μm, whose removal ratio could be increased by 20.62%. When the cooling rate was less than 0.3 K · min-1 , however, the variation rates of the three evaluation criterions above declined significantly, which suggested that a critical value existed for the effect of the cooling rate of ladle stream on the tundish performances. The establishment of the critical ladle stream cooling rate should be very important to achieve persistent metallurgical properties of tundish over the whole casting stage, together with the reasonable ladle insulation design.