Esophageal cancer poses diagnostic,therapeutic and economic burdens in highrisk regions.Artificial intelligence(AI)has been developed for diagnosis and outcome prediction using various features,including clinicopathol...Esophageal cancer poses diagnostic,therapeutic and economic burdens in highrisk regions.Artificial intelligence(AI)has been developed for diagnosis and outcome prediction using various features,including clinicopathologic,radiologic,and genetic variables,which can achieve inspiring results.One of the most recent tasks of AI is to use state-of-the-art deep learning technique to detect both early esophageal squamous cell carcinoma and esophageal adenocarcinoma in Barrett’s esophagus.In this review,we aim to provide a comprehensive overview of the ways in which AI may help physicians diagnose advanced cancer and make clinical decisions based on predicted outcomes,and combine the endoscopic images to detect precancerous lesions or early cancer.Pertinent studies conducted in recent two years have surged in numbers,with large datasets and external validation from multi-centers,and have partly achieved intriguing results of expert’s performance of AI in real time.Improved pre-trained computer-aided diagnosis algorithms in the future studies with larger training and external validation datasets,aiming at real-time video processing,are imperative to produce a diagnostic efficacy similar to or even superior to experienced endoscopists.Meanwhile,supervised randomized controlled trials in real clinical practice are highly essential for a solid conclusion,which meets patient-centered satisfaction.Notably,ethical and legal issues regarding the blackbox nature of computer algorithms should be addressed,for both clinicians and regulators.展开更多
The increasing popularity of endoscopic submucosal dissection(ESD)as a treatment for early gastric cancer has highlighted the importance of quality assessment in achieving curative resections.This article emphasizes t...The increasing popularity of endoscopic submucosal dissection(ESD)as a treatment for early gastric cancer has highlighted the importance of quality assessment in achieving curative resections.This article emphasizes the significance of evaluating ESD quality,not only for curative cases but also for non-curative ones.Postoperative assessment relies on the endoscopic curability(eCura)classification,but management strategies for eCuraC-1 tumour with a positive horizontal margin are unclear.Current research primarily focuses on comparing additional surgical procedures in high-risk patients,while studies specifically targeting eCuraC-1 patients are limited.Exploring management strategies and follow-up outcomes for such cases could provide valuable insights.Furthermore,the application of molecular imaging using near-infrared fluorescent tracers holds promise for precise tumour diagnosis and navigation,potentially impacting the management of early-stage gastric cancer patients.Advancing research in these areas is essential for improving the overall efficacy of endoscopic techniques and refining treatment indications.展开更多
BACKGROUND Endoscopic biliary stenting is a well-established palliative treatment for patients with unresectable distal malignant biliary obstruction(MBO). However, the main problem with stent placement is the relativ...BACKGROUND Endoscopic biliary stenting is a well-established palliative treatment for patients with unresectable distal malignant biliary obstruction(MBO). However, the main problem with stent placement is the relatively short duration of stent patency.Although self-expanding metal stents(SEMSs) have a longer patency period than plastic stents(PSs), the higher costs limit the wide use of SEMSs. A PS with an antireflux valve is an attractive idea to prolong stent patency, but no ideal design for an antireflux PS(ARPS) has been proposed. We developed a new ARPS with a "duckbilled" valve attached to the duodenal end of the stent.AIM To compare the patency of ARPSs with that of traditional PSs(TPSs) in patients with unresectable distal MBO.METHODS We conducted a single-center, prospective, randomized, controlled, double-blind study. This study was conducted at the West China Hospital of Sichuan University. Consecutive patients with extrahepatic MBO were enrolled prospectively. Eligible patients were randomly assigned to receive either an ARPS or a TPS. Patients were followed by clinic visits or telephone interviews every 1-2 mo until stent exchange, death, or the final study follow-up in October 2018. The primary