Effect and mechanism of reductive polyaniline on the stability of nitrocellulose

The search for new green and efficient stabilizers is of great importance for the stabilization of nitrocellulose(NC). This is due to the shortcomings of traditional stabilizers, such as high toxicity. In this study, reduced polyaniline(r-PANI), which has a similar functional structure to diphenylamine(DPA) but is non-toxic, was prepared from PANI based on the action with N_(2)H_(4) and NH_(3)-H_(2)O, and used for the first time as a potential stabilizer for NC. XPS, FTIR, Raman, and SEM were used to characterize the reduced chemical structure and surface morphology of r-PANI. In addition, the effect of r-PANI on the stabilization of NC was characterized using DSC, VST, isothermal TG, and MMC. Thermal weight loss was reduced by 83% and 68% and gas pressure release by 75% and 49% compared to pure NC and NC&3%DPA, respectively.FTIR and XPS were used to characterize the structural changes of r-PANI before and after reaction with NO_(2). The 1535 cm^(-1) and 1341 cm^(-1) of the FTIR and the 404.98 eV and 406.05 eV of the XPS showed that the -NO_(2) was generated by the absorption of NO_(2). Furthermore, the quantum chemical calculation showed that NO_(2) was directly immobilized on r-PANI by forming -NO_(2) in the neighboring position of the benzene ring.

Vinous-throated parrotbills breed in invasive smooth cordgrass habitat:Can native birds avoid the potential ecological trap?

Native animals are facing long-term coexistence with invasive plants worldwide,the impacts of which on animal behavior remain poorly known.Potential ecological traps could threaten native birds breeding in invasive plant habitats,but behavioral strategies for birds to avoid such risks are few concerned.The invasion of Smooth Cordgrass(Spartina alterniflra) has seriously varied the vegetation landscape in the coastal wetlands of eastern China,and affected the habitat selection of native birds.Here,we investigated the nesting and breeding characteristics of a common native passerine,the Vinous-throated Parrotbill(Sinosuthora webbiana),in habitats dominated by native Common Reed(Phragmites australis) and exotic cordgrass.We found that parrotbills could complete their breeding cycle in cordgrass habitat.Most nest failure was attributed to predation in native habitat but tide inundation in cordgrass habitat.However,the nest success rate and daily survival rate(DSR) in cordgrass habitat were higher.Moreover,nest height was markedly higher in cordgrass habitat and was the most important influencing variable(positively correlated with the DSR).These results suggest that cordgrass habitat is a potential ecological trap due to the tide inundation,but some parrotbills seem to effectively avoid this risk by increasing nest height.Our study reveals that a native passerine changes its nesting behavior to accommodate invasive plant habitat and highlights that habitat changes caused by invasive plants may drive the adaptive evolution of native animal behavior.The limitation of these results must be acknowledged for the small sample size,and there is a need for a larger sample and long-term data for further verification.

The Bioprospecting of Microbial-Derived Antimicrobial Peptides for Sustainable Agriculture

Strategies aimed at defining,discovering,and developing alternatives to traditional antibiotics will underlie the development of sustainable agricultural systems.Among such strategies,antimicrobial peptides(AMPs)with broad-spectrum antimicrobial activity and multifaceted mechanisms of action are recognized as ideal alternatives in the post-antibiotic era.In particular,AMPs derived from microbes with active metabolisms that can adapt to a variety of extreme environments have long been sought after.Consequently,this review summarizes information on naturally occurring AMPs,including their biological activity,antimicrobial mechanisms,and the preparation of microbial-derived AMPs;it also outlines their applications and the challenges presented by their use in the agroindustry.By dissecting the research results on microbial-derived AMPs of previous generations,this study contributes valuable knowledge on the exploration and realization of the applications of AMPs in sustainable agriculture.

Coating Process of Paeonol Sustained Release Pills

[Objectives] To study the coating process of paeonol sustained release pills by extrusion-spheronization method taking ethyl cellulose as the coating material. [Methods] Paeonol pills were made by Auari AW-95 Full Automatic Pill Making Machine. Coating of paeonol sustained release pills was prepared by Auari Mini Pill Polishing Machine. The prescription and process factors of paeonol sustained release pills coating were investigated by single factor experiment and orthogonal experiment. The release of paeonol sustained release pills was determined according to the cumulative release curve of paeonol. [Results] The prepared paeonol sustained release pills released slowly within 24 h, and the release rate reached 80% in 12 h. [Conclusions] The prepared paeonol sustained release pills basically meet the 24 h sustained release standard, and can be further developed and applied.

