Effect of endoscopic full-thickness resection assisted by distal serosal turnover with floss traction for gastric submucosal masses

BACKGROUND Complex and high-risk surgical complications pose pressing challenges in the clinical implementation and advancement of endoscopic full-thickness resection(EFTR).Successful perforation repair under endoscopy,thereby avoiding surgical intervention and postoperative complications such as peritonitis,are pivotal for effective EFTR.AIM To investigate the effectiveness and safety of EFTR assisted by distal serosal inversion under floss traction in gastric submucosal tumors.METHODS A retrospective analysis of patients with gastric and duodenal submucosal tumors treated with EFTR assisted by the distal serosa inversion under dental floss traction from January 2023 to January 2024 was conducted.The total operation time,tumor dissection time,wound closure time,intraoperative bleeding volume,length of hospital stay and incidence of complications were analyzed.RESULTS There were 93 patients,aged 55.1±12.1 years.Complete tumor resection was achieved in all cases,resulting in a 100% success rate.The average total operation time was 67.4±27.0 min,with tumor dissection taking 43.6±20.4 min.Wound closure times varied,with gastric body closure time of 24.5±14.1 min and gastric fundus closure time of 16.6±8.7 min,showing a significant difference(P<0.05).Intraoperative blood loss was 2.3±4.0 mL,and average length of hospital stay was 5.7±1.9 d.There was no secondary perforation after suturing in all cases.The incidence of delayed bleeding was 2.2%,and the incidence of abdominal infection was 3.2%.No patient required other surgical intervention during and after the operation.CONCLUSION Distal serosal inversion under dental-floss-assisted EFTR significantly reduced wound closure time and intraoperative blood loss,making it a viable approach for gastric submucosal tumors.

George Eliot's Feminism in The Mill on the Floss

George Eliot(1819-1880)is an outstanding female writer in Victorian Age.Virginia Woolf,a feminist pioneer,once praised her as"the pride and paragon of the female".However,her feminism is ambivalent.On the one hand,she dares to challenge the male-dominated society and supports women’s rights to receive education and freedom of love and marriage.On the other hand,she emphasizes that women should make self-sacrifice to help men achieve their goals.Based on The Mill on the Floss and studies of previous scholars,this thesis tries to analyze George Eliot’s ambivalent feminism.Thus it is beneficial for readers to observe and think about women’s future.

Floss release, seed fall and germination of kapok seeds (<i>Ceiba pentandra</i>) in an urban environment

The tropical forest kapok tree occurs widely in urban environments, dispersing thousands of floss during the fruiting season. However, its seedlings are rarely seen around human settlements, raising questions on what factorsmight be limiting its recruitment. We examined the pattern of floss release, seed fall post-dispersal and influences of watering frequency on germination ofCeiba pentandraseeds. Evening,overall, was associated with a significantlyhigher rate and quantity of floss release (p= 0.0001) than were mid-day and morning, correlating well with the speed of wind across the day (rh = 0.666,p= 0.001). Mean dispersal quantity differed significantly between the individual sampled trees, in which the highest dispersal was recorded from trees located in relatively open areas and the lowest was recorded in closed stand trees. Seed fall was higher within100 mdistances than seed fall farther away from dispersing trees, depending on the microsites and weather conditions. Germination started on day 5 onwards and only 15.67% of sown seeds germinated. Watering frequency strongly influenced seed germination while local human activities determined fate of dispersed seeds. We conclude that recruitment ofC. pentandraspecies in the study area may have been limited by environmental and human factors operating at various local and spatial scales.