outcome was the duration of stent patency. Secondary outcomes included the rate of technical success, the rate of clinical success,adverse events, and patient survival.RESULTS Between February 2016 and December 2017, 38 patients were randomly assigned to two groups, with 19 patients in each group, to receive ARPSs or TPSs. Stent insertion was technically successful in all patients. There were no significant differences between the two groups in the rates of clinical success or the rates of early or late adverse events(P = 0.660, 1.000, and 1.000, respectively). The median duration of stent patency in the ARPS group was 285 d [interquartile range(IQR),170], which was significantly longer than that in the TPS group(median, 130 d;IQR, 90, P = 0.005). No significant difference in patient survival was noted betwe展开更多
BACKGROUND The incidence of post-endoscopic retrograde cholangiopancreatography(ERCP)cholangitis(PEC)in patients who underwent mechanical lithotripsy(ML)for large stone removal is high(up to 13.3%).One of the main cau...BACKGROUND The incidence of post-endoscopic retrograde cholangiopancreatography(ERCP)cholangitis(PEC)in patients who underwent mechanical lithotripsy(ML)for large stone removal is high(up to 13.3%).One of the main causes is remaining small fragments or sludge that can impair normal biliary drainage.Endoscopic placement of a nasobiliary tube or a conventional plastic biliary stent has been commonly used under such conditions,but the patient may suffer from significant discomfort after the placement of a nasobiliary tube,while additional endoscopy is required for stent removal.We developed a biliary spontaneous dislodgement spiral stent(BSDSS)to overcome those shortcomings.AIM To evaluate the feasibility,safety,and effectiveness of inserting a BSDSS for patients who underwent ML for large stone removal.METHODS We conducted a single-center,retrospective,cohort study at West China Hospital,Sichuan University.A total of 91 consecutive patients with large biliary stones(≥10 mm)in the common bile duct who underwent ML between November 2017 and July 2018 were included.The 49 eligible patients were divided into the BSDSS group and the nasobiliary tube group.Technical success,post-ERCP adverse events(including PEC,post-ERCP pancreatitis,stone recurrence,BSDSS retention,self-extraction and dislocation of the nasobiliary tube),drainage time,and postoperative stay were measured and compared.RESULTS Twenty-one patients in the BSDSS group and 28 patients in the nasobiliary tube group were included in the analyses.The baseline characteristics and clinical information were similar in the two groups.Insertions of BSDSS and nasobiliary tube were technically successful in all 49 patients.There was no significant difference in the incidence of overall post-ERCP adverse events between the two groups(4.8%in the BSDSS group vs 17.9%in the nasobiliary tube group,P=0.219).The median duration of drainage time(3 d in the BSDSS group vs 4 d in the nasobiliary tube group)and length of postoperative stay(4 d in the BSDSS group vs 5 d in the 展开更多
Human respiratory syncytial virus(RSV)infection is the leading cause of lower respiratory tract illness(LRTI),and no vaccine against LRTI has proven to be safe and effective in infants.Our study assessed attenuated re...Human respiratory syncytial virus(RSV)infection is the leading cause of lower respiratory tract illness(LRTI),and no vaccine against LRTI has proven to be safe and effective in infants.Our study assessed attenuated recombinant RSVs as vaccine candidates to prevent RSV infection in mice.The constructed recombinant plasmids harbored(5′to 3′)a T7 promoter,hammerhead ribozyme,RSV Long strain antigenomic cDNA with cold-passaged(cp)mutations or cp combined with temperature-sensitive attenuated mutations from the A2 strain(A2cpts)or further combined with SH gene deletion(A2cptsΔSH),HDV ribozyme(δ),and a T7 terminator.These vectors were subsequently co-transfected with four helper plasmids encoding N,P,L,and M2-1 viral proteins into BHK/T7-9 cells,and the recovered viruses were then passaged in Vero cells.The rescued recombinant RSVs(rRSVs)were named rRSV-Long/A2cp,rRSV-Long/A2cpts,and rRSV-Long/A2cptsΔSH,respectively,and stably passaged in vitro,without reversion to wild type(wt)at sites containing introduced mutations or deletion.Although rRSV-Long/A2cpts and rRSV-Long/A2cptsΔSH displayed temperature-sensitive(ts)phenotype in vitro and in vivo,all rRSVs were significantly attenuated in vivo.Furthermore,BALB/c mice immunized with rRSVs produced Th1-biased immune response,resisted wtRSV infection,and were free from enhanced respiratory disease.We showed that the combination ofΔSH with attenuation(att)mutations of cpts contributed to improving att phenotype,efficacy,and gene stability of rRSV.By successfully introducing att mutations and SH gene deletion into the RSV Long parent and producing three rRSV strains,we have laid an important foundation for the development of RSV live attenuated vaccines.展开更多