Surface regulated Ni nanoparticles on N-doped mesoporous carbon as an efficient electrocatalyst for CO_(2)reduction

Low cost,highly selective and efficient electrocatalysts for CO_(2)reduction reaction(CO_(2)RR)is crucial for lowering the global carbon footprint and mitigating energy shortages.Here,we first report a highly selective and efficient electrocatalyst for CO_(2)RR to CO using a surface-regulated Ni nanoparticles supported on N-doped CMK-3(N,O-Ni/CMK3).Compared with most Ni metal catalysts previously reported with severe competitive hydrogen evolution during the CO_(2)RR,the N,O-Ni/CMK3 catalyst presents a superior CO faradaic efficiency of about 97%,a high CO partial current density(13.01 mA cm^(-1))and turnover frequency(4.25 s^(–1)).The comprehensive characterization provides evidence that the N,O co-regulated Ni acts as the active center.Taking advantage of the N,O co-regulated chemical environment,N,O-Ni/CMK3 also displays a decent stability at negative potentials.Our work paves a novel approach for developing transition metal catalysts for CO_(2)RR with enhanced activity and selectivity via regulating surface chemical environment.

Haemodynamic Analysis of the Relationship between the Morphological Alterations of the Ascending Aorta and the Type A Aortic-Dissection Disease

Type A aortic dissection(AD)is one of the most serious cardiovascular diseases,whose risk predictors are controversial.The purpose of this research was to investigate how elongation accompanied by dilation of the ascending aorta(AAo)affects the relevant haemodynamic characteristics using image-based computational models.Five elongated AAos with different levels of dilation have been reconstructed based on the centerlines data of an elderly and an AD patient.Numerical simulations have been performed assuming an inflow waveform and a Windkessel model with three elements for all outflow boundaries.The numerical results have revealed that the elongation of AAo can disturb the systolic helical flow pattern between the root of AAo and the aortic arch.The helical flow inside the AAo starts to develop into a vortex flow when the elongated AAo becomes dilated.The vortex gives rise to a localized oscillatory shear index at the ostia of the brachiocephalic artery(BA)and the inner curve of the aortic arch.This study suggests that abnormal growth of AAo,especially accompanied by its moderate dilation,can be considered as morphological risk factors of AD.

Effects of size and location of distal tear on hemodynamics and wave propagation in type B aortic dissection

The type B aortic dissection(TBAD)is a perilous disease with high morbidity and mortality rates.The hemodynamics of TBAD in different scenarios has been widely studied by computational fluid dynamics(CFD)research.However,the flow pattern and wave propagation characteristics in the cardiovascular system with TBAD are not yet clear,and the effect of the distal tear is still unknown.In this work,a onedimensional(1D)cardiovascular system model coupling with a zero-dimensional(0D)lumped-parameter model is introduced to study the hemodynamics and wave propagation in the cardiovascular system.The results show that the proposed 0D-1D method well captures the oscillation and retrograde characteristics for the flow in the false lumen(FL),and the smaller distal tear damps the retrograde flow.Besides,the distal tear should also be paid attention to,and the wave intensity(WI)can be used as an access mark of the degree of the aortic dissection(AD).

Study of Effect of Boundary Conditions on Patient-Specific Aortic Hemodynamics

Cardiovascular computational fluid dynamics(CFD)based on patient-specific modeling is increasingly used to predict changes in hemodynamic parameters before or after surgery/interventional treatment for aortic dissection(AD).This study investigated the effects of flow boundary conditions(BCs)on patient-specific aortic hemodynamics.We compared the changes in hemodynamic parameters in a type A dissection model and normal aortic model under different BCs:inflow from the auxiliary and truncated structures at aortic valve,pressure control and Windkessel model outflow conditions,and steady and unsteady inflow conditions.The auxiliary entrance remarkably enhanced the physiological authenticity of numerical simulations of flow in the ascending aortic cavity.Thus,the auxiliary entrance can well reproduce the injection flow fromthe aortic valve.In addition,simulations of the aortic model reconstructed with an auxiliary inflow structure and pressure control and the Windkessel model outflow conditions exhibited highly similar flow patterns and wall shear stress distribution in the ascending aorta under steady and unsteady inflow conditions.Therefore,the inflow structure at the valve plays a crucial role in the hemodynamics of the aorta.Under limited time and calculation cost,the steady-state study with an auxiliary inflow valve can reasonably reflect the blood flow state in the ascending aorta and aortic arch.With reasonable BC settings,cardiovascular CFD based on patient-specific ADmodels can aid physicians in noninvasive and rapid diagnosis.

