Using harmonic beam combining to generate pulse-burst in nonlinear optical laser

The ultrashort lasers working in pulse-burst mode reveal great machining performance in recent years. The number of pulses in bursts effects greatly on the removal rate and roughness. To generate a more equal amplitude of pulses in burst with linear polarization output and time gap adjustable, we propose a new method by the harmonic beam combining(HBC).The beam combining is commonly used in adding pulses into the output beam while maintaining the pulse waveform and beam quality. In the HBC, dichroic mirrors are used to combine laser pulses of fundamental wave(FW) into harmonic wave(HW), and nonlinear crystals are used to convert the FW into HW. Therefore, HBC can add arbitrarily more HW pulses to generate pulse-burst in linear polarization with simple structure. The amplitude of each pulse in bursts can be adjusted the same to increase the stability of the burst, the time gap of each pulse can be adjusted precisely by proper time delay. Because HBC adds pulses sequentially, the peak power density of the burst is the same as each pulse, pulses can be combined without concern of back-conversion which often occurs in high peak power density. In the demonstration, the extendibility of HBC was verified by combining two beams with a third beam. The combined efficiency rates were larger than 99%, and the beam quality of each beam was maintained at M^(2)≈1.4.

Problem-solving model guided by stimulus-organism-response theory:State of mind and coping styles of depressed mothers after cesarean delivery

BACKGROUND The use of a problem-solving model guided by stimulus-organism-response(SOR)theory for women with postpartum depression after cesarean delivery may inform nursing interventions for women with postpartum depression.AIM To explore the state of mind and coping style of women with depression after cesarean delivery guided by SOR theory.METHODS Eighty postpartum depressed women with cesarean delivery admitted to the hospital between January 2022 and October 2023 were selected and divided into two groups of 40 cases each,according to the random number table method.In the control group,the observation group adopted the problem-solving nursing model under SOR theory.The two groups were consecutively intervened for 12 weeks,and the state of mind,coping styles,and degree of post-partum depression were analyzed at the end of the intervention.RESULTS The Edinburgh Postnatal Depression Scale and Hamilton Depression Scale-24-item scores of the observation group were lower than in the control group after care,and the level of improvement in the state of mind was higher than that of the control group(P<0.05).The level of coping with illness in the observation group after care(26.48±3.35)was higher than that in the control group(21.73±3.20),and the level of avoidance(12.04±2.68)and submission(8.14±1.15)was lower than that in the control group(15.75±2.69 and 9.95±1.20),with significant differences(P<0.05).CONCLUSION Adopting the problem-solving nursing model using SOR theory for postpartum depressed mothers after cesarean delivery reduced maternal depression,improved their state of mind,and coping level with illness.

抗体药物偶联物相关眼毒性的研究进展

抗体药物偶联物(ADC)是一类具有独特作用机制的抗肿瘤新药,目前已成为肿瘤领域的焦点和热点。在ADC药物相关临床研究中,眼毒性是其特征性不良事件之一,虽然大多数眼部不良事件程度轻微且可逆,但部分患者的治疗进程可能受到影响。因此美国食品药品管理局要求在该类药物说明书中增加眼毒性的黑框警示。本研究对ADC药物眼毒性的流行病学、临床表现、发生机制和防治策略进行综述,旨在提高临床医务人员对ADC药物相关眼毒性的认识,为临床ADC药物的个体化风险评估、早期诊断和医学管理提供参考。

Phase-coherence dynamics of frequency-comb emission via high-order harmonic generation in few-cycle pulse trains

Frequency-comb emission via high-order harmonic generation(HHG)provides an alternative method for the coherent vacuum ultraviolet(VUV)and extreme ultraviolet(XUV)radiation at ultrahigh repetition rates.In particular,the temporal and spectral features of the HHG were shown to carry profound insight into frequency-comb emission dynamics.Here we present an ab initio investigation of the temporal and spectral coherence of the frequency comb emitted in HHG of He atom driven by few-cycle pulse trains.We find that the emission of frequency combs features a destructive and constructive coherences caused by the phase interference of HHG,leading to suppression and enhancement of frequency-comb emission.The results reveal intriguing and substantially different nonlinear optical response behaviors for frequency-comb emission via HHG.The dynamical origin of frequency-comb emission is clarified by analyzing the phase coherence in HHG processes in detail.Our results provide fresh insight into the experimental realization of selective enhancement of frequency comb in the VUV–XUV regimes.

