Endoscopic diagnosis and treatment of superficial nonampullary duodenal tumors

The diagnostic and treatment guidelines of superficial non-ampullary duodenal tumors have not been standardized due to their low prevalence.Previous reports suggested that a superficial adenocarcinoma(SAC) should be treated via local resection because of its low risk of lymph node metastasis,whereas a highgrade adenoma(HGA) should be resected because of its high risk of progression to adenocarcinoma.Therefore,pretreatment diagnosis of SAC or HGA is important to determine the appropriate treatment strategy.There are certain endoscopic features known to be associated with SAC or HGA,and current practice prioritizes the endoscopic and biopsy diagnosis of these conditions.Surgical treatment of these duodenal lesions is often related to high risk of morbidity,and therefore endoscopic resection has become increasingly common in recent years.Endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) are the commonly performed endoscopic resection methods.EMR is preferred due to its lower risk of adverse events;however,it has a higher risk of recurrence than ESD.Recently,a new and safer endoscopic procedure that reduces adverse events from EMR or ESD has been reported.

Laparoscopic and endoscopic co-operative surgery for nonampullary duodenal tumors

AIM To assess the safety and feasibility of laparoscopic and endoscopic co-operative surgery(LECS) for early nonampullary duodenal tumors.METHODS Twelve patients with a non-ampullary duodenal tumor underwent LECS at our hospital. One patient had two mucosal lesions in the duodenum. The indication for this procedure was the presence of duodenal tumors with a low risk for lymph node metastasis. In particular, the tumors included small(less than 10 mm) submucosal tumors(SMT) and epithelial mucosal tumors, such as mucosal cancers or large mucosal adenomas with malignant suspicion. The LECS procedures, such as full-thickness dissection for SMT and laparoscopic reinforcement after endoscopic submucosal dissection(ESD) for epithelial tumors, were performed for the 13 early duodenal lesions in 12 patients. Here we present the short-term outcomes and evaluate the safety and feasibility of this new technique.RESULTS Two SMT-like lesions and eleven superficial epithelial tumor-like lesions were observed. Seven and Six lesions were located in the second and third parts of the duodenum, respectively. All lesions were successfully resected en bloc. The defect in the duodenal wall was manually sutured after resection of the duodenal SMT. For epithelial duodenal tumors, the ulcer bed was laparoscopically reinforced via manual suturing after ESD. Intraoperative perforation occurred in two out of eleven epithelial tumor-like lesions during ESD; however, they were successfully laparoscopically repaired. The median operative time and intraoperative estimated blood loss were 322 min and 0 mL, respectively. Histological examination of the tumors revealed one adenoma with moderate atypia, ten adenocarcinomas, and two neuroendocrine tumors. No severe postoperative complications(Clavien-Dindo classification grade Ⅲ or higher) were reported in this series, but minor leakage secondary to pancreatic fistula occurred in one patient.CONCLUSION LECS can be a safe and minimally invasive treatment option for non-ampullary early duodenal tumors.

Optimal Design of Multiple Stress Constant Accelerated Life Test Plan on Non-rectangle Test Region

For optimal design of constant stress accelerated life test（CSALT） with two-stress, if the stresses could not reach the highest levels simultaneously, the test region becomes non-rectangular. For optimal CSALT design on non-rectangle test region, the present method is only focused on non-rectangle test region with simple boundary, and the optimization algorithm is based on experience which can not ensure to obtain the optimal plan. In this paper, considering the linear-extreme value model and the optimization goal to minimize the variance of lifetime estimate under normal stress, the optimal design method of two-stress type-I censored CSALT plan on general non-rectangular test region is proposed. First, two properties of optimal test plans are proved and the relationship of all the optimal test plans is determined analytically. Then, on the basis of the two properties, the optimal problem is simplified and the optimal design method of two-stress CSALT plan on general non-rectangular test region is proposed. Finally, a numerical example is used to illustrate the feasibility and effectiveness of the method, The result shows that the proposed method could obtain the optimal test plan on non-rectangular test regions with arbitrary boundaries. This research provides the theory and method for two-stress optimal CSALT planning on non-rectangular test regions.