Super-resolution imaging for in situ monitoring sub-cellular micro-dynamics of small molecule drug

Small molecule drugs play a pivotal role in the arsenal of anticancer pharmacological agents. Nonetheless, their small size poses a challenge when directly visualizing their localization, distribution, mechanism of action (MOA), and target engagement at the subcellular level in real time. We propose a strategy for developing triple-functioning drug beacons that seamlessly integrate therapeutically relevant bioactivity, precise subcellular localization, and direct visualization capabilities within a single molecular entity. As a proof of concept, we have meticulously designed and constructed a boronic acid fluorescence drug beacon using coumarin–hemicyanine (CHB). Our CHB design includes three pivotal features: a boronic acid moiety that binds both adenosine triphosphate (ATP) and adenosine diphosphate (ADP), thus depleting their levels and disrupting the energy supply within mitochondria;a positively charged component that targets the drug beacon to mitochondria;and a sizeable conjugated luminophore that emits fluorescence, facilitating the application of structured illumination microscopy (SIM). Our study indicates the exceptional responsiveness of our proof-of-concept drug beacon to ADP and ATP, its efficacy in inhibiting tumor growth, and its ability to facilitate the tracking of ADP and ATP distribution around the mitochondrial cristae. Furthermore, our investigation reveals that the micro-dynamics of CHB induce mitochondrial dysfunction by causing damage to the mitochondrial cristae and mitochondrial DNA. Altogether, our findings highlight the potential of SIM in conjunction with visual drug design as a potent tool for monitoring the in situ MOA of small molecule anticancer compounds. This approach represents a crucial advancement in addressing a current challenge within the field of small molecule drug discovery and validation.

Surface demineralized freeze-dried bone allograft followed by reimplantation in a failed mandibular dental implant

The removal of a failed implant with high torque causes significant damage to the surrounding tissue,compromising bone regeneration and subsequent osseointegration in the defect area.Here,we report a case of carrier screw fracture followed by immediate implant removal,bone grafting and delayed reimplantation.A dental implant with a fractured central carrier screw was removed using the bur-forceps technique.The resulting three-wall bone defect was filled with granular surface demineralized freeze-dried bone allograft(SD-FDBA).Cone-beam computerized tomography was performed at 1week,6months and 15months postoperatively and standardized for quantitative evaluation.The alveolar bone width and height at 15months post-surgery were about 91%of the original values,with a slightly lower bone density,calculated using the gray value ratio.The graft site was reopened and was found to be completely healed with dense and vascularized bone along with some residual bone graft.Reimplantation followed by restoration was performed 8months later.The quality of regenerated bone following SD-FDBA grafting was adequate for osseointegration and longterm implant success.The excellent osteogenic properties of SD-FDBA are attributed to its human origin,cortical bone-like structure,partly demineralized surfaces and bone morphogenetic protein-2-containing nature.Further investigation with more cases and longer follow-up was required to confirm the final clinical effect.

Berberine might block colorectal carcinogenesis by inhibiting the regulation of B-cell function by Veillonella parvula

