Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction:Updated meta-analysis

BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)failure.However,most of the studies that have assessed its efficacy and safety were small and hetero-geneous.Prior meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing evidence.AIM To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP failure.METHODS We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,2022.Primary outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse events.Meta-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately included.The pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of patients.Overall reinter-vention rate was 7.3%.Subgroup analyses showed results were generally consistent.CONCLUSION ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is impossible.The consistency of results across most subgroups suggested that this is a generalizable approach.

糖尿病视网膜病变患者的生活质量及其影响因素

目的:分析糖尿病视网膜病变(diabetic retinopathy,DR)患者的生活质量(quality of life,QOL)及其影响因素。方法:分别采用一般情况问卷、视功能损害眼病患者生活质量量表(scale of quality of life in patients with visual impairment,SQQL-VI)和社会支持评定量表对103例DR患者进行问卷调查。采用向后逐步多重线性回归分析法分析年龄、性别、文化程度及社会支持度等因素对DR患者生活质量的影响。结果:DR患者的SQQL-VI量表中总生活质量评分为63.59±9.58分,症状与视功能评分为53.13±8.51分,身体机能评分为28.39±3.86分,社会活动评分为27.95±3.63分,精神心理方面评分为27.78±3.85分。单因素分析结果显示,不同年龄、文化程度、职业、家庭月收入、医疗费用负担方式、糖尿病病程和社会支持度DR患者的生活质量评分的差异有统计学意义(P<0.05)。多重线性回归分析显示,年龄、文化程度、医疗费用负担方式、糖尿病病程及社会支持度是DR患者生活质量的独立影响因素。结论:DR患者的生活质量较差,年龄、文化程度、医疗费用负担方式、糖尿病病程及社会支持是其主要影响因素,可通过减少经济负担、增加社会支持改善DR患者的生活质量。

Clinical effects and complications of TIPS for portal hypertension due to cirrhosis:A single center

AIM:To determine the clinical effects and complications of transjugular intrahepatic portosystemic shunt(TIPS)for portal hypertension due to cirrhosis.METHODS:Two hundred and eighty patients with portal hypertension due to cirrhosis who underwent TIPS were retrospectively evaluated.Portal trunk pressure was measured before and after surgery.The changes in hemodynamics and the condition of the stent were assessed by ultrasound and the esophageal and fundic veins observed endoscopically.RESULTS:The success rate of TIPS was 99.3%.The portal trunk pressure was 26.8±3.6 cmH2O after surgery and 46.5±3.4 cmH2O before surgery(P<0.01).The velocity of blood flow in the portal vein increased.The internal diameters of the portal and splenic veins were reduced.The short-term hemostasis rate was100%.Esophageal varices disappeared completely in68%of patients and were obviously reduced in 32%.Varices of the stomach fundus disappeared completely in 80%and were obviously reduced in 20%of patients.Ascites disappeared in 62%,were markedly reduced in 24%,but were still apparent in 14%of patients.The total effective rate of ascites reduction was 86%.Hydrothorax completely disappeared in 100%of patients.The incidence of post-operative stent stenosis was 24%at 12 mo and 34%at 24 mo.The incidence of post-operative hepatic encephalopathy was 12%at3 mo,17%at 6 mo and 19%at 12 mo.The incidence of post-operative recurrent hemorrhage was 9%at 12mo,19%at 24 mo and 35%at 36 mo.The cumulative survival rate was 86%at 12 mo,81%at 24 mo,75%at 36 mo,57%at 48 mo and 45%at 60 mo.CONCLUSION:TIPS can effectively lower portal hypertension due to cirrhosis.It is significantly effective for hemorrhage of the digestive tract due to rupture of esophageal and fundic veins and for ascites and hydrothorax caused by portal hypertension.