A mutation of the start codon in the X region of hepatitis B virus DNA in a patient with non-B,non-C chronic hepatitis

There are cases of hepatitis involving occult hepatitis B virus(HBV)infection in which,even though the HB surface antigen(HBsAg)is negative,HBV-DNA is detected by a polymerase chain reaction(PCR).We con-ducted a sequence analysis of the entire HBV region in a case of non-B non-C chronic hepatitis in a 46-yearold female.A diagnosis of non-B non-C chronic hepatitis was made.Although HBV markers,such as HBs antibody(anti-HBs),anti-HBc,HBeAg and anti-HBe,were negative,HBV-DNA was positive.Nested PCR was performed to amplify the precore region of HBV-DNA and all remaining regions by long nested PCR.Sequence analysis of the two obtained bands was conducted by direct sequencing.Compared with the control strains,the ATG(Methionine)start codon in the X region had mut ated to GTG(Valine).It is assumed that a mutation at the start codon in the X region may be the reason why HBV markers are negative in some cases of hepatitis that involve occult HBV infection.

Deletion of a Non-Catalytic Region Increases the Enzymatic Activity of a β-Agarase from Flammeovirga sp. MY04

A Glycoside hydrolase(GH) typically contains one catalytic module and varied non-catalytic regions(NCRs). However, effects of the NCRs to the catalytic modules remain mostly unclear except the carbohydrate-binding modules(CBMs). Aga G4 is a GH16 endo-β-agarase of the agarolytic marine bacterium Flammeovirga sp. MY04. The enzyme consists of an extra sugar-binding peptide within the catalytic module, with no predictable CBMs but function-unknown sequences in the NCR, which is a new characteristic of agarase sequences. In this study, we deleted the NCR sequence, a 140-amino acid peptide at the C-terminus and expressed the truncated gene, aga G4-T140, in Escherichia coli. After purification and refolding, the truncated agarase r Aga G4-T140 retained the same catalytic temperature and p H value as r Aga G4. Using combined fluorescent labeling, HPLC and MS/MS techniques, we identified the end-products of agarose degradation by r Aga G4-T140 as neoagarotetraose and neoagarohexaose, with a final molar ratio of 1.53:1 and a conversion ratio of approximately 70%, which were similar to those of r Aga G4. However, the truncated agarase r Aga G4-T140 markedly decreased in protein solubility by 15 times and increased in enzymatic activities by 35 times. The oligosaccharide production of r Aga G4-T140 was approximately 25 times the weight of that produced by equimolar r Aga G4. This study provides some insights into the influences of NCR on the biochemical characteristics of agarase Aga G4 and implies some new strategies to improve the properties of a GH enzyme.

The non-point output of different agriculture landuse types in Zhexi hydraulic region of Taihu Basin

This paper takes Zhexi hydraulic region in Taihu Basin as a study area. On the basis of hydraulic analysis function of Arcgis8.3, the drainages were delineated by selecting the monitoring points and discharge stations as outlets. The landuse map were finished by denoting the TM/ETM image. The precipitation map was finished by spatial interpolation according to the rainfall monitoring records. Overlaying the drainage boundary, landuse map and precipitation map, the rainfall, different landuse type area, and runoff pollution concentration and runoff were calculated. Based on these data in different sub-watersheds, by Origin7.0 regression tool, an equation is established to predict runoff using the relationships between runoff, precipitation depth and land use patterns in each of the sub-watersheds. Selecting the sub-watershed which is mainly composed of forest landuse type, the mean runoff concentration (MRC) from sub-watershed has been estimated. The mean runoff concentration of farmland has been estimated by the same methods after the contribution of forest landuse type was removed. The results are: for the forest landuse type, the mean runoff concentrations of COD, BOD, Total N and Total P are 2.95 mg/l, 1.080 mg/l, 0.715 mg/l, and 0.039 mg/l, respectively; for the farmland, the mean runoff concentrations of COD, BOD, Total N and Total P are 5.721 mg/l, 3.097 mg/l, 2.092 mg/l, and 0.166 mg/l, respectively. By using these results, the agriculture non-point pollution loads have been assessed. The loads of COD, BOD, Total N and Total P in Zhexi region are 14,631.69 t/a, 6401.93 t/a, 4281.753 t/a and 287.67 t/a, respectively.

CHINA'S REGIONAL DISPARITY IN 1981-2000:OPENNESS AND DEVELOPMENT OF NON-STATE-OWNED ENTERPRISES AND FISCAL DECENTRALIZATION

While China's economic growth has been impressive since 1978, regional disparity in terms of provincial per capita GDP has been increasing. On the other hand, this rapid but uneven growth was accompanied by China's deepening openness and structural reforms including the development of non-state-owned enterprises (non-SOEs) and fiscal decentralization. Based on quantitative analyses, this paper tries to explore the features of regional disparity in China and the relationships between regional growth and China's openness and economic structure reforms in the period from 1981 to 2000. The paper finds that the catching-up of the coastal region to the initially rich provinces, which are mainly located in inland areas, brought about a convergence of the growth pattern across provinces in the 1980s.The subsequent divergence in the provincial growth rates between the coast and the interior generated an enlarging regional disparity in China in the 1990s. The ever-faster growth in the coastal region was benefited by China's openness and the development of non-state-owned enterprises. The development of non-state-owned enterprises underlies the higher operational efficiency in the coastal region. Additionally, with the insignificant regression results, fiscal decentralization was observed to facilitate faster growth in the coast region. The findings justify the initiative of the 'West Region Development Strategy' and offer some policy implications for China.