COVID-19 and liver dysfunction in children:Current views and new hypotheses

Coronavirus disease 2019(COVID-19)poses an extremely serious global impact on public healthcare for individuals of all ages,including children.Increasing evidence has shown that liver abnormalities are commonly found in children with COVID-19,and age-related features in innate and adaptive response have been demonstrated.However,there are few reports and studies on COVID-19 related liver injury in children,and the data are scattered.So that many contradictions have arose.This situation is not only due to the serious ethical issues in studying pediatric patients with COVID-19,but also because of the short duration and wide coverage of the COVID-19 epidemic,the severity and complexity of clinical cases varied,as did the inclusion criteria for case reporting and patient outcomes.Therefore,we totaled the incidences,characteristics and pathomechanism of liver injury in children since the COVID-19 outbreak.The etiology of COVID-19-related liver injury is divided into three categories:(1)The direct mechanism involves severe acute respiratory syndrome coronavirus 2 binding to angiotensin-converting enzyme 2 in the liver or bile duct to exert direct toxicity;(2)the indirect mechanisms include an inflammatory immune response and hypoxia;and(3)COVID-19-related treatments,such as mechanical ventilation and antiviral drugs,may cause liver injury.In summary,this minireview provides fundamental insights into COVID-19 and liver dysfunction in children.

MSCTA联合术中超声在小肾癌后腹腔镜肾部分切除手术中的应用价值

目的探讨多层螺旋CT血管成像(MSCTA)联合术中超声在小肾癌后腹腔镜肾部分切除术(LPN)中的应用价值。方法选择影像学显示肿瘤直径≤4.0 cm的小肾癌患者55例,其均采用后腹腔镜肾部分切除术。根据术中是否行超声,将其分为超声组(28例)和非超声组(27例)。左肾肿瘤33例,右肾肿瘤22例;肿瘤直径为1.5～5.0 cm,平均3.0 cm。比较两组手术时间、出血量、术中热缺血时间、微小癌灶发现率、术后漏尿、切缘阳性率及肾小球滤过率(GFR)功能。结果超声组手术时间少于非超声组(P <0.05),超声组术中出血量少于非超声组(P <0.05);超声组术中热缺血时间少于非超声组(P <0.05);中转开放手术例数超声组少于非超声组(P <0.05)。微小病灶检出例数:超声组1例;非超声组0例;术后漏尿例数:超声组0例,非超声组1例。切缘阳性率:超声组为0.0%,非超声组为3.7%。超声组术前、术后患肾GFR分别为(55.1±7.2)和(53.1±7.7)ml/min(P>0.05),非超声组术前、术后患肾GFR分别为(55.8±7.0)和(50.4±6.5)ml/min(P>0.05)。结论术中超声可快速准确的定位肿瘤组织,尽可能的保留肾单位、减少切缘阳性率,有利于术后患肾功能的恢复。

FOXM1在SAP/ALI小鼠肺组织修复过程中的变化及其意义

目的探讨重症急性胰腺炎(SAP)急性肺损伤(ALI)修复过程中叉头框蛋白M1(FOXM1)的表达变化及其意义。方法将BALB/c小鼠随机分为假手术组(10只)和模型组(50只),模型组小鼠又随机分为模型组1、3、7、10和14 d 5个亚组,每组10只。采用雨蛙肽腹腔注射诱导SAP/ALI模型,观察肺组织病理变化、肺微血管通透性、肺组织含水量及血清淀粉酶浓度。采用实时荧光定量聚合酶链反应和Western blot检测肺损伤修复过程中不同时间点FOXM1 mRNA和蛋白的表达水平,分析FOXM1蛋白表达与肺微血管通透性的相关性。结果与假手术组比较,模型复制后各时间点肺组织形态发生改变,但随着时间的推移而不断减轻(P<0.05)。血清淀粉酶、肺微血管通透性及肺组织含水量变化规律与肺组织损伤后病理学评分改变相似。同时,肺组织FOXM1 mRNA表达水平有明显的动态演变规律,复制后第1天表达下调,第3天开始逐渐上调,第7天达高峰,第10天逐渐恢复,第14天时基本回到基础水平,且FOXM1蛋白也有相似的表达规律。FoxM1蛋白表达水平与肺微血管通透性呈负相关(P<0.05)。结论 FOXM1可能在促进肺气血屏障的修复过程中发挥重要作用。

