AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy(DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral...AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy(DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study.The patients underwent DPOC using an intraductal anchoring balloon,which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope.The device was later voluntarily withdrawn from the market by the manufacturer.RESULTS:Fourteen patients underwent DPOC using the anchoring balloon.Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients.In 12(86%) patients,ductal access required sphincteroplasty with a 10-mm dilating balloon.Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients(93%).Therapeutic interventions by DPOC were successfully completed in all five attempted cases(intraductal biopsy in one and DPOC guided laser lithotripsy in four).Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon.This required hospitalization and antibiotics.Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma.CONCLUSION:Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation.展开更多
A test items knowledge library system of for adaptive learning is proposed in this paper. The first step is to carry out the quantity and quality analysis of the test items by using the Bloom＇s revised taxonomy and s...A test items knowledge library system of for adaptive learning is proposed in this paper. The first step is to carry out the quantity and quality analysis of the test items by using the Bloom＇s revised taxonomy and scale anchoring respectively to produce the characteristics for test items. A smoothing method of arbitrary anchoring revised from scale anchoring is first proposed to make tests more accurate in distinguishing test levels. In addition, raised three dimensional indicators based on the Bloom＇s revised taxonomy are adopted to validate test contents and therefore it concretely describes the examining function of items. The items obtained have the precise and concrete properties; an item knowledge library is therefore constructed combining teaching materials and items using the technologies of ontology and knowledge management. Finally, a knowledge library system of test items is established to achieve the purpose of adaptive learning for learners.展开更多
Cardiac ankyrin repeat protein （CARP） not only serves as an important component of muscle sarcomere in the cytoplasm, but also acts as a transcription co-factor in the nucleus. Previous studies have demonstrated tha...Cardiac ankyrin repeat protein （CARP） not only serves as an important component of muscle sarcomere in the cytoplasm, but also acts as a transcription co-factor in the nucleus. Previous studies have demonstrated that CARP is up-regulated in some cardiovascular disorders and muscle diseases; however, its role in these diseases remains controversial now. In this review, we will discuss the continued progress in the research related to CARP, including its discovery, structure, and the role it plays in cardiac development and heart diseases.展开更多
文摘AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy(DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study.The patients underwent DPOC using an intraductal anchoring balloon,which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope.The device was later voluntarily withdrawn from the market by the manufacturer.RESULTS:Fourteen patients underwent DPOC using the anchoring balloon.Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients.In 12(86%) patients,ductal access required sphincteroplasty with a 10-mm dilating balloon.Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients(93%).Therapeutic interventions by DPOC were successfully completed in all five attempted cases(intraductal biopsy in one and DPOC guided laser lithotripsy in four).Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon.This required hospitalization and antibiotics.Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma.CONCLUSION:Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation.
文摘A test items knowledge library system of for adaptive learning is proposed in this paper. The first step is to carry out the quantity and quality analysis of the test items by using the Bloom＇s revised taxonomy and scale anchoring respectively to produce the characteristics for test items. A smoothing method of arbitrary anchoring revised from scale anchoring is first proposed to make tests more accurate in distinguishing test levels. In addition, raised three dimensional indicators based on the Bloom＇s revised taxonomy are adopted to validate test contents and therefore it concretely describes the examining function of items. The items obtained have the precise and concrete properties; an item knowledge library is therefore constructed combining teaching materials and items using the technologies of ontology and knowledge management. Finally, a knowledge library system of test items is established to achieve the purpose of adaptive learning for learners.
基金Project supported by the National Natural Science Foundation of China(No.31171392)
文摘Cardiac ankyrin repeat protein （CARP） not only serves as an important component of muscle sarcomere in the cytoplasm, but also acts as a transcription co-factor in the nucleus. Previous studies have demonstrated that CARP is up-regulated in some cardiovascular disorders and muscle diseases; however, its role in these diseases remains controversial now. In this review, we will discuss the continued progress in the research related to CARP, including its discovery, structure, and the role it plays in cardiac development and heart diseases.