Molecular Detection of Mutations within the Quinolone Resistance-Determining Regions in Non Typhoidal Salmonella Isolates from Malaysia

Introduction: The efficacy of chemotherapy in bacteraemia caused by non-typhoidal Salmonella (NTS) is compromised by antibiotic resistance. Objective: This study was undertaken to describe the mechanism of resistance among clinical NTS isolates. Materials & Methodology: Thirty of NTS were isolated from blood (n = 19), stool (n = 10) and bronchioalveolar lavage (BAL;n = 1) respectively. These isolates were tested for susceptibility testing by disc diffusion method against ampicillin, gentamicin, tetracycline, co-trimoxazole, nalidixic acid, ciprofloxacin and ceftriaxone. Epsilometer tests (E-test) for nalidixic acid and ciprofloxacin were performed for nalidixic acid resistant isolates by disc diffusion method. DNA sequencing was carried out on six of the nalidixic acid resistant Salmonella Enteritidis isolates to identify mutations within quinolones resistance determining regions (QRDR) of gyrA, gyrB, parC and parE genes. Results: Resistance rates of NTS isolates from blood, stool, and BAL were respectively 37%, 20% and 0% for ampicillin, 79%, 40% and 0% for tetracycline, 32%, 40% and 0% for co-trimoxazole, 37%, 10% and 100% for nalidixic acid. Eight isolates were resistant to nalidixic acid and had exhibited reduced susceptibility towards ciprofloxacin by E-test. Mutation within QRDR was detected in gyrA gene (n = 6;Asp 47 → His [3], Asp 51 → Asn [1], Asp 73 → Gly [1], and Gly 48 → Asp [1]) and double mutation was detected in parE gene (n = 3;Gly 48 → Asp [3], Glu 82 → Ser [3]). Out of six isolates, three isolates were found to have both gyrA and parE gene mutations. Conclusions: There was no mutation observed in gyrB and parC gene. Mutation in gyrA gene was sufficient to induce decreased susceptibility to ciprofloxacin. Variation in amino acid sequences are novel, while detection of other gene mutation was uncommon.

A Non-Monotone Trust Region Method with Non-Monotone Wolfe-Type Line Search Strategy for Unconstrained Optimization

In this paper, we propose and analyze a non-monotone trust region method with non-monotone line search strategy for unconstrained optimization problems. Unlike the traditional non-monotone trust region method, our algorithm utilizes non-monotone Wolfe line search to get the next point if a trial step is not adopted. Thus, it can reduce the number of solving sub-problems. Theoretical analysis shows that the new proposed method has a global convergence under some mild conditions.

Argyrophilic nucleolar organizer region in MIB-1 positive cells in non-small cell lung cancer: clinicopathological significance and survival

Objective:To evaluate the relation between argyrophilic nucleolar organizer region(Ag NOR)-associated proteins and clinicopathological parameters and survival in non-small-cell lung cancer(NSCLC).Methods:A total of 207 surgical specimens diagnosed as NSCLC were included in this study.Double-staining procedures were performed using antigen Ki-67(clone MIB-1)and silver nitrate by immunohistochemical and Ag NOR-staining methods.Results:The Ag NOR area in MIB-1-positive cells of NSCLC is related to clinicopathological parameters under the TNM(tumor,node,and metastasis)system.The survival of patients with small Ag NOR area in MIB-1-positive cells is better than that of patients with large Ag NOR area.Molecular,biological(Ag NOR area in MIB-1-positive cells),and clinicopathological(greatest tumor dimension,metastases to regional lymph nodes,histology,and differentiation)parameters are independent prognostic factors of NSCLC.Conclusion:The Ag NOR area in MIB-1-positive cells is related to clinicopathological parameters and survival in NSCLC.

A Non-Asymptotic Confidence Region with a Fixed Size for a Scalar Function Value: Applications in C-OTDR Monitoring Systems

In this paper we will investigate some non-asymptotic properties of the modified least squares estimates for the non-linear function f(λ*) by observations that nonlinearly depend on the parameter λ*. Non-asymptotic confidence regions with fixed sizes for the modified least squares estimate are used. The obtained confidence region is valid for a finite number of data points when the distributions of the observations are unknown. Asymptotically the suggested estimates represent usual estimates of the least squares. The paper presents the results of practical applications of the proposed method in C-OTDR monitoring systems.