右美托咪定对脑肿瘤手术患者的麻醉效果分析

目的比较右美托咪定与丙泊酚复合麻醉对脑肿瘤手术患者的麻醉效果、血流动力学及脑保护作用。方法选取2018年2月-2020年2月在新疆医科大学附属肿瘤医院择期行脑肿瘤手术的62例患者。其中,神经胶质瘤37例,脑膜瘤25例。采用随机数字表法分为右美托咪定组和丙泊酚组,每组31例。监测患者麻醉诱导开始前(T0)、术中切开硬脑膜时(T1)、完全去除肿瘤时(T2)、手术结束时(T3)及手术结束后24 h(T4)的心率(HR)、平均动脉压(MAP)、中心静脉氧饱和度(ScVO2)、颈内静脉氧饱和度(SjVO2)及神经元特异性烯醇化酶(NSE)、S100β蛋白水平,记录患者苏醒时间、拔管时间、拔管后警觉/镇静(OAA/S)评分及术后不良反应发生情况。结果HR、MAP在不同时间、不同组间及变化趋势上有差异(P<0.05)。ScVO2、SjVO2和NSE、S100β蛋白水平在不同时间、不同组间及变化趋势上有差异(P<0.05)。右美托咪定组苏醒时间、拔管时间低于丙泊酚复合麻醉组(P<0.05),而OAA/S评分高于丙泊酚复合麻醉组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定较丙泊酚复合麻醉对脑肿瘤手术患者具有更好的麻醉镇静效果,有利于血流动力学稳定和脑代谢,有效保护患者脑组织,安全性较高,具有重要的临床应用价值。

放射治疗对肺癌患者NKG2D、HMGB1及DC细胞活性的影响

目的分析接受放射治疗(以下简称放疗)肺癌患者在放疗不同阶段外周血细胞因子NKG2D、高迁移率蛋白1(HMGB1)的变化及与树突状细胞(DC细胞)活性的相关性。方法选取承德医学院附属医院30例肺癌放疗患者,分别在放疗前及放疗后不同时段通过ELISA检测NKG2D、HMGB1,通过免疫磁珠法检测DC细胞。结果 HMGB1、NKG2D的浓度于放疗2 000、4 000及6 000 cGy时逐渐下降(P<0.05)。DC细胞活性差异无统计学意义(P<0.05)。DC细胞与HMGB1、NKG2D无相关性(r=-0.204和0.105,P=0.281和0.580)。结论放射治疗可降低肺癌患者HMGB1、NKG2D的水平,激活免疫功能,但对肺癌患者外周血中DC细胞的活性无影响,外周血中DC细胞活性与HMGB1、NKG2D无相关。

丙酮酸盐腹膜透析液腹腔复苏对大鼠肾脏缺血再灌注损伤的作用

目的 研究丙酮酸盐腹膜透析液腹腔复苏对失血性休克复苏后大鼠肾脏缺血再灌注损伤的保护作用及其可能机制。方法 40只健康雄性SD大鼠随机分为假手术组(Sham组)、静脉复苏组(VR组)、生理盐水腹腔复苏组(NR组)、丙酮酸盐腹膜透析液腹腔复苏组(PR组)4组,每组10只。VR组、NR组与PR组制备失血性休克大鼠模型,Sham组仅行右颈总动脉、左股动脉、右股静脉穿刺及全身肝素化。复苏后24 h采集标本,使用血液分析仪检测肌酐和尿素氮浓度,HE染色观察肾组织病理学结果并进行Paller评分,ELISA法检测肾组织IL-1β、TNF-α含量,Western blot法测定p-STAT3、p-JAK2的表达水平。结果 与Sham组相比,VR组、NR组与PR组肾小管Paller评分、血清肌酐及尿素氮水平均升高,IL-1β、TNF-α含量增加,p-STAT3、p-JAK2表达水平上调(P <0.05)。与VR组、NR组相比,PR组肾小管Paller评分、血清肌酐及尿素氮水平降低,IL-1β、TNF-α含量减少,p-STAT3、p-JAK2表达水平下调(P <0.05)。结论 丙酮酸盐腹膜透析液腹腔复苏能够减轻失血性休克复苏后肾缺血再灌注损伤,改善肾功能,其机制可能与降低炎症反应、抑制JAK2/STAT3信号通路的激活有关。