The Use of Floss in Medical Faculties of Inner Mongolia Medical University in 2017

Purpose: The aim of the present study was to determine the degree of using floss and the demographic characteristics of medical faculties of Inner Mongolia Medical University. Materials and Methods: Participants completed the questionnaire in the classroom. These participants came from the medical faculties of Chinese Medicine and Western Medicine. These participants were interviewed to determine the demographic characteristics. Non-flossors responded according to their reasons for not flossing. Results: A total of 3481 effective data were available for analysis. The floss prevalence was 17.21%, which was lower by 5.72% for students living in rural areas, when compared to students living in urban areas. The largest proportion of non-flossing participants in rural areas answered, “I do not know what a floss is”, while participants in urban answered, “I do not want to use it”. The largest proportion of answered flossing frequency was less than once a month. Conclusion: The present study indicates that the prevalence of using floss in medical faculties in Inner Mongolia Medical University was higher, when compared to that in Sichuan province, China, but lower than that in other countries. Although the students use floss, more than one-third of students use floss less than once a month, which is close to “never”. The prevalence in rural areas is lower than those in urban areas. Male not only comprises the total number of prevalence, but also has a frequency greater than that in females. The emphasis on using floss should be improved in medical students.

A Feministic Duality Insight into the The Mill on the Floss

The novel The Mill on the Floss is a semi-autobiography which has much value in exploring Eliot's special feministic view.The change of Maggie's personality in her growing up process and her choice in kinship and romantic relatiomhip reveals the duality of Eliot's feminism.On the one hand,she holds that women should have self-consciousness and the bisexual dualism holds little ground.On the other hand,Eliot also advocates women's serf-denial,obedience and serf-sacrifice in lfie.This essay aims to analyze the duality of Eliot's feministic viewpoint in comideration of the social background in Victorian Age and point out the the implicit feminism view in the fate of Maggie.

Influence of storage duration and processing on chromatic attributes and flavonoid content of moxa floss

OBJECTIVE： Moxibustion is an important traditional Chinese medicine therapy using heat from ignited moxa floss for disease treatment. The purpose of the present study is to establish a reproducible method to assess the color of moxa floss, discriminate the samples based on chromatic coordinates and explore the relationship between chromatic coordinates and total flavonoid content （TFC）. METHODS： Moxa floss samples of different storage years and production ratios were obtained from a moxa production factory in Henan Province, China. Chromatic coordinates （L＊, a＊ and b＊） were analyzed with an ultraviolet-visible spectrophotometer and the chroma （C＊） and hue angle （h~） values were calculated. TFC was determined by a colorimetric method. Data were analyzed with correlation, principal component analysis （PCA）. RESULTS： Significant differences in the chromatic values and TFC were observed among samples of different storage years and production ratios. Samples of higher production ratio displayed higher chromatic characteristics and lower TFC. Samples of longer storage years contained higher TFC. Preliminary separation of moxa floss production ratio was obtained by means of color feature maps developed using L＊-a＊ or L＊-b＊ as coordinates. PCA allowed the separation of the samples from their storage years and production ratios based on their chromatic characteristics and TFC. CONCLUSION： The use of a colorimetric technique and CIELAB coordinates coupled with chemometrics can be practical and objective for discriminating moxa floss of different storage years and production ratios. The development of color feature maps could be used as a model for classifying the color grading of moxa floss.

Brushing, Flossing Stave Off Diabetes

人类对人体奥秘的探索与了解尚处初级阶段。本文提出的一个问题就让我们感到新奇与愕然。洁齿与口腔卫生有助于抑制糖尿病: Gum(齿龈)disease may even be more important than obesity or age as a factorin the onset of diabetes in adults。 上句可译:就诱发成年人糖尿病的因素而言,齿龈疾病也许比肥胖和年龄这两个因素更为重要。 因此,我们有必要认识:the importance of prevention and early treatment ofgum disease in people who are at risk of developing diabetes。 本文对inflammation([医]炎症,发炎)提出了一个颇有原创性的观点:…heart disease has a substantial inflammatory component。】