基于Kinect的虚拟健身跑锻炼系统

健身跑是体育运动中最常用的锻炼方式,不恰当的跑步方式,不仅达不到理想的健身效果,而且很容易对身体特别是膝盖造成伤害。针对目前跑步系统缺乏科学指导和全程监测,本文提出了一个基于Kinect的虚拟健身跑锻炼系统。在动作识别方面,通过角度特征和关节点相对位置对Kinect采集的跑步动作信息进行降维,并分割出跑步动作元,利用动作元的曲线特征和分类模型匹配,进行跑步动作识别,同时对跑步姿态进行科学指导。在运动建模方面,分析用户心率和跑步强度的关系,构建用户的健身跑运动模型,并建立个性化科学跑步运动方案,使心率始终处在安全有效的心率区间内。实验结果表明,该系统具有较强的实用性和可行性,能够为用户进行安全、有效地健身跑锻炼提供科学的技术支持。

Adenomyoma of the distal common bile duct demonstrated by endoscopic ultrasound: A case report and review of the literature

BACKGROUND Adenomyomatous hyperplasia of the distal common bile duct(CBD)is very rare,with only scarce case reports in the literature.Diagnosis is usually based on imaging findings,and endoscopic biopsy is very difficult before operation.It is believed that adenomyomatous hyperplasia has little or no risk of malignant transformation.CASE SUMMARY A 68-year-old woman with abdominal pain in the right upper quadrant was referred to our hospital.Abdominal ultrasonography in the emergency ward revealed acute cholecystitis and dilated CBD.Laboratory findings showed elevated levels of transaminases,phosphatase,andγ-glutamyltranspeptidase.Pharmaceutical treatment for 3 d did not relieve the symptoms.Magnetic resonance cholangiopancreatography(MRCP)and computed tomography(CT)showed proximal bile duct dilatation but could not identify the cause.Endoscopic ultrasonography(EUS)demonstrated a mixed echogenic mass in the distal CBD.During surgery,a firm mass was found in the distal CBD and the Whipple procedure was performed with the initial concern of malignancy.Histology showed diffuse adenomyomatous hyperplasia.CONCLUSION EUS may be a useful choice to diagnose adenomyoma of the distal CBD before operation,especially in patients with ambiguous MRCP/CT findings.

RNA Interference Mediated Silencing of Tissue Factor in Human Umbilical Vein Endothelial Cells

Objective: To construct to silence tissue factor (TF) expression in Human Umbilical Vein Endothelial Cells (HUVECs) for providing evidence of the gene therapy and prevention of coagulation dysfunction in placental abruption (PA) neonates. Methods: Cultured HUVECs in vitro were divided into control group and PA group, each including non-prevention, scramble siRNA and TF-siRNA subgroups. pENTRTM/U6-shRNA/TF vector expressing TF were constructed and transfected into HUVECs. The mRNA expression of TF was tested with RT-PCR, and TF protein expression was detected with immunofluorescence staining. Results: Monolayer HUVECs with short-rod and short spindle shaped were adherent to the bottom, forming paving stone arrangement. The TF mRNA expression was significantly different between control group and PA group (P 0.01) and among different subgroups (P 0.01). In non-prevention subgroups, significant difference was observed in TF mRNA expression between control group and PA group (P 0.05). Significant difference in TF mRNA expression was found in false-prevention subgroups (P 0.05). The TF mRNA expression was markedly different among different subgroups in control (P 0.01), and the similar result among different PA subgroups (P 0.01). In both control and PA groups, the TF mRNA expression was the lowest after TF silencing. Immunofluorescence staining showed high TF expression in HUVECs in false-prevention subgroups. In scramble siRNA group, the TF protein expression reduced as compared to non-prevention group and reduced dramatically after TF silencing as compared to control. Conclusion: pENTRTM/U6-TF-shRNA is able to significantly inhibit the TF mRNA and protein expression in HUVECs from healthy neonates and PA neonates.

Correlation of serum apoptotic molecule and cytokine levels with cognitive function in epileptic patients