Operative link on gastritis assessment stage is an appropriate predictor of early gastric cancer

AIM: To assess the predictive value of Operative Link on Gastritis Assessment(OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM) stages in gastric cancer.METHODS: A prospective study was conducted with 71 patients with early gastric cancer(EGC) and 156 patients with non-EGC. All patients underwent endoscopic examination and systematic biopsy. Outcome measures were assessed and compared, including the Japanese endoscopic gastric atrophy(EGA) classification method and the modified OLGA method as well as the modified OLGIM method. Helicobacter pylori(H. pylori) status was determined for all study participants. Stepwise logistic regression modeling was performed to analyze correlations between EGC and the EGA, OLGA and OLGIM methods.RESULTS: For patients with EGC and patients with non-EGC, the proportions of moderate-to-severe EGA cases were 64.8% and 44.9%, respectively(P = 0.005), the proportions of OLGA stages Ⅲ-Ⅳ cases were 52.1% and 22.4%, respectively(P < 0.001), and the proportions of OLGIM stages Ⅲ-Ⅳ cases were42.3% and 19.9%, respectively(P < 0.001). OLGA stage and OLGIM stage were significantly related to EGA classification; specifically, logistic regression modeling showed significant correlations between EGC and moderate-to-severe EGA(OR = 1.95, 95% CI: 1.06-3.58, P = 0.031) and OLGA stages Ⅲ-Ⅳ(OR = 3.14, 95%CI: 1.71-5.81, P < 0.001), but no significant correlation between EGC and OLGIM stages Ⅲ-Ⅳ(P = 0.781). H. pylori infection rate was significantly higher in patients with moderate-to-severe EGA(75.0% vs 54.1%, P = 0.001) or OLGA/OLGIM stages Ⅲ-Ⅳ(OLGA: 83.6% vs 55.8%, P < 0.001; OLGIM: 83.6% vs 57.8%, P < 0.001).CONCLUSION: OLGA classification is optimal for EGC screening. A surveillance program including OLGA stage and H. pylori infection status may facilitate early detection of gastric cancer.

High levels of serum interleukin-6 increase mortality of hepatitis B virus-associated acute-on-chronic liver failure

BACKGROUND Patients with hepatitis B virus-associated acute-on-chronic liver failure(HBVACLF)present a complex and poor prognosis.Systemic inflammation plays an important role in its pathogenesis,and interleukin-6(IL-6)as a pro-inflammatory cytokine is related with severe liver impairment and also plays a role in promoting liver regeneration.Whether serum IL-6 influences HBV-ACLF prognosis has not been studied.AIM To determine the impact of serum IL-6 on outcome of patients with HBV-ACLF.METHODS We performed a retrospective study of 412 HBV-ACLF patients.The findings were analyzed with regard to mortality and the serum IL-6 level at baseline,as well as dynamic changes of serum IL-6 within 4 wk.RESULTS The serum IL-6 level was associated with mortality.Within 4 wk,deceased patients had significantly higher levels of IL-6 at baseline than surviving patients[17.9(7.3-57.6)vs 10.4(4.7-22.3),P=0.011].Patients with high IL-6 levels(>11.8 pg/mL)had a higher mortality within 4 wk than those with low IL-6 levels(≤11.8 pg/mL)(24.2%vs 13.2%,P=0.004).The odds ratios calculated using univariate and multivariate logistic regression were 2.10(95%confidence interval[CI]:1.26-3.51,P=0.005)and 2.11(95%CI:1.15-3.90,P=0.017),respectively.The mortality between weeks 5 and 8 in patients with high IL-6 levels at 4 wk was 15.0%,which was significantly higher than the 6.6%mortality rate in patients with low IL-6 levels at 4 wk(hazard ratio=2.39,95%CI:1.05-5.41,P=0.037).The mortality was 5.0%in patients with high IL-6 levels at baseline and low IL-6 levels at 4 wk,7.5%in patients with low IL-6 levels both at baseline and at 4 wk,11.5%in patients with low IL-6 levels at baseline and high IL-6 levels at 4 wk,and 16.7%in patients with high IL-6 levels both at baseline and at 4 wk.The increasing trend of the mortality rate with the dynamic changes of IL-6 was significant(P for trend=0.023).CONCLUSION A high level of serum IL-6 is an independent risk factor for mortality in patients with HBV-ACLF.Furthermore,a sustained high level or dynamic elevated level of serum IL-6 indicates a higher mortality.