体内牙线牵引法在内镜黏膜下剥离术治疗早期结直肠癌及癌前病变中的应用效果分析

目的探讨体内牙线牵引法在内镜黏膜下剥离术(ESD)治疗早期结直肠癌及癌前病变中的应用效果。方法回顾性分析2022年1月至2023年12月于首都医科大学附属北京安贞医院消化内科行ESD的98例早期结直肠癌和癌前病变患者的临床资料。根据内镜下治疗方法分为牙线组(51例)和对照组(47例),对照组则行标准ESD,牙线组在ESD术中加用体内牙线牵引辅助。比较2组患者ESD手术操作时间、术中出血发生率、病灶切除效果、术后并发症发生率、住院时间等临床资料。结果牙线组手术时间、术中出血比例短于/低于对照组[25.0(17.3,30.0)min比45.0(32.0,64.0)min、39.2%(20/51)比53.2%(25/47)](均P<0.05)。2组整块切除率、完整切除率、术后并发症发生率和住院时间比较差异均无统计学意义(均P>0.05)。2组术后均无迟发穿孔发生。结论体内牙线牵引法在ESD治疗早期结直肠癌及癌前病变中可明显缩短手术操作时间,降低术中出血发生率,安全有效。

牙线辅助内牵引下内镜黏膜下剥离术在直肠神经内分泌肿瘤中的应用效果观察

目的评估牙线辅助内牵引下内镜黏膜下剥离术(ESD)切除直肠神经内分泌肿瘤(NEN)的有效性和安全性。方法收集2017年1月至2023年6月在首都医科大学附属北京安贞医院消化内科进行结肠镜检查并接受治疗的34例直肠NEN患者的资料进行回顾性分析。根据内镜手术方法将其分为牙线内牵引下ESD治疗组(10例)和传统ESD治疗组(24例),比较2组患者的手术操作时间、手术并发症、术后组织病理、住院时间和住院费用等指标。结果病变位于距肛门3~10 cm处,肿瘤直径3~12 mm,均为单发病灶,2组肿瘤最大径、完整切除率差异均无统计学意义(均P>0.05)。牙线内牵引下ESD治疗组的手术时间短于传统ESD治疗组[23.5(16.8,25.3)min比30.0(22.8,36.0)min],差异有统计学意义(P=0.012)。传统ESD治疗组有2例(8.3%)出现术后并发症。所有患者均未累及固有肌层,无淋巴血管受累。牙线内牵引下ESD治疗组无一例术后病理显示肿瘤紧贴烧灼缘,而传统ESD治疗组有5例(20.8%)术后病理显示肿瘤紧贴烧灼缘。牙线内牵引下ESD治疗组住院时间短于传统ESD治疗组[6(5,7)d比8(7,11)d],差异有统计学意义(P=0.002),2组住院费用差异无统计学意义(P=0.326)。结论牙线辅助内牵引下ESD治疗直肠NEN,手术方法便捷,有利于暴露手术视野,提高完整切除率,减少并发症。

橡皮圈与牙线牵引辅助内镜黏膜下剥离术治疗消化道早癌的疗效比较

目的比较橡皮圈牵引和牙线牵引辅助内镜黏膜下剥离术(ESD)对消化道早癌患者的疗效。方法103例消化道早癌患者根据ESD中辅助牵引技术的不同,分为橡皮圈牵引组(橡皮圈组,51例)和牙线牵引辅助组(牙线组,52例)。比较2组术前基本情况、黏膜下补充注射量、术中止血夹脱离次数、出血量、手术时间、术后迟发性出血、肿瘤一次性完整切除率、术后住院时间及术后72 h并发症发生率。术后3、6、12个月时进行疼痛视觉模拟量表(VAS)和简明健康状况调查表(SF-36)评分,统计术后12个月内并发症情况。结果橡皮圈组术前黏膜下补充注射体积、术中出血量、止血夹脱离次数、手术时间、术后72 h并发症发生率和术后住院时间均低于牙线组(P<0.05);2组术后迟发性出血发生率比较差异无统计学意义(P>0.05)。随访12个月,橡皮圈组患者手术后疼痛程度较轻、生活质量良好,手术后12个月内并发症发生率降低(P<0.05)。结论与牙线牵引辅助比较,橡皮圈牵引辅助ESD可缩短手术时间,减少术后并发症,值得推广。