We propose a nonvolatile resistive random access memory device by employing nanodispersion of zirconia(ZrO2) quantum dots(QDs) for the formation of an active layer. The memory devices comprising a typical sandwich str...We propose a nonvolatile resistive random access memory device by employing nanodispersion of zirconia(ZrO2) quantum dots(QDs) for the formation of an active layer. The memory devices comprising a typical sandwich structure of Ag(top)/ZrO2(active layer)/Ti(bottom) are fabricated using a facile spin-coating method. The optimized device exhibits a high resistance state/low resistance state resistance difference(about 10 Ω), a good cycle performance(the number of cycles larger than 100), and a relatively low conversion current(about 1 μA). Atomic force microscopy and scanning electron microscope are used to observe the surface morphology and stacking state of the ZrO2 active layer. Experimental results show that the ZrO2 active layer is stacked compactly and has a low roughness(Ra=4.49 nm) due to the uniform distribution of the ZrO2 QDs. The conductive mechanism of the Ag/ZrO2/Ti device is analyzed and studied, and the conductive filaments of Ag ions and oxygen vacancies are focused on to clarify the resistive switching memory behavior. This study offers a facile approach of memristors for future electronic applications.展开更多
Soil moisture is a limiting factor for vegetation restoration on the Loess Plateau, China. Micro-topography may cause heterogeneities in the distribution of soil moisture, but little is known about its effect on deep ...Soil moisture is a limiting factor for vegetation restoration on the Loess Plateau, China. Micro-topography may cause heterogeneities in the distribution of soil moisture, but little is known about its effect on deep soil moisture. Our study aims to explore the distribution and impact of soil moisture within the upper 10 m of soil for different microtopographies. Taking undisturbed slope as the control, five micro-topographies were selected. Soil moisture over a depth of 0-10 m from 2017 to 2019 was investigated, and soil particle size and soil organic matter were measured. Variance analysis and multiple comparisons were used to analyze the difference in soil moisture for different microtopographies and multiple-linear regression was used to analyze the influence of micro-topography on soil moisture. There are significant differences in soil moisture within the different layers underlying the examined micro-topographies, while the inter-annual variation in soil water storage for the selected microtopographies increase with increased rainfall. The depth of influence of micro-topographic vegetation on soil moisture exceeded 1000 cm for a gully(GU), 740 cm for a sink hole(SH), 480 cm for a scarp(SC), 360 cm for an ephemeral gully(EG) and 220 cm for a platform(PL). Micro-topography will cause the heterogeneous distribution of soil moisture in the shallower layers, which changes the vegetation distribution differences between micro-topographies. This may be the survival strategy of herbaceous vegetation in response to climate change in the Loess Plateau. For future vegetation restoration efforts, we need to pay attention to the influence of microtopography on soil moisture.展开更多
A copper-inducible, Cre-loxP recombination-mediated DNA excision system has been developed in transgenic tobacco plants. The copper inducible system derived from yeast was used for the control of the expression of the...A copper-inducible, Cre-loxP recombination-mediated DNA excision system has been developed in transgenic tobacco plants. The copper inducible system derived from yeast was used for the control of the expression of the Cre recombinase. Upon copper induction, the GVS reporter gene expression unit flanked by two direct lox sites was excised from the transgenic tobacco genome. Quantitative fluorometric GUS assays, Northern blot and PCR analyses showed a high-efficient, copper-dependent and Cre-loxP mediated DNA recombination in all the tested transgenic lines. The copper inducible foreign gene excision might be of great potential in genetic control of transgenic crops.展开更多