Sterols and Terpenoids from Viburnum odoratissimum

A new stigmasterol type natural product,viburodorol A(1),along with eleven known sterols and terpenoids(2–12),were isolated from the aerial parts of Viburnum odoratissimum.The structure of 1 was elucidated on the basis of comprehensive spectroscopic analysis.It’s noteworthy that compound 2,the major constituent of this plant,can signifi-cantly stimulate glucose absorption in insulin resistant HepG2 cells without affecting cell viability.Furthermore,this compound can also restore the glucose absorption in DXMS-induced insulin resistant 3T3-L1 cells.

Emodin ameliorates lipopolysaccharides-induced corneal inflammation in rats

· AIM: To investigate the effect of emodin on pseudomonas aeruginosa lipopolysaccharides(LPS)-induced corneal inflammation in rats.· METHODS: Corneal infection was induced by pseudomonas aeruginosa LPS in Wistar rats. The inflammation induced by LPS were examined by slit lamp microscope and cytological checkup of aqueous humor.Corneal tissue structure was observed by hematoxylin and eosin(HE) staining. The activation of nuclear factor kappa B(NF-κB) was determined by Western blot.Messenger ribonucleic acid(m RNA) of tumor necrosis factor-α(TNF-α) and intercellular adhesion molecule-1(ICAM-1) in LPS-challenged rat corneas were measured with reverse transcription-polymerase chain reaction(RT-PCR).· RESULTS: Typical manifestations of acute corneal inflammation were observed in LPS-induce rat model,and the corneal inflammatory response and structure were improved in rats pretreated with emodin. Treatment with emodin could improve corneal structure, reduce corneal injure by reducing corneal inflammatory response. Emodin could inhibit the decreasing lever of inhibitor of kappa B alpha(IкBα) express, and the m RNA expression of TNF-α and ICAM-1 in corneal tissues was also inhibited by emodin. The differences were statistically significant between groups treated with emodin and those without treatment(P 【0.01).·CONCLUSION: Emodin could ameliorate LPS-induced corneal inflammation, which might via inhibiting the activation of NF-κB.

Combined thrombectomy and intracoronary administration of glycoprotein IIb/IIIa inhibitors improves myocardial reperfusion in patients undergoing primary percutaneous coronary intervention： a meta-analysis

BackgroundSuboptimal 心肌的灌注在有圣片断举起的病人是普通的经历主要经皮的冠的干预(PPCI ) 的心肌的梗塞(STEMI ) 。而且，它导致增加的梗塞尺寸和死亡率。我们执行了元分析评估渴望 thrombectomy 的角色(在)在心肌的灌注和临床的 outcomes.MethodsPubMed 的改进与 glycoprotein IIb/IIIa 禁止者( GPI )的 intracoronary 管理结合了， Embase ，科学的网，并且中央数据库被寻找因为调查的使随机化的控制试用( RCT )联合了在并且 intracoronary GPI 治疗对在独自一个。利息的结果是在心肌的梗塞的 thrombolysis 心肌的灌注等级( TMPG )，梗塞尺寸()由心脏的磁性的回声成像估计了，左室的喷射部分( LVEF )，主要不利心脏的事件(向)在短期( 1 个月)并且长期( 6-12 月)后续，并且在包含 923 个病人的医院 stay.ResultsEight 试用期间为复杂并发症放血被包括。与相比在独自一个，联合了在， intracoronary GPI 显著地增加了 TMPG 3 流动(RR：1.15， 95% CI：1.04 ～ 1.26 ) ，减少[吝啬的差别(MD ) ：-3.46,95% CI：-5.18 到 -1.73], 和改进 LVEF (MD：1.44， 95% CI：0.54 ～ 2.33 ) 。而且， GPI 使用减少了在长期的后续的向的风险(RR：0.60， 95% CI：0.37 ～ 0.98 ) 。在未成年者的发生的二个组之间没有重要差别，主要流血 complications.ConclusionsOur 调查结果显示出那与相比在独自一个，联合了在， intracoronary GPI 治疗导致了改进心肌的灌注，更好心脏的功能，并且没有向的幸存与经历 PPCI 的 STEMI 为病人在长期的后续受益。