海拔对大别山区野生宽叶山蒿叶片性状和品质的影响

目的:探究海拔对大别山区野生宽叶山蒿叶片性状和品质的影响。方法:对宽叶山蒿的叶片性状、出绒率、叶绒燃烧热解质量和叶片成分含量进行测定,利用相关性分析筛选与海拔有关联的指标,并通过主成分分析对不同海拔叶片成分进行综合评价。结果:随着海拔升高,宽叶山蒿叶长和叶宽呈先减小后增加的趋势,出绒率呈逐渐升高的趋势;除海拔1720 m宽叶山蒿叶绒的综合燃烧特性较差、燃烧放热量较少外,各海拔叶绒的点燃性能、燃烧后的速度和稳定性、燃烧持久性、燃尽性能和燃烧过程的放热量均相似。叶片成分比较发现,海拔≤1084 m,桉油精、α-古巴烯、石竹烯和氧化石竹烯相对含量较高;海拔≥1550 m,乙酸龙脑酯、大根香叶烯D相对含量较高;海拔≥1084 m,绿原酸、隐绿原酸、异绿原酸C质量分数较高。相关性分析发现,宽叶山蒿叶片性状与海拔不相关,出绒率、大根香叶烯D相对含量、绿原酸质量分数、隐绿原酸质量分数与海拔呈正相关(P<0.01),异绿原酸C质量分数与海拔呈正相关(P<0.05),氧化石竹烯相对含量与海拔呈负相关(P<0.01)。主成分分析显示,高海拔宽叶山蒿叶片成分综合得分较高。结论:不同海拔造成的环境差异可能是导致野生宽叶山蒿叶片性状、出绒率、叶绒燃烧热解质量和叶片成分差异的重要因素,高海拔更利于野生宽叶山蒿的生长。

日本古代“绵襖甲”与唐代“皂绢甲”渊源考略

公元8世纪中叶至9世纪初期,日本曾仿照唐代甲胄样式大规模制造并装备了一种由丝绸制成的“绵襖甲”。本文首先对中日两国现存文字资料进行梳理,发现日本“绵襖甲”源于《唐六典》所载“皂绢甲”,是一种用丝绸缝制并以丝絮填充的新型纺织物软甲。这种丝绸铠甲既能御寒又能抵御矢石,还可以穿着在铁甲之下缓冲铁甲所受冲击力,但最终因不符合日本实际战争情况而遭日本方面废止。而后通过将中日两国现存的图像资料进行整理和比较,对唐代“皂绢甲”的真实规制与成造进行解析与探究,推测《唐六典》所载“皂绢甲”是以“鳍袖半臂”的形制出现。

牙线牵引与IT刀辅助内镜黏膜下剥离术治疗胃角病变的临床对比研究

目的:研究牙线牵引辅助一次性黏膜切开刀与末端绝缘(insulated-tip,IT)刀辅助一次性黏膜切开刀进行黏膜下剥离治疗胃角早癌及癌前病变的临床疗效对比。方法:选取2015年12月—2023年8月南京医科大学第一附属医院收治的146例早期胃角黏膜病变患者为研究对象,按照治疗方案分为牙线牵引组(n=73)与IT刀组(n=73),对两组手术时间、病灶剥离时间、肌层损伤、手术效果及术后并发症情况进行评价和比较。结果:牙线牵引组肌层损伤及止血夹的使用数量相比IT刀组显著减少(P<0.05)。牙线牵引组的病灶整块切除率、R0切除率、治愈性切除率、切缘阳性率及围手术期并发症发生率(术后出血、穿孔)与IT刀组比较差异无统计学意义(P>0.05)。单因素Logistic回归分析显示,牙线牵引辅助一次性黏膜切开刀进行黏膜下剥离能够有效减少肌层损伤(OR=0.37,95%CI:0.18~0.74,P=0.006)。结论:对于胃角早癌及癌前病变,采用牙线牵引辅助一次性黏膜切开刀进行内镜黏膜下剥离术能够有效减少肌层损伤,确保手术的安全性和有效性。