Background:Colorectal carcinogenesis and progression are related to the gut microbiota and the tumor immune microenvironment.Our previous clinical trial demonstrated that berberine(BBR)hydrochloride might reduce the recurrence and canceration of colorectal adenoma(CRA).The present study aimed to further explore the mechanism of BBR in preventing colorectal cancer(CRC).Methods:We performed metagenomics sequencing on fecal specimens obtained from the BBR intervention trial,and the differential bacteria before and after medication were validated using quantitative polymerase chain reaction.We further performed Apc Min/+animal intervention tests,RNA sequencing,flow cytometry,immunohistochemistry,and enzyme-linked immunosorbent assays.Results:The abundance of fecal Veillonella parvula(V.parvula)decreased significantly after BBR administration(P=0.0016)and increased through the development from CRA to CRC.Patients with CRC with a higher V.parvula abundance had worse tumor staging and a higher lymph node metastasis rate.The intestinal immune pathway of Immunoglobulin A production was activated,and the expression of TNFSF13B(Tumor necrosis factor superfamily 13b,encoding B lymphocyte stimulator[BLyS]),the representative gene of this pathway,and the genes encoding its receptors(interleukin-10 and transforming growth factor beta)were significantly upregulated.Animal experiments revealed that V.parvula promoted colorectal carcinogenesis and increased BLyS levels,while BBR reversed this effect.Conclusion:BBR might inhibit V.parvula and further weaken the immunomodulatory effect of B cells induced by V.parvula,thereby blocking the development of colorectal tumors.Trial Registraion:ClinicalTrials.gov,No.NCT02226185.

三江平原沼泽湿地4种优势植物空间格局对不同水位环境的响应

水文过程是沼泽湿地最基本的生态过程,理解物种空间格局形成机制及其种群特征随水位环境变化的规律对于科学指导沼泽湿地植被恢复具有重要意义。本研究分别选择三江平原季节性积水与常年积水沼泽,应用点格局方法中的完全空间随机模型、泊松聚块模型和嵌套双聚块模型分析了毛薹草(Carex lasiocarpa)、漂筏薹草(C.pseudocuraica)、狭叶甜茅(Glyceria spiculosa)、小叶章(Deyeuxia angustifolia)4个主要优势植物种群的空间格局,并测定了不同水位环境条件下的种群密度和个体大小特征。结果表明:在沼泽湿地中,4个优势种群在0-200 cm的尺度范围内都偏离了完全随机模型,表现为集体性聚集分布特征,且聚集距离主要集中在0-50 cm之间。随着水位的升高,毛薹草种群密度、个体生物量、株高和基径都呈显著增大趋势,但其聚集强度变弱;而小叶章种群密度和个体大小则显著降低,其聚集强度增大;漂筏薹草和狭叶甜茅种群密度、个体大小和聚集强度变化并不显著。在季节性积水区,4个物种在小尺度上均偏离了泊松聚块模型,符合嵌套双聚块模型,即在大聚块中分布较高密度的小聚块。但是,在常年积水区,仅毛薹草、漂筏薹草和狭叶甜茅3个物种符合嵌套双聚块模型,而小叶章种群则符合泊松聚块模型,说明在高水位胁迫下小叶章种群空间格局的大聚块中不存在较高密度的小聚块。综上所述,水位环境胁迫主要通过影响繁殖分配、种内竞争、易化作用以及个体大小变异等生物学过程共同决定着三江平原淡水沼泽湿地植物种群的斑块化分布特征,不同零模型可以帮助解释种群空间分布格局的形成机制。

Zn改性对Ni/ZSM-22催化剂费托重柴油异构降凝性能的影响

采用离子交换、成型、负载方法对ZSM-22分子筛进行改性,得到不同Zn负载量的ZSM-22分子筛载体,通过X射线衍射、N2物理吸附-脱附及吡啶吸附红外等表征其物化性质。以改性ZSM-22分子筛为酸性组分、Ni为金属组分制备Ni基加氢异构催化剂,以费托重柴油为原料对其异构降凝性能进行评价。结果表明,离子交换对分子筛结构影响较小,且Zn在分子筛表面呈高度分散状。分子筛负载Zn可降低Br?nsted (B)酸与Lewis (L)酸的酸量比值(B/L),且随Zn负载量增加,B/L值降低,异构烃收率提高,有效抑制裂解反应,提高柴油收率。负载Zn可明显降低重型柴油冷滤点,随Zn负载量逐渐提高,冷滤点上升。在金属加氢性能相同时,减少B酸含量有利于提升催化剂上金属位与酸性位的匹配及重型柴油异构性能。以所制Zn负载量为0.42wt%的Ni基分子筛催化剂在柴油的冷滤点达到国六车用柴油标准-10#柴油要求(冷滤点-5℃)时,柴油收率仍高达90.65%。