Release test of alliin/alliinase double-layer tablet by HPLC-Allicin determination

A simple, precise and accurate method was developed and validated for the determination of allicin release from alliin/alliinase double-layer tablets. According to Appendix XC Ⅱ of Chinese Pharmacopoeia 2010 edition Volume II, a small glass-method was adopted at the rotational speed of 100 r/min using 100 mL phosphate buffer （pH 6.8） as release medium. The release amount was determined by HPLC with a C18 column （250 mm × 4.6 mm, 5 μm） using the mobile phase consisting of methanol -0.4% carboxylic acid （65：35） at a flow rate of 1 mL/min and UV detection at 242 nm. The current method demonstrates good linearity over the range 4.052- 405.2 μg/mL （r2=0.9999） with an average recovery of 105.5%（RSD= 1.25%）. The accumulative release of alliin/alliinase double-layer tablets had good homogeneity for withinand betweenbatches. The method established is simple, accurate and repeatable for the determination of allicin release from alliin/alliinase double-layer tablets.

Hypercohones A-C,acylphloroglucinol derivatives with homo-adamantane cores from Hypericum cohaerens

Three new homo-adamantanyl type natural products were derived from polyprenylated polycyclic acylphloroglucinol.Hypercohones A-C(1-3),along with five other known hypercohones(4-8),were isolated from the aerial parts of Hypericum cohaerens.The structures of 1-3 were elucidated on the basis of comprehensive spectroscopic analysis.The inhibitory activities of these isolates against five human cancer cell lines in vitro were tested.

Construction of a convolutional neural network classifier developed by computed tomography images for pancreatic cancer diagnosis

BACKGROUND Efforts should be made to develop a deep-learning diagnosis system to distinguish pancreatic cancer from benign tissue due to the high morbidity of pancreatic cancer.AIM To identify pancreatic cancer in computed tomography(CT)images automatically by constructing a convolutional neural network(CNN)classifier.METHODS A CNN model was constructed using a dataset of 3494 CT images obtained from 222 patients with pathologically confirmed pancreatic cancer and 3751 CT images from 190 patients with normal pancreas from June 2017 to June 2018.We established three datasets from these images according to the image phases,evaluated the approach in terms of binary classification(i.e.,cancer or not)and ternary classification(i.e.,no cancer,cancer at tail/body,cancer at head/neck of the pancreas)using 10-fold cross validation,and measured the effectiveness of the RESULTS The overall diagnostic accuracy of the trained binary classifier was 95.47%,95.76%,95.15%on the plain scan,arterial phase,and venous phase,respectively.The sensitivity was 91.58%,94.08%,92.28%on three phases,with no significant differences(χ2=0.914,P=0.633).Considering that the plain phase had same sensitivity,easier access,and lower radiation compared with arterial phase and venous phase,it is more sufficient for the binary classifier.Its accuracy on plain scans was 95.47%,sensitivity was 91.58%,and specificity was 98.27%.The CNN and board-certified gastroenterologists achieved higher accuracies than trainees on plain scan diagnosis(χ2=21.534,P<0.001;χ2=9.524,P<0.05;respectively).However,the difference between CNN and gastroenterologists was not significant(χ2=0.759,P=0.384).In the trained ternary classifier,the overall diagnostic accuracy of the ternary classifier CNN was 82.06%,79.06%,and 78.80%on plain phase,arterial phase,and venous phase,respectively.The sensitivity scores for detecting cancers in the tail were 52.51%,41.10%and,36.03%,while sensitivity for cancers in the head was 46.21%,85.24%and 72.87%on three phases,respectively.Difference in sensitivity for cancers in the head among the three phases was significant(χ2=16.651,P<0.001),with arterial phase having the highest sensitivity.CONCLUSION We proposed a deep learning-based pancreatic cancer classifier trained on medium-sized datasets of CT images.It was suitable for screening purposes in pancreatic cancer detection.