体内牙线牵引技术在辅助结直肠病变内镜黏膜下剥离术教学中的作用

目的探讨体内牙线牵引技术在辅助结直肠病变内镜黏膜下剥离术(ESD)教学中的作用。方法选择2024年4月1日至7月31日于首都医科大学附属北京安贞医院消化内科因结直肠病变行ESD治疗的27例患者。本期共有4名初级ESD内镜医师参与ESD操作的教学培训,所有ESD操作由熟练ESD内镜操作的医师指导、初级内镜医师操作,并收集患者的临床资料和病理结果。结果入选的27例进行结直肠病变ESD治疗的患者中男16例、女11例,年龄(61±9)岁。病变部位包括回盲部病变1例、升结肠病变3例、横结肠病变3例、降结肠病变4例、乙状结肠病变5例、直肠病变11例。病理类型包括低级别管状腺瘤13例、低级别绒毛管状腺瘤5例、锯齿状腺瘤3例、神经内分泌肿瘤3例、高级别上皮内瘤变3例。所有患者均未出现出血、穿孔、感染等并发症,整块切除率和完整切除率均为100%。4名初级ESD内镜医师均迅速地掌握了ESD操作技术,安全有效。结论对于初级内镜医师,应用体内牙线牵引技术辅助结直肠病变ESD操作,有助于其迅速掌握ESD,安全有效。

艾叶炮制前后5种化学成分的含量变化研究

目的:建立HPLC法同时测定艾叶及炮制品酒艾叶、醋艾叶、醋炭艾叶、炒炭艾叶中新绿原酸、绿原酸、隐绿原酸、异绿原酸B、异绿原酸C的含量,并比较炮制前后含量变化规律。方法:以AQ-C_(18)为液相色谱柱;以乙腈和0.4%磷酸水为流动相梯度洗脱;流速为1.0 mL/min;检测波长为325 nm,柱温为30℃。结果:新绿原酸、绿原酸、隐绿原酸、异绿原酸B、异绿原酸C在0.94~18.80、0.45~9.06、0.57~11.38、1.03~20.62、0.68~13.5μg/mL的质量浓度内与峰面积呈良好的线性关系(R^(2)分别为0.9996,0.9997,0.9993,0.9998,0.9996),精密度、稳定性、重复性良好,平均加样回收率分别为99.86%,99.26%,101.43%,98.08%,100.82%,相对标准偏差(RSD)分别为1.84%、1.94%、2.51%、2.28%、2.30%。结论:本研究建立的HPLC法高效简便、专属性强,能较好地对艾叶及其炮制品中苯丙素类成分进行含量测定。

河西出土十六国衣物疏中“收绵”及相关词语考证

出土于甘肃河西地区的7枚十六国时期随葬衣物疏中都记载了“故×绵n斤”一语,“绵”上之字应释为何字及其含义,学界意见至今尚未达成一致。文章结合相关文献,对出土随葬衣物疏中“×绵”及相关词语进行了考释。“绵”上之字应释为“收”字,“×绵”即“收绵”,“收”指“收采的”,“绵”指棉花,当指草棉的棉花纤维。

运动后施加筋膜加压带对DOMS的影响研究

目的:探讨在运动后使用筋膜加压带对普通男大学生下肢股四头肌延迟性肌肉酸痛的影响。方法:选择8名健康非体育专业男大学生,年龄为(19.5±1.20)岁,受试者的双侧下肢分别为加压组和对照组。进行模拟延迟性肌肉酸痛的运动后,测试受试者在运动前、运动后即刻及运动后24 h、48 h各时间段的主观疼痛程度、关节活动度、最大等动肌力。结果:(1)运动造模后即刻、24 h及48 h后两组在关节活动度方面不存在显著性差异(P>0.05);(2)运动造模后即刻加压组的主观疼痛程度显著低于对照组(P<0.05),并在24 h及48 h后更显著(P<0.01);(3)运动造模后即刻、24 h及48 h后加压组较对照组在延迟性肌肉酸痛(DOMS)后的肌力下降现象具有一定保护作用但不存在显著性差异(P>0.05);(4)结果表明,DOMS后使用筋膜加压带干预能够减轻运动后的肌肉酸痛现象,但不具有改善关节活动度和缓解肌力下降的作用。