Achalasia is a type of esophageal motility disorder,consisting of relaxation dysfunction of the lower esophagus and disturbed esophageal peristalsis.Related clinical symptoms include dysphagia,regurgitation,chest pain...Achalasia is a type of esophageal motility disorder,consisting of relaxation dysfunction of the lower esophagus and disturbed esophageal peristalsis.Related clinical symptoms include dysphagia,regurgitation,chest pain,and weight loss.Traditional treatment options include endoscopic botulinum toxin injection,endoscopic pneumatic dilation,and laparoscopic Heller’s myotomy.These therapies mainly relieve symptoms by reducing the pressure on the lower esophageal sphincter and reducing blood flow resistance at the esophagogastric junction.Based on endoscopic submucosal dissection and natural orifice transluminal endoscopic surgery,peroral endoscopic myotomy(POEM)is a purely endoscopic method of myotomy with minimal invasiveness and a low rate of adverse events when performed by experienced operators.Since then,numerous studies have shown the significant clinical efficacy and safety of POEM.The purpose of this article is to introduce different modified POEMs,special indications for different POEMs,and their advantages as well as disadvantages.展开更多
BACKGROUND There is little data available on the role of new anti-reflux plastic stents(ARPSs).AIM To compare the use of ARPSs with that of traditional plastic stents(TPSs)for patients with biliary strictures.METHODS ...BACKGROUND There is little data available on the role of new anti-reflux plastic stents(ARPSs).AIM To compare the use of ARPSs with that of traditional plastic stents(TPSs)for patients with biliary strictures.METHODS Consecutive patients with biliary strictures who underwent first endoscopic biliary stenting between February 2016 and May 2019 were included.The onset of stent-related cholangitis,stent patency,clinical success,and other adverse events were evaluated.RESULTS Sixty-seven patients in the ARPS group and 66 patients in the TPS group were included in the final analyses.Fewer patients experienced stent-related cholangitis in the ARPS group than that in the TPS group(8 patients vs 18 patients;P=0.030).The median time till the onset of first stent-related cholangitis was later in the ARPS group than that in the TPS group(128.5 d vs 76 d;P=0.039).The cumulative median stent patency in the ARPS group was 185 d,which was significantly longer than that in the TPS group(133 d;P=0.001).The clinical success rates and other adverse events did not significantly differ between both groups.CONCLUSION Placement of new ARPS might be a safe and effective optional therapeutic strategy to reduce the risk of stent-related cholangitis and prolong stent patency.展开更多
基金Supported by Sichuan Science and Technology Department Key R and D Projects,No.2019YFS0257and Chengdu Technological Innovation R and D Projects,No.2018-YFYF-00033-GX.
文摘Esophageal cancer poses diagnostic,therapeutic and economic burdens in highrisk regions.Artificial intelligence(AI)has been developed for diagnosis and outcome prediction using various features,including clinicopathologic,radiologic,and genetic variables,which can achieve inspiring results.One of the most recent tasks of AI is to use state-of-the-art deep learning technique to detect both early esophageal squamous cell carcinoma and esophageal adenocarcinoma in Barrett’s esophagus.In this review,we aim to provide a comprehensive overview of the ways in which AI may help physicians diagnose advanced cancer and make clinical decisions based on predicted outcomes,and combine the endoscopic images to detect precancerous lesions or early cancer.Pertinent studies conducted in recent two years have surged in numbers,with large datasets and external validation from multi-centers,and have partly achieved intriguing results of expert’s performance of AI in real time.Improved pre-trained computer-aided diagnosis algorithms in the future studies with larger training and external validation datasets,aiming at real-time video processing,are imperative to produce a diagnostic efficacy similar to or even superior to experienced endoscopists.Meanwhile,supervised randomized controlled trials in real clinical practice are highly essential for a solid conclusion,which meets patient-centered satisfaction.Notably,ethical and legal issues regarding the blackbox nature of computer algorithms should be addressed,for both clinicians and regulators.