Endoscopic full-thickness resection using an over-the-scope device:A prospective study

BACKGROUND Endoscopic submucosal dissection to treat mucosal and submucosal lesions sometimes results in low rates of microscopically margin-negative(R0)resection.Endoscopic full-thickness resection(EFTR)has a high R0 resection rate and allows for the definitive diagnosis and treatment of selected mucosal and submucosal lesions that are not suitable for conventional resection techniques.AIM To evaluate the efficacy and safety of EFTR using an over-the-scope clip(OTSC).METHODS This prospective,single-center,non-randomized clinical trial was conducted at the endoscopy center of Shengjing Hospital of China Medical University.The study included patients aged 18-70 years who had gastric or colorectal submucosal tumors(SMTs)(≤20 mm in diameter)originating from the muscularis propria based on endoscopic ultrasound(EUS)and patients who had early-stage gastric or colorectal cancer(≤20 mm in diameter)based on EUS and computed tomography.All lesions were treated by EFTR combined with an OTSC for wound closure between November 2014 and October 2016.We analyzed patient demographics,lesion features,histopathological diagnoses,R0 resection(negative margins)status,adverse events,and follow-up results.RESULTS A total of 68 patients(17 men and 51 women)with an average age of 52.0±10.5 years(32-71 years)were enrolled in this study,which included 66 gastric or colorectal SMTs and 2 early-stage colorectal cancers.The mean tumor diameter was 12.6±4.3 mm.The EFTR procedure was successful in all cases.The mean EFTR procedure time was 39.6±38.0 min.The mean OTSC defect closure time was 5.0±3.8 min,and the success rate of closure for defects was 100%.Histologically complete resection(R0)was achieved in 67(98.5%)patients.Procedure-related adverse events were observed in 11(16.2%)patients.The average post-procedure length of follow-up was 48.2±15.7 mo.There was no recurrence during follow-up.CONCLUSION EFTR combined with an OTSC is an effective and safe technique for the removal of select subepithelial and epithelial lesions that are not amenable to conventional endoscopic resection techniques.

Application of bone transgenic zebrafish in anti-osteoporosis chemical screening

Background: The zebrafish(Danio rerio) has recently been shown to be an ideal model to study bone disease including osteoporosis. The zebrafish osteoporosis model could be induced by glucocorticoid treatment with chemical staining for reflecting the level of bone mineralization. However, this methodology was unstable.Here, we developed a novel methodology to directly evaluate the bone mass and density.Methods: We generated and used the bone of transgenic zebrafish Tg(ola.sp7:nlsGFP) to evaluate the bone mass and density by measuring the areal extent and the integrated optical density(IOD) of enhanced green fluorescent protein(eGFP).This methodology was further compared with the traditional chemically stained method showing the bone mineralization. Furthermore, genes related to zebrafish osteoporosis were analyzed by quantitative reverse transcription-polymerase chain reaction(qRT-PCR).Results: Our results of new methods were consistent with those from chemically stained fish, following glucocorticoid-induction or epimedium flavonoid(FE)-rescue treatments. q RT-PCR analyses on mRNA levels revealed that glucocorticoid induces osteoporosis by downregulating the expression of osteoblast-related factors osterix,osteocalcin, and osteopontin, and upregulating the expression of osteoclast-related factor tartrate-resistant acid phosphatase. In FE-rescued fish, the expression of osteogenic factors osterix, osteocalcin, and osteopontin were increased.Conclusion: Compared to the traditional chemical staining methods, the new osteoporosis model using Tg(ola.sp7:nlsGFP) is more convenient and efficient for studying osteoporosis in vivo, and especially for high-throughput anti-osteoporosis drug screening.