表征与非表征视角下饮食地域刻板印象的验证与测量

饮食在地域之间不断交融,跨越国界、民族及社区,既成为一种表征的文化意义结构,也成为非表征的日常参与和实践,在表征与非表征视角下,饮食地域刻板印象的存在与具体内容值得探讨。为了厘清这一问题,本研究采用混合研究法对饮食地域刻板印象进行验证和测量。子研究1使用了问卷调查法检验外显层面的饮食地域刻板印象,子研究2采用语义启动的实验范式检验内隐层面的饮食地域刻板印象。研究发现,被试在内隐和外显层面均持有饮食地域刻板印象,主要包括主食偏好、口味偏好、份量偏好和具体菜品4个维度。本研究验证了饮食地域刻板印象具有外显和内隐、经验与情景并存的特征,这扩展了表征与非表征理论相结合的饮食社会文化地理知识。

旱区陆面非降水性水分研究进展和展望

随着全球气候变暖,自然生态系统和水资源压力不断增加,加剧了全球水资源的短缺。旱区非降水性水分(Non-precipitation Water,NPW),作为一种重要的水源,对旱区生态系统和陆面水分平衡具有显著影响。本文基于国内外非降水性水分研究现状,总结其在西北旱区的观测方法、变化特征、形成机制及对陆面水分平衡和作物的影响。在结合非降水性水分研究国际趋势的基础上,指出当前研究的不足和问题,以及未来研究的重点方向:揭示陆面非降水性水分的复杂形成机制,加强对不同气候区和下垫面非降水性水分的认知,建立专门的陆面非降水性水分观测系统,发展其在数值模式中的参数化,以及制定陆面非降水性水分开发利用的技术标准。

中国城市碳排放绩效:动态分解、空间差异与影响因素

以非径向方向距离函数为框架,构造全要素碳排放绩效指数对中国2006—2019年城市碳排放治理绩效进行测度。在此基础上从经济含义、跨期动态变化、区域均衡等层面对全要素碳排放绩效指数进行多维分解,检验中国城市碳排放绩效的影响因素。结果表明:第一,样本期内全国城市平均全要素碳排放绩效指数总体呈波动上升态势,动态分解结果显示,中国各地的平均碳排放绩效水平不断改进,创新效应对其贡献逐年增大但赶超效应贡献不足;第二,空间分异方面,珠三角、长三角、粤闽浙沿海、长江中游等东部地区城市群不仅平均碳排放绩效水平普遍较高,且碳排放绩效的增长速度较快,中西部地区仅成渝城市群碳排放绩效表现较好,中原、京津冀等城市群近年来碳排放绩效的改善速度较快;第三,基尼系数测度及其分解显示,近年中国城市碳排放绩效指数的分异程度逐步加深,分异成因主要为城市群组间差异,城市群内部差异贡献度较低;第四,Lasso分析及双固定面板模型分析结果显示,经济发展水平、清洁能源使用、金融发展、绿色环保和科技支持能够有效改善城市层面的碳排放绩效,能源消耗强度和第二产业就业人员比重对碳排放绩效具有负面影响;最后,城市群因子探测结果显示,各城市群间的驱动因子存在一定差异。

数字技术赋能京津冀产业结构升级的效应研究

数字技术的应用与发展,是现阶段中国经济高质量发展的需要,是产业结构升级的重要技术支撑。以京津冀地区13市2011—2021年面板数据为基础,运用双固定效应模型、中介效应模型、门槛效应模型等多种计量方法对数字技术对产业结构升级的影响进行实证分析。研究结果表明,数字技术对产业结构升级具有促进效应;在地区异质性分析中发现数字技术与产业结构升级的关系在资源型与非资源型城市间尚未产生显著性差异。进一步分维度来看,数字技术对产业结构升级的促进作用主要源于数字技术应用;随着产业结构升级分位点位置的上升,数字技术对产业结构升级的促进效应呈现逐渐增强的特征,使京津冀地区存在数字鸿沟的风险。此外,数字技术对产业结构升级的影响具有经济发展水平的门槛特征,当经济发展水平不断跨过门槛值时,数字技术对产业结构升级的促进作用会增强;数字技术可以通过投资拉动和金融发展效率促进产业结构升级,而市场消费需求和人力资本结构高级化则在其影响中起到遮掩效应。