基金the China Postdoctoral Science Foundation,No.2022M712265.
文摘The increasing popularity of endoscopic submucosal dissection(ESD)as a treatment for early gastric cancer has highlighted the importance of quality assessment in achieving curative resections.This article emphasizes the significance of evaluating ESD quality,not only for curative cases but also for non-curative ones.Postoperative assessment relies on the endoscopic curability(eCura)classification,but management strategies for eCuraC-1 tumour with a positive horizontal margin are unclear.Current research primarily focuses on comparing additional surgical procedures in high-risk patients,while studies specifically targeting eCuraC-1 patients are limited.Exploring management strategies and follow-up outcomes for such cases could provide valuable insights.Furthermore,the application of molecular imaging using near-infrared fluorescent tracers holds promise for precise tumour diagnosis and navigation,potentially impacting the management of early-stage gastric cancer patients.Advancing research in these areas is essential for improving the overall efficacy of endoscopic techniques and refining treatment indications.
基金Supported by the Sichuan Province Science and Technology Department,China,No.2017SZ0009
文摘BACKGROUND Endoscopic biliary stenting is a well-established palliative treatment for patients with unresectable distal malignant biliary obstruction(MBO). However, the main problem with stent placement is the relatively short duration of stent patency.Although self-expanding metal stents(SEMSs) have a longer patency period than plastic stents(PSs), the higher costs limit the wide use of SEMSs. A PS with an antireflux valve is an attractive idea to prolong stent patency, but no ideal design for an antireflux PS(ARPS) has been proposed. We developed a new ARPS with a "duckbilled" valve attached to the duodenal end of the stent.AIM To compare the patency of ARPSs with that of traditional PSs(TPSs) in patients with unresectable distal MBO.METHODS We conducted a single-center, prospective, randomized, controlled, double-blind study. This study was conducted at the West China Hospital of Sichuan University. Consecutive patients with extrahepatic MBO were enrolled prospectively. Eligible patients were randomly assigned to receive either an ARPS or a TPS. Patients were followed by clinic visits or telephone interviews every 1-2 mo until stent exchange, death, or the final study follow-up in October 2018. The primary outcome was the duration of stent patency. Secondary outcomes included the rate of technical success, the rate of clinical success,adverse events, and patient survival.RESULTS Between February 2016 and December 2017, 38 patients were randomly assigned to two groups, with 19 patients in each group, to receive ARPSs or TPSs. Stent insertion was technically successful in all patients. There were no significant differences between the two groups in the rates of clinical success or the rates of early or late adverse events(P = 0.660, 1.000, and 1.000, respectively). The median duration of stent patency in the ARPS group was 285 d [interquartile range(IQR),170], which was significantly longer than that in the TPS group(median, 130 d;IQR, 90, P = 0.005). No significant difference in patient survival was noted betwe
文摘BACKGROUND The incidence of post-endoscopic retrograde cholangiopancreatography(ERCP)cholangitis(PEC)in patients who underwent mechanical lithotripsy(ML)for large stone removal is high(up to 13.3%).One of the main causes is remaining small fragments or sludge that can impair normal biliary drainage.Endoscopic placement of a nasobiliary tube or a conventional plastic biliary stent has been commonly used under such conditions,but the patient may suffer from significant discomfort after the placement of a nasobiliary tube,while additional endoscopy is required for stent removal.We developed a biliary spontaneous dislodgement spiral stent(BSDSS)to overcome those shortcomings.AIM To evaluate the feasibility,safety,and effectiveness of inserting a BSDSS for patients who underwent ML for large stone removal.METHODS We conducted a single-center,retrospective,cohort study at West China Hospital,Sichuan University.A total of 91 consecutive patients with large biliary stones(≥10 mm)in the common bile duct who underwent ML between November 2017 and July 2018 were included.The 49 eligible patients were divided into the BSDSS group and the nasobiliary tube group.Technical success,post-ERCP adverse events(including PEC,post-ERCP pancreatitis,stone recurrence,BSDSS retention,self-extraction and dislocation of the nasobiliary tube),drainage time,and postoperative stay were measured and compared.RESULTS Twenty-one patients in the BSDSS group and 28 patients in the nasobiliary tube group were included in the analyses.The baseline characteristics and clinical information were similar in the two groups.Insertions of BSDSS and nasobiliary tube were technically successful in all 49 patients.There was no significant difference in the incidence of overall post-ERCP adverse events between the two groups(4.8%in the BSDSS group vs 17.9%in the nasobiliary tube group,P=0.219).The median duration of drainage time(3 d in the BSDSS group vs 4 d in the nasobiliary tube group)and length of postoperative stay(4 d in the BSDSS group vs 5 d in the
基金This work was supported by grants from the Natural Science Foundation of China(81771777,32070922).