Objective:To investigate the correlation of serum apoptotic molecule and cytokine levels with cognitive function in epileptic patients.Methods: 78 adult epileptic patients admitted to our hospital between December 2016 and December 2018 were selected as the epilepsy group, and 50 normal people who underwent physical examination in our hospital during the same period were selected as the normal control group. The differences in serum levels of apoptotic molecules [bcl-1, bax, survivin, caspase-3, caspase-4 and caspase-10], inflammatory factors [interleukin-1β (IL-1β), interleukin-2 (IL-2), tumor necrosis factor (TN-α) and high mobility group protein B1 (HMGB1)], oxidative stress indexes [advanced oxidation protein product (AOPP), malondialdehyde (MDA) and glutathione peroxidase (GSH-Px)] and adipokines [adiponectin (APN) and leptin] as well as Mini-Mental State Examination (MMSE) scores were compared between the two groups, and Pearson test was used to evaluate the correlation of serum apoptotic molecule and cytokine levels with cognitive function in patients with epilepsy.Results: Serum bcl-1 and survivin levels in the epilepsy group were lower than those in the normal control group, while bax, caspase-3, caspase-4 and caspase-10 levels were higher than those in the normal control group;serum IL-1β, IL-2, TNF-α and HMGB1 levels were all higher than those in the normal control group;serum AOPP and MDA levels were higher than those in the normal control group, while GSH-Px level was lower than that in the normal control group;serum APN level was lower than that in the normal control group, while Leptin level was higher than that in the normal control group;MMSE score was significantly lower than that in the normal control group (P<0.05). Pearson test showed that the serum levels of apoptotic molecules, inflammatory factors, oxidative stress indexes and adipokines in epileptic patients were directly correlated with MMSE score (P<0.05).Conclusion:The cognitive function of epileptic patients is affected by apoptosis, inflammatory stress response, adipokine expression and other factors. Active regulation of the above internal environment factors may be one of the means to improve the cognitive status of epileptic patients.

Effects of lamotrigine + sodium valproate therapy on the nerve cell nutrition and apoptosis status as well as inflammatory response in patients with intractable epilepsy

Objective: To investigate the effects of lamotrigine + sodium valproate therapy on the nerve cell nutrition and apoptosis as well as inflammatory response in patients with intractable epilepsy. Methods: A total of 70 patients with intractable epilepsy who were treated in our hospital between August 2013 and October 2016 were divided into routine group (n=35) and study group (n=35) by random number table method, routine group received sodium valproate therapy and study group received lamotrigine combined with sodium valproate therapy. The differences in serum levels of neurotrophy indexes, nerve apoptosis indexes and inflammatory factors were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in serum levels of neurotrophy indexes, nerve apoptosis indexes and inflammatory factors between the two groups. After treatment, serum BDNF and NGF levels of study group were higher than those of routine group;serum Bcl-2, Fas and FasL levels of study group were lower than those of routine group whereas Bax level was higher than that of routine group;serum IL-1β, IL-6 and PGE2 levels of study group were lower than those of routine group. Conclusion: Lamotrigine combined with sodium valproate therapy can effectively increase the neurotrophy, inhibit the nerve apoptosis and reduce the systemic inflammatory response in patients with intractable epilepsy.

Binding mechanism of halide ions to bovine serum albumin and hemoglobin: investigated by ion selective-electrode

The binding mechanism of the interactions of halide ions (F–, Br– and I–) with bovine serum albumin (BSA) and hemoglobin (Hb) were studied at different temperatures, by using ion-selective electrodes. The experimental data were treated according to Klotz equation, and the number of binding sites and the binding constants were determined. The results show that the binding sites of F– on protein molecules are more than those of Br– and I–. Additionally, the number of the binding sites for halide ions on protein molecules increases with increasing temperature. This study also indicates that the binding constants for the interactions of halide ions with proteins gradually decrease as the size of halide ions and temperature increases. These behaviors were reasonably interpreted with the structural and thermodynamic factors. The thermodynamic functions at different temperatures were calculated with thermodynamic equations, and the enthalpy change for the interactions were also determined by isothermal titration calorimetry (ITC) at 298.15 K, which indicate that the interactions of halide ions with proteins are mainly electrostatic interaction.

Protective effects of EGCG on Bifenthrin-Induced Oxidative Stress in the Human Embryonic Lung Fibroblast Cell Line HFL-I

Bifenthrin(BF) is an important type I synthetic fluorinated pyrethroid insecticide and acaricide.Previous investigations have indicated that the metabolisms of BF in human cells were through oxidative processes,and cytotoxicity was induced by the oxidative stress.In this study,the protective effects of EGCG,which is a major individual of green tea polyphenols,on the human embryonic lung fibroblast cell line HFL-I exposed to BF were investigated.The results showed that BF could induce oxidative stress leading to cytotoxicity in HFL-I cells.The pretreatment of EGCG at low concentrations significantly recovered the cell viability and morphology,inhibited excess generation of ROS,enhanced antioxidant enzyme activities and avoided loss of mitochondrial membrane potential.The results suggested that EGCG might eliminate the BF-induced damage in HFL-I cells.