Dichotomous roles of neutrophils in modulating pathogenic and repair processes of inflammatory bowel diseases

Neutrophils are considered as complex innate immune cells and play a critical role in maintaining intestinal mucosal homeostasis.They exert robust pro-inflammatory effects and recruit other immune cells in the acute phase of pathogen infection and intestinal inflammation,but paradoxically,they also limit exogenousmicrobial invasion and facilitate mucosal restoration.Hyperactivation or dysfunction of neutrophils results in abnormal immune responses,leading to multiple autoimmune and inflammatory diseases including systemic lupus erythematosus,rheumatoid arthritis,and inflammatory bowel diseases(IBD).As a refractory intestinal inflammatory disease,the pathogenesis and progression of IBD are associated with complicated immune response processes in which neutrophils are profoundly involved.However,the consensus on potential roles of neutrophils in modulating pathogenic and repair processes of IBD remains not fully understood.Accumulated infiltrating neutrophils cross the epithelial barrier and contribute to microbial dysbiosis,aggravated intestinal architectural damage,compromised resolution of intestinal inflammation and increased risk of thrombosis during IBD.Paradoxically,activated neutrophils are also associated with effective elimination of invaded microbiota,promoted angiogenesis and tissue restoration of gutmucosa in IBD.Here,we discuss the beneficial and detrimental roles of neutrophils in the onset and resolution of intestinalmucosal inflammation,hoping to provide a precise overview of neutrophil functions in the pathogenesis of IBD.

Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

Background The effect of cerebral small vessel disease(CSVD)and intracranial arterial stenosis(ICAS)on stroke outcomes remains unclear.Methods Data of 1045 patients with minor stroke or transient ischaemic attack(TIA)were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events(CHANCE)trial.We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale(mRS)scores using ordinal logistic regression models.Results Among the 1045 patients,CSVD was present in 830 cases(79.4%)and ICAS in 460(44.0%).Patients with>1 ICAS segment showed the highest risk of new strokes(HR 2.03,95%CI 1.15 to 3.56,p=0.01).No association between CSVD and the occurrence of new strokes was found.The presence of severe CSVD(common OR(cOR)2.01,95%CI 1.40 to 2.89,p<0.001)and>1 ICAS segment(cOR 2.15,95%CI 1.57 to 2.93,p<0.001)was associated with higher mRS scores.Severe CSVD(HR 10.70,95%CI 1.16 to 99.04,p=0.04),but not ICAS,was associated with a higher risk of bleeding events.Six-point modified CSVD score improved the predictive power for bleeding events and disability.Interpretation CSVD is associated with more disability and bleeding events,and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months.CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.

Disability-adjusted life years and the trends of the burden of colorectal cancer:a population-based study in Shanghai,China during 2002 to 2016

Background:Colorectal cancer(CRC)still ranks the top in morbidity and mortality of cancers worldwide,posing a huge threat and burden to the society.We aimed to determine the age-standardized incidence,mortality,and disability-adjusted life years(DALYs)of CRC and explore potential changes in the temporal trends of the CRC burden in Shanghai during 2002 to 2016.Methods:The cancer statistics and demographics were obtained from the Cancer Registry and the Statistics Bureau of Pudong New Area,respectively.Data from 2002 to 2016 were included and analyzed retrospectively.DALYs were calculated using DisMod and the age-standardized rates(ASRs)were obtained according to Segi world standard population.Joinpoint regression was used to measure the trends in CRC incidence and to estimate the annual percent change.Results:The increasing trend of CRC ASR incidence halted after 2014,coinciding with the introduction of the Shanghai CRC screening program.The ASRs of mortality and DALYs increased,at 0.42%(P<0.05)and 4.07%(P<0.001)per year,respectively,which were mainly driven by men and individuals aged above the CRC screening program target.Conclusions:The disease burden of CRC in Shanghai remains serious,especially among men,and individuals aged>74 years.The benefits of the screening program have been partially proven by the ASRs of CRC incidence,providing important insights into better and wider application of screening programs.