模拟数学结合响应面法优化新型鸡肉松的工艺

以鸡胸肉为主要原料,通过煮制、烘烤、炒制等工序处理,将提取的甘草浸提液加入到半成品鸡肉松中从而制备出一款新型风味鸡肉松。以鸡肉松的模糊感官评分为评价指标,根据单因素试验结果,利用Box-Behnken试验设计与响应面分析法相结合的方法,得到鸡肉松最佳工艺参数。在最优工艺下制成的鸡肉松色泽金黄、无杂质、味道鲜美。对成品鸡肉松进行贮藏期间稳定性研究,结果表明,新型鸡肉松的最优工艺参数为煮制时间55 min,烘烤温度为60℃,甘草浸提液添加量为11%,烘烤时间为34 min。

筋膜加压带在运动与康复领域的应用与机制

背景:筋膜加压带是一种新兴的防治损伤工具与辅助运动训练策略,其可以增加关节活动度、提高运动表现、缓解疼痛,在运动与康复领域的应用越来越广泛。目的:对筋膜加压带的作用机制和其在运动与康复领域的应用进行综述,为后续研究提供借鉴。方法:以“筋膜加压带、肌筋膜加压带、组织加压带、巫毒带、血流限制、筋膜剪切、肌肉骨骼康复、运动损伤”为中文检索词,检索中国知网、万方、维普数据库;以“tissue flossing;compression tissue flossing;floss band;voodoo flossband;blood flow restriction;shearing of fascia;musculoskeletal rehabilitation;sport injury”为英文检索词,检索PubMed及EBSCO数据库,检索各数据库2000年1月至2022年10月的相关文献,根据纳入及排除标准最终纳入86篇文献。结果与结论:筋膜加压带干预可改善下肢关节活动度、提高冲刺和跳跃运动表现、促进关节损伤康复,在主观上起到缓解疼痛的作用。但筋膜加压带干预对改善上肢关节活动度效果并不显著,对急性提升下肢肌力尚有争议,对提升下肢平衡稳定、改善心理状态有良好趋势,但还需更多研究去证实。筋膜加压带干预的可能机制主要是筋膜剪切、疼痛门控、血流限制与再灌注、压迫作用。筋膜加压带是一种有用的治疗选择,它可以在未来的运动训练、运动损伤预防和康复领域提供重要的贡献,但还需要进行更多长期深入的研究。

新型牦牛肉松工艺优化、特性及其风味成分分析

为满足高原牦牛肉制品市场需求,开发一款新型咸蛋黄海苔牦牛油酥肉松。以感官评价为指标,通过单因素试验、正交试验优化得到牦牛油酥肉松最优工艺,测定其含松率、蓬松度、净蓬松度、绒松度等,并对其色度、质构及营养成分等理化指标进行测定,采用固相微萃取-气相色谱-质谱联用技术(SPME-GC-MS)测定肉松风味物质。结果表明,最佳工艺为:煮制时间130 min,酥松温度100℃,酥松时间13 min,咸蛋黄添加量5%,海苔添加量10%;在此工艺下制得的肉松水分含量低,含松率、蓬松度、净蓬松度、绒松度均高于试验组;色度和质构分析表明,肉松L^(*)值为46.5、a^(*)值为7.72、b^(*)值为24.41;硬度为108.689 g、弹性为0.165、内聚性为0.096,咀嚼性为1.702,其中蛋白质和脂肪含量分别为29.05%和20.77%,保留了牦牛肉原本的营养价值,GC-MS共检测出87种风味物质,其中包括烃类20种、酮类13种、酸类19种、醛类8种、醇类9种、酯类7种、醚类4种、其他类7种。研究结果可为新型牦牛肉松的加工和生产提供一定的技术支撑和理论依据。