烧结砖行业转型升级中面临问题之探讨（一）

对烧结砖行业转型升级中面临的问题,如燃料结构、原材料性能以及与工艺设备之间关系、环境保护与生产工艺过程之间关系、标准制定与合理生产工艺之间关系、隧道窑合理结构与合理焙烧制度之间关系、干燥室与隧道窑之间关系、挤出机配置与整线自动化控制之间关系等问题进行深层次的探讨和重新认识。

烧结砖行业转型升级中面临问题之探讨（二）

对烧结砖行业转型升级中面临的问题,如燃料结构、原材料性能以及与工艺设备之间关系、环境保护与生产工艺过程之间关系、标准制定与合理生产工艺之间关系、隧道窑合理结构与合理焙烧制度之间关系、干燥室与隧道窑之间关系、挤出机配置与整线自动化控制之间关系等问题进行深层次的探讨和重新认识。

烧结砖行业转型升级中面临问题之探讨(三)

对烧结砖行业转型升级中面临的问题,如燃料结构、原材料性能以及与工艺设备之间关系、环境保护与生产工艺过程之间关系、标准制定与合理生产工艺之间关系、隧道窑合理结构与合理焙烧制度之间关系、干燥室与隧道窑之间关系、挤出机配置与整线自动化控制之间关系等问题进行深层次的探讨和重新认识。

烧结砖行业转型升级中面临问题之探讨(四)

对烧结砖行业转型升级中面临的问题,如燃料结构、原材料性能以及与工艺设备之间关系、环境保护与生产工艺过程之间关系、标准制定与合理生产工艺之间关系、隧道窑合理结构与合理焙烧制度之间关系、干燥室与隧道窑之间关系、挤出机配置与整线自动化控制之间关系等问题进行深层次的探讨和重新认识。

烧结砖行业转型升级中面临问题之探讨(五)

对烧结砖行业转型升级中面临的问题,如燃料结构、原材料性能以及与工艺设备之间关系、环境保护与生产工艺过程之间关系、标准制定与合理生产工艺之间关系、隧道窑合理结构与合理焙烧制度之间关系、干燥室与隧道窑之间关系、挤出机配置与整线自动化控制之间关系等问题进行深层次的探讨和重新认识。

老年教育的数字人文创新与转型设计研究

目的:老年教育是积极老龄化的重要组成部分,数字人文方法在老年教育设计中的应用研究,是对数字化背景下智慧教育发展的路径探索,也是对老年教育方法论的拓展及教育物理空间的重新思考和设计,有助于创造适老化的智慧教育空间,鼓励老年人积极参与学习。方法:梳理国内外老年教学机构、教育模式及课程设置等相关资料并对比分析,总结出国内老年教育的困境与多方面特征。针对“新老人”群体和社区老年教育,运用可视化、虚拟现实、人工智能等数字人文方法与技术工具,分别从软件与硬件层面提出了老年教育的转型思路。结论:通过对老年人生理、心理需求的分析,将数字人文与老年教育设计结合,从政策支持、平台建设、教学模式及空间环境四个方面提出了建构方法,使其满足“新老人”群体不断增长的学习需求和多样化的学习方式,提升教育参与度,为老年教育的数字化发展路径做出探索。

