New trends in diagnosis and management of gallbladder carcinoma

Gallbladder(GB)carcinoma,although relatively rare,is the most common biliary tree cholangiocarcinoma with aggressiveness and poor prognosis.It is closely associated with cholelithiasis and long-standing large(>3 cm)gallstones in up to 90%of cases.The other main predisposing factors for GB carcinoma include molecular factors such as mutated genes,GB wall calcification(porcelain)or mainly mucosal microcalcifications,and GB polyps≥1 cm in size.Diagnosis is made by ultrasound,computed tomography(CT),and,more precisely,magnetic resonance imaging(MRI).Preoperative staging is of great importance in decisionmaking regarding therapeutic management.Preoperative staging is based on MRI findings,the leading technique for liver metastasis imaging,enhanced three-phase CT angiography,or magnetic resonance angiography for major vessel assessment.It is also necessary to use positron emission tomography(PET)-CT or ^(18)F-FDG PET-MRI to more accurately detect metastases and any other occult deposits with active metabolic uptake.Staging laparoscopy may detect dissemination not otherwise found in 20%-28.6%of cases.Multimodality treatment is needed,including surgical resection,targeted therapy by biological agents according to molecular testing gene mapping,chemotherapy,radiation therapy,and immunotherapy.It is of great importance to understand the updated guidelines and current treatment options.The extent of surgical intervention depends on the disease stage,ranging from simple cholecystectomy(T1a)to extended resections and including extended cholecystectomy(T1b),with wide lymph node resection in every case or IV-V segmentectomy(T2),hepatic trisegmentectomy or major hepatectomy accompanied by hepaticojejunostomy Roux-Y,and adjacent organ resection if necessary(T3).Laparoscopic or robotic surgery shows fewer postoperative complications and equivalent oncological outcomes when compared to open surgery,but much attention must be paid to avoiding injuries.In addition to surgery,novel targeted treatment along with immunotherapy and recent improvements in radiotherapy and chemotherapy(neoadjuvant-adjuvant capecitabine,cisplatin,gemcitabine)have yielded promising results even in inoperable cases calling for palliation(T4).Thus,individualized treatment must be applied.

Current considerations on intraductal papillary neoplasms of the bile duct and pancreatic duct

Pancreatobiliary intraductal papillary neoplasms(IPNs)represent precursors of pancreatic cancer or bile duct cholangiocarcinoma that can be detected and treated.Despite advances in diagnostic methods,identifying these premalignant lesions is still challenging for treatment providers.Modern imaging,biomarkers and molecular tests for genomic alterations can be used for diagnosis and follow-up.Surgical intervention in combination with new chemotherapeutic agents is considered the optimal treatment for malignant cases.The balance between the risk of malignancy and any risk of resection guides management policy;therefore,treatment should be individualized based on a meticulous preoperative assessment of high-risk stigmata.IPN of the bile duct is more aggressive;thus,early diagnosis and surgery are crucial.The conservative management of low-risk pancreatic branch-duct lesions is safe and effective.

Neofusicoccum parvum causing canker of seedlings of Juglans regia in China

Cankered, dying seedlings of Juglans regia were observed in Shaanxi province in the northwest region of China. Neofusicoccum parvum was isolated from these cankered tissues, with the identification based on mor- phology and an ITS-nrDNA sequence. In order to demonstrate how cultures of N. parvum could cause the expected symptoms, artificial infection, using these isolates and re-isolation of the pathogen, was used. This is the first report on this taxon as a walnut canker pathogen in China.

Lasiodiplodia pseudotheobromae causes stem canker of Chinese hackberry in China

Chinese hackberry(Celtis sinensis Pers.)is an adaptable species widely growing in southern China.The symptoms of canker on stems of seedlings were discovered mid-July 2017 in Shuyang,Jiangsu Province.The diseased portions of the stems were dark brown due to discoloured xylem.Some seedlings showed symptoms of wilting,leaf fall,twig dieback,and tissue discolouration.The outbreak period was concentrated in July and August,suggesting that the disease spread during summer months.Possible fungal causal agents were isolated from naturally infected canker tissue and discoloured xylem.The isolate from xylem tissue with a high frequency(>50%)was named Ls7 type.Pathogenicity tests were carried out on 4-yearold seedlings.The symptoms of canker began to develop 20 days after inoculation with Ls7 isolate and by day 35,there were dark,enlarged longitudinal lesions.A phylogenetic tree of the isolate was developed using the internal transcribed spacer,elongation factor-1α(tef1-α),β-tubulin gene(TUB)and RNA polymerase II subunit primer genes(RPB2).Based on morphological features and phylogenetic information,the pathogen was identifi ed as Lasiodiplodia pseudotheobromae.This is the fi rst report of L.pseudotheobromae causing canker on Chinese hackberry stems in China.

Crop pest image recognition based on the improved ViT method Author links open overlay panel

The crop pests and diseases in agriculture is one of the most important reason for the reduction of bulk grain and oil crops and the decline of fruit and vegetable crop quality,which threaten macroeconomic stability and sustainable development.However,the recognition method based on manual and instruments has been unable to meet the needs of scientific research and production due to its strong subjectivity and low efficiency.The recognition method based on pattern recognition and deep learning can automatically fit image features,and use features to classify and predict images.This study introduced the improved Vision Transformer(ViT)method for crop pest image recognition.Among them,the region with the most obvious features can be effectively selected by block partition.The self-attention mechanism of the transformer can better excavate the special solution that is not an obvious lesion area.In the experiment,data with 7 classes of examples are used for verification.It can be illustrated from results that this method has high accuracy and can give full play to the advantages of image processing and recognition technology,accurately judge the crop diseases and pests category,provide method reference for agricultural diseases and pests identification research,and further optimize the crop diseases and pests control work for agricultural workers in need.