对外直接投资对中国区域经济韧性影响研究

对外直接投资(OFDI)是影响中国区域经济韧性的重要因素。基于2005—2019年省级面板数据,运用非空间面板模型、空间面板模型和中介效应模型实证分析了OFDI对中国区域经济韧性的影响及作用机制。研究表明:OFDI总体上促进了中国区域经济韧性的提升,该结论在一系列稳健性检验后依然成立;OFDI对邻近地区经济韧性的提升具有溢出效应。中介机制检验发现,OFDI能通过人力资本和技术创新机制间接提升中国区域经济韧性。空间异质性分析表明,OFDI促进东部地区和中西部地区经济韧性的提升,且对东部地区经济韧性的推动作用高于中西部地区;时间异质性分析表明,金融危机抵抗期OFDI对中国区域经济韧性的提升具有抑制作用,而在金融危机恢复期和转型期具有促进作用。

云南小碗红糖非遗品牌发展路径研究

随着农业的发展,农产品品牌化对推进乡村振兴和农业农村现代化发挥着重要作用。本文以云南省巧家县红糖产业为研究对象,通过实地调研和网络调研相结合的方法,总结巧家县红糖产业发展的机遇与优势,发现巧家县小碗红糖品牌发展存在品牌价值缺位、产品附加值不高、发展合力不足、培育机制不完善等问题。为此,提出丰富品牌多元要素、优化生产质量标准、壮大本土经营主体、明晰品牌培育机制等策略,为巧家小碗红糖品牌建设进一步完善提供建议与参考。

地方环境对流动人口回流意愿的非线性影响——基于流入地与户籍地的比较分析

基于2017年流动人口动态监测调查数据,以流动人口回流意愿为响应变量,以流入地和户籍地的地方环境、个人及家庭因素为解释变量,引入机器学习领域的梯度提升决策树模型,重点探究不同地区地方环境对流动人口回流意愿的非线性影响及阈值效应。研究发现:①户籍地和流入地的地方环境对流动人口回流意愿的总体贡献率达44.1%,是影响回流意愿的重要因素,且两地贡献率大致相当。②地方环境因素与回流意愿间的非线性与线性关系并存。其中,医疗卫生资源、基础教育资源、空气污染状况等因素对回流意愿具有明显的非线性影响,而经济增长、气温条件则以线性影响为主。研究揭示了中国国内城-乡人口回流的特殊性与复杂性,有助于深化新时期人口迁移研究,并为地方人口政策制定提供科学借鉴。

基于WEP-QTP模型的近65 a黄河源区径流演变分析

为研究黄河源区径流演变规律,以WEP-QTP(The Water and Energy transfer Processes in the Qinghai⁃Tibet Plateau)模型为基础构建基于水热耦合的黄河源区冻土水文模型。采用玛曲站2019—2021年冻融期逐日土壤温度及土壤液态含水率对模型进行验证,率定期及验证期决定系数(R2)均值为0.8左右,均方根误差(RMSE)均值分别为1.0℃及0.04左右;采用8个冻土监测点1971—2000年冻融期逐日冻土深度进行验证,决定系数(R2)均值为0.89,均方根误差(RMSE)均值为214.81 mm。模型模拟黄河源区1956—2020年逐月流量过程,效率系数(NSE)为0.8左右,相对误差(RE)为5%左右,表明模型能较好地模拟黄河源区径流过程。利用M-K趋势检验分析得到1956—2020年黄河源区径流呈不显著增加趋势,其变化趋势是降水与气温共同影响的结果。冻融期、非冻融期径流与全年趋势一致。降水增加、气候变暖及冻土退化使径流组分发生变化,地表径流及地下径流均呈增加趋势,但地下径流在全年及冻融期增加趋势更加显著。

基于小平面区域特征的文物碎片重组算法

针对非薄壁文物碎片重组复原过程中,因碎片边缘或断裂面磨损而导致拼接误差大的问题,提出了一种基于小平面区域特征的文物碎片拼接算法。首先根据区域增长分割把碎片的三维点云分割出许多小平面,建立以小平面作为拼接的特征区域,根据特征描述找到初始相似的小平面区域对,然后灵活应用几何约束+随机采样一致性(RANSAC)约束策略的方法,消除误匹配;最后通过4PCS(4-Points Congruent Sets)算法进行碎片的粗对齐,再根据迭代最近点算法(ICP)实现碎片的精确拼接。实验结果表明:小平面的特征描述简单,且有较强的稳健性,采用两级约束策略的方法较好的解决了误匹配问题,提高了磨损碎片拼接的成功率,同时有效减少渗透现象。