水泵水轮机在S特性区的流态及压力脉动研究

抽水蓄能机组的四象限特征曲线存在着S形曲线,抽水蓄能机组运行工况复杂,机组经常在多个工况之间转换,机组在水轮机和水泵状态之间频繁切换,都会穿越S形曲线。S特性可以导致水泵水轮机机组产生强烈的振动,使得机组并网困难,振动剧烈,甚至因压力超标严重影响电站的安全稳定运行。在业界的共同努力下,S形问题对工程投运影响已经得到了根本解决,但是S形问题的诱发机理并不十分清楚。因此该文以某模型水泵水轮机为研究对象,通过全流道非定常数值模拟和基于全特性试验的粒子图像测速法(particle image velocimetry,PIV)相结合,根据机组的运行特性,选取水泵水轮机三个开度下的13个工况点内部流动特性及压力脉动特性进行了研究。综合数值模拟及试验结果,获得空载工况,小流量工况及反水泵工况下无叶区漩涡的运动规律。分析了漩涡结构对无叶区压力脉动特性的影响。结果表明,空载工况对S特性区压力脉动幅频特性存在影响,空载工况与无叶区压力脉动存在必然联系。各工况点下无叶区压力脉动主频大部分工况为叶片通过频率,即9 f_(n)(f_(n)为转频),部分工况受尾水管压力脉动影响主频为0.66 f_(n)。通过计算和试验对比发现,无叶区漩涡结构的周期性运动对无叶区压力脉动的周向分布存在重大影响。

GST pull-down结合质谱筛选猪圆环病毒2型ORF4潜在互作蛋白

猪圆环病毒2型编码的ORF4蛋白是近年来发现的新蛋白。迄今为止,人们对ORF4所参与的细胞生物学过程知之甚少。本研究首先构建了带双标签的真核表达载体pCMV-N-Flag-GST,再将ORF4基因插入该载体中,形成pCMV-N-Flag-GST-ORF4。将质粒转染293T细胞表达ORF4后,通过GSTPull-down试验捕获细胞内潜在与ORF4互作的蛋白库。经SDS-PAGE分离及银染后,对所得的特异性条带进行质谱鉴定,筛选出5个与ORF4潜在互作的蛋白,包括丝氨酸/苏氨酸蛋白磷酸酶6催化亚基、α心肌蛋白、β肌动蛋白、SEC-14样蛋白5和肌球蛋白myosin 9。上述研究结果为深入揭示ORF4在病毒感染细胞过程中发挥的作用提供新的思路与方向。

Development of evaluation model for intensive land use in urban centers

Starting with exptoration from the perspective of urban spaces, this research was conducted by anatyzing the functionat areas--urban centers with the most hightighted contradictions in terms of intensive land use in order to devetop an evatuation model for intensive land use in urban centers. Based on quantitative research methods, and taking into account three aspects of intensive use, i.e., buitdings, lands and traffic as wetl as muttiple evaluation factors, this paper conducted the research horizontatty by means of quantitative and comparative studies on each individual factor, devetoped the evatuation model for intensive rand use in urban centers, and anatyzed the driving forces of intensive land use from the aspects of buitdings, land use, roads, etc.

Differential CircRNA Expression Profiles in PK-15 Cells Infected with Pseudorabies Virus Type Ⅱ

Circular RNAs(circ RNAs)belong to a class of non-coding RNAs with diverse biological functions.However,little is known about their roles in case of pseudorabies virus(Pr V)infection.Here,we analyzed the expression profile of host circ RNAs from a virulent Pr V type II strain DX(Pr V-DX)infected and an attenuated g E/TK deficient(g E-TK-Pr V)strain of Pr V infected PK-15 cells.Circ RNAs were identified by findcirc and analyzed with DESeq 2.Compared with the mock cells,449 differentially expressed(DE)circ RNAs(233 down-regulated and 216 up-regulated)from Pr V-DX infected and578 DE circ RNAs(331 down-regulated and 247 up-regulated)from g E-TK-Pr V infected PK-15 cells were identified.In addition,459 DE circ RNAs(164 down-regulated and 295 up-regulated)between the Pr V-DX and g E-TK-Pr V infected cells were identified.The expression patterns of 13 circ RNAs were validated by reverse transcription quantitative real-time PCR(RT-q PCR)and results were similar as of RNA-seq.The putative target mi RNA binding sites of DE circ RNAs were predicted by using mi Randa and ps Robot.The circ RNA-mi RNA-m RNA network was constructed and certain mi RNAs that have possible roles in antiviral immune response,such as mi R-210 and mi R-340,were predicted.GO and KEGG pathway analysis demonstrated that DE circ RNAs were enriched in the processes such as cellular metabolism,protein binding,RNA degradation and regulation of actin cytoskeleton.Collectively,these findings might provide the useful information for a better understanding of mechanisms underlying the interaction between Pr V-II and host cells.