Hybrid plant regeneration from interfamilial somatic hybridization between grapevine (Vitia vinifera L.) and Red Thorowax (Bupleurum scorzonerifolium Willd)

The protoplasts of Red Thorowax ( Bupleurum scorzonerifolium) irradiated by ultraviolet light (UV) at an intensity of 260μW/cm2 for 0, 1,2 and 3 min respectively were fused with that of grapevine ( Vitia vinifera). The regenerated 19 clones, every one derived from a single fused cell, were identified as hybrids by phenotype, isozyme, chromosome and 5S rDNA spacer region analysis. The results reveal that all of them are somatic hybrids. 11 hybrid calli includ-

Super-resolution imaging reveals the subcellular distribution of dextran at the nanoscale in living cells

Theranostic visualization of dextran at the nanoscale is beneficial for understanding the bioregulatory mechanisms of this molecule. In this study, we applied structured illumination microscopy(SIM) to capture the distribution of Cy5-Dextran at different incubation periods in living cells. The results showed that Cy5-Dextran could be absorbed by He La cells. In addition, we clarified that Cy5-Dextran exhibited differential organelle distribution(lysosomal or mitochondrial) in a time-dependent manner. Moreover,lysosomal Cy5-Dextran localization was found to be independent of the autophagy process, while Cy5-Dextran localized to the mitochondria triggered a pro-apoptotic event, upregulating the levels of reactive oxygen species(ROS) to accelerate mitochondrial fragmentation. This work uses a visualized strategy to reveal the anti-tumor bioactivity of dextran, which was achieved by regulating apoptosis and autophagy.

Transcriptome analyses of insect cells to facilitate baculovirus-insect expression

The High Five cell line （BTI-TN-5B1-4） isolated from the cabbage looper, Trichoplusia ni is an insect cell line widely used for baculovirus-mediated recombinant protein expression. Despite its widespread application in industry and academic laboratories, the genomic background of this cell line remains unclear. Here we sequenced the transcriptome of High Five cells and assembled 25,234 transcripts. Codon usage analysis showed that High Five cells have a robust codon usage capacity and therefore suit for expressing proteins of both eukaryotic- and prokaryotic-origin. Genes involved in glycosylation were profiled in our study, providing guidance for engineering glycosylated proteins in the insect cells. We also predicted signal peptides for transcripts with high expression abundance in both High Five and Sf21 cell lines, and these results have important implications for optimizing the expression level of some secretory and membrane proteins.

Safety and feasibility of same day discharge after per oral endoscopic pyloromyotomy in refractory gastroparesis: a pilot study

Background:Gastroparesis is a debilitating medical condition with limited treatment options.Gastric per-oral pyloromyotomy(G-POEM)has emerged as a promising treatment option with remarkable short-term clinical success shown in multiple studies.While the post-procedure protocol is not standardized across many centers,the majority of the centers observes these patients in the hospital after the procedure for monitoring.In this single-center prospective study,we evaluated the safety and feasibility of same day discharge after the G-POEM procedure.Methods:All the patients with refractory gastroparesis undergoing G-POEM from October 2019 to March 2020 were enrolled.A total of 25 patients were enrolled in the procedure.Based on the pre-defined criteria,patients were either discharged on the same day after the procedure or admitted to the hospital for further observation.The patient and procedure-related data were extracted from the chart review.Univariate analysis was performed(chi-squared test)on categorical variables after organizing categorical variables as numeric counts or percentages.The student t test was performed on continuous variables after reporting as mean and standard deviation.For analysis with a smaller sample size,Fisher exact and Mann–Whitney tests were used.Results:A total of 25 patients were enrolled.The technical success of G-POEM was 100%and clinical success was 80%(20/25)at 1-month follow-up.Of the 25 patients,9 patients(36%)were discharged on the same day according to the procedure from the recovery unit.Of the remaining 16 patients who were admitted to the hospital post-procedure,10(40%)were admitted due to procedure-related causes while other admissions were either pre-planned or due to social reasons.The average Charlson comorbidity index was lower in the same day discharge group(P<0.05).The number of patients requiring double myotomy was higher in the same day discharge group(P<0.05).The overall complication rate of G-POEM in the study cohort was 12%(3/25)with all complications being mild without any severe adverse events.Conclusion:G-POEM is a safe and effective method of treatment for refractory GP with higher clinical success in short-term follow-up.The same day discharge after G-POEM is safe and feasible in>50%of patients with close periprocedural monitoring.