文摘Human respiratory syncytial virus(RSV)infection is the leading cause of lower respiratory tract illness(LRTI),and no vaccine against LRTI has proven to be safe and effective in infants.Our study assessed attenuated recombinant RSVs as vaccine candidates to prevent RSV infection in mice.The constructed recombinant plasmids harbored(5′to 3′)a T7 promoter,hammerhead ribozyme,RSV Long strain antigenomic cDNA with cold-passaged(cp)mutations or cp combined with temperature-sensitive attenuated mutations from the A2 strain(A2cpts)or further combined with SH gene deletion(A2cptsΔSH),HDV ribozyme(δ),and a T7 terminator.These vectors were subsequently co-transfected with four helper plasmids encoding N,P,L,and M2-1 viral proteins into BHK/T7-9 cells,and the recovered viruses were then passaged in Vero cells.The rescued recombinant RSVs(rRSVs)were named rRSV-Long/A2cp,rRSV-Long/A2cpts,and rRSV-Long/A2cptsΔSH,respectively,and stably passaged in vitro,without reversion to wild type(wt)at sites containing introduced mutations or deletion.Although rRSV-Long/A2cpts and rRSV-Long/A2cptsΔSH displayed temperature-sensitive(ts)phenotype in vitro and in vivo,all rRSVs were significantly attenuated in vivo.Furthermore,BALB/c mice immunized with rRSVs produced Th1-biased immune response,resisted wtRSV infection,and were free from enhanced respiratory disease.We showed that the combination ofΔSH with attenuation(att)mutations of cpts contributed to improving att phenotype,efficacy,and gene stability of rRSV.By successfully introducing att mutations and SH gene deletion into the RSV Long parent and producing three rRSV strains,we have laid an important foundation for the development of RSV live attenuated vaccines.
基金the National Natural Science Foundation of China(No.21808009)the Beijing Natural Science Foundation,China(No.2182051)。
文摘We propose a nonvolatile resistive random access memory device by employing nanodispersion of zirconia(ZrO2) quantum dots(QDs) for the formation of an active layer. The memory devices comprising a typical sandwich structure of Ag(top)/ZrO2(active layer)/Ti(bottom) are fabricated using a facile spin-coating method. The optimized device exhibits a high resistance state/low resistance state resistance difference(about 10 Ω), a good cycle performance(the number of cycles larger than 100), and a relatively low conversion current(about 1 μA). Atomic force microscopy and scanning electron microscope are used to observe the surface morphology and stacking state of the ZrO2 active layer. Experimental results show that the ZrO2 active layer is stacked compactly and has a low roughness(Ra=4.49 nm) due to the uniform distribution of the ZrO2 QDs. The conductive mechanism of the Ag/ZrO2/Ti device is analyzed and studied, and the conductive filaments of Ag ions and oxygen vacancies are focused on to clarify the resistive switching memory behavior. This study offers a facile approach of memristors for future electronic applications.
基金financially supported by the 13th Five-Year National Key Research and Development Project (No.2016YFC0501705) funded by the Ministry of Science and Technology (MOST),P.R.China。
文摘Soil moisture is a limiting factor for vegetation restoration on the Loess Plateau, China. Micro-topography may cause heterogeneities in the distribution of soil moisture, but little is known about its effect on deep soil moisture. Our study aims to explore the distribution and impact of soil moisture within the upper 10 m of soil for different microtopographies. Taking undisturbed slope as the control, five micro-topographies were selected. Soil moisture over a depth of 0-10 m from 2017 to 2019 was investigated, and soil particle size and soil organic matter were measured. Variance analysis and multiple comparisons were used to analyze the difference in soil moisture for different microtopographies and multiple-linear regression was used to analyze the influence of micro-topography on soil moisture. There are significant differences in soil moisture within the different layers underlying the examined micro-topographies, while the inter-annual variation in soil water storage for the selected microtopographies increase with increased rainfall. The depth of influence of micro-topographic vegetation on soil moisture exceeded 1000 cm for a gully(GU), 740 cm for a sink hole(SH), 480 cm for a scarp(SC), 360 cm for an ephemeral gully(EG) and 220 cm for a platform(PL). Micro-topography will cause the heterogeneous distribution of soil moisture in the shallower layers, which changes the vegetation distribution differences between micro-topographies. This may be the survival strategy of herbaceous vegetation in response to climate change in the Loess Plateau. For future vegetation restoration efforts, we need to pay attention to the influence of microtopography on soil moisture.
基金supported by the 863 Program,China(2002AA224011 and 2001AA212161).
文摘A copper-inducible, Cre-loxP recombination-mediated DNA excision system has been developed in transgenic tobacco plants. The copper inducible system derived from yeast was used for the control of the expression of the Cre recombinase. Upon copper induction, the GVS reporter gene expression unit flanked by two direct lox sites was excised from the transgenic tobacco genome. Quantitative fluorometric GUS assays, Northern blot and PCR analyses showed a high-efficient, copper-dependent and Cre-loxP mediated DNA recombination in all the tested transgenic lines. The copper inducible foreign gene excision might be of great potential in genetic control of transgenic crops.
文摘Achalasia is a type of esophageal motility disorder,consisting of relaxation dysfunction of the lower esophagus and disturbed esophageal peristalsis.Related clinical symptoms include dysphagia,regurgitation,chest pain,and weight loss.Traditional treatment options include endoscopic botulinum toxin injection,endoscopic pneumatic dilation,and laparoscopic Heller’s myotomy.These therapies mainly relieve symptoms by reducing the pressure on the lower esophageal sphincter and reducing blood flow resistance at the esophagogastric junction.Based on endoscopic submucosal dissection and natural orifice transluminal endoscopic surgery,peroral endoscopic myotomy(POEM)is a purely endoscopic method of myotomy with minimal invasiveness and a low rate of adverse events when performed by experienced operators.Since then,numerous studies have shown the significant clinical efficacy and safety of POEM.The purpose of this article is to introduce different modified POEMs,special indications for different POEMs,and their advantages as well as disadvantages.
文摘BACKGROUND There is little data available on the role of new anti-reflux plastic stents(ARPSs).AIM To compare the use of ARPSs with that of traditional plastic stents(TPSs)for patients with biliary strictures.METHODS Consecutive patients with biliary strictures who underwent first endoscopic biliary stenting between February 2016 and May 2019 were included.The onset of stent-related cholangitis,stent patency,clinical success,and other adverse events were evaluated.RESULTS Sixty-seven patients in the ARPS group and 66 patients in the TPS group were included in the final analyses.Fewer patients experienced stent-related cholangitis in the ARPS group than that in the TPS group(8 patients vs 18 patients;P=0.030).The median time till the onset of first stent-related cholangitis was later in the ARPS group than that in the TPS group(128.5 d vs 76 d;P=0.039).The cumulative median stent patency in the ARPS group was 185 d,which was significantly longer than that in the TPS group(133 d;P=0.001).The clinical success rates and other adverse events did not significantly differ between both groups.CONCLUSION Placement of new ARPS might be a safe and effective optional therapeutic strategy to reduce the risk of stent-related cholangitis and prolong stent patency.
