Electrohydraulic lithotripsy through endoscopic retrograde cholangiopancreatography combined with SpyGlass in the treatment of complex pancreatic duct stones: A case report and literature review

The incidence of pancreatic duct stones (PDS) is less than 1%. After the formation of stones, the lumen of the pancreatic duct is blocked, and the pancreatic juice cannot be discharged smoothly, resulting in the impairment of the internal and external secretions of the pancreas. Several national guidelines now recommend endoscopic retrograde cholangiopancreatography (ERCP) as the treatment for PDS. The emergence of SpyGlass makes it possible to visualize the ERCP blind area of the pancreatic system directly. Electrohydraulic lithotripsy (EHL) under SpyGlass can crush large and pressure-resistant stones into smaller fragments, significantly improving the success of the endoscopic treatment of large stones. Here, we report a patient presented with acute alcohol-associated pancreatitis, found to have PDS on imaging, who underwent ERCP combined with SpyGlass (EHL), avoiding surgery, reducing trauma, and being discharged from the hospital with a rapid recovery. Therefore, endoscopic therapy is effective and safe for PDS patients. The combination therapy of this patient is the first use of SpyGlass for PDS in our centre, which marks a new stage in the application of endoscopic therapy for pancreatic diseases

Culture Adapts to Aging: Intangible Cultural Heritage Inheritance and Development and Its Aging Adaptability

This paper studies the protection and inheritance of intangible cultural heritage (ICH), analyzes the status quo of its digital communication, and proposes the necessity of its development in contemporary culture. However, the existing literature lacks the systematic definition and research exploration of the term "Culture Adapts to Aging". The research on the inheritance and development of ICH is also an indispensable part of cultural aging development. Through sorting out the status, development status, and practical significance of the aging development of ICH in the cultural power; Summarize the principles, methods, and significance of the aging development of ICH. This paper provides an important clue for the in-depth study of the aging development of cultural and ICH, and also provides a theoretical and methodological reference for the integration of intangible heritage inheritance, innovative design, elderly group industry, and other fields

A numerical study on premixed hydrogen/air flames in a narrow channel with thermally orthotropic walls

Premixed hydrogen/air micro-flame stabilizations in a narrow channel confined by two parallel plates with thermally isotropic and orthotropic wall materials are numerically studied using a OpenFOAM-based, reacting flow code. For a range of simulated equivalence ratios and inflow velocities, two modes of flame shapes (convex-shaped and concave-shaped) are observed, accompanying with variations of the number of heat release rate peaks in flame structures, which can be attributed to the appearance of some critical O-participating and H-participating elementary reactions. Flame stability limits are studied for three sets of wall thermal conductivities of k = 16 W/m K, k = 128 W/m K (isotropic) and k = 128 W/m K & k = 16 W/m K (orthotropic). The low velocity limits show invariant with wall thermal conductivities, while the high velocity limits in descending order are found to be: “k = 128 W/m K” > “k = 128 W/m K & k = 16 W/m K” > “k = 16 W/m K”. The logic behind is the competition between two mechanisms: the wall pre-heating effects and the transverse heat losses to the ambient. The critical convective heat transfer coefficients that reflect the combustor's ability to resist heat losses are also investigated among the three cases. The reduction of the transverse thermal conductivity can have a high critical coefficient value in the low-inflow velocity regime while makes negligible impacts on extending the critical coefficient in the high-inflow velocity regime. In summary, the use of thermally orthotropic wall materials leads to a slightly decreased high velocity limit (~3% lower) but a considerably increased critical convective heat transfer coefficient in the high-inflow velocity-regime (~25% higher), as compared to the thermally isotropic combustor of k = 128 W/m K

Vertical Greening Systems: Technological Benefits, Progresses and Prospects

A vertical greening system is becoming increasingly crucial in resolving the energy crisis and environmental problems in a sustainable ecosystem. Researchers have conducted a comprehensive study on vertical greening systems from technology, functional and architectural perspectives. These include ecological, economic and social functions. Most of the current studies emphasize the benefits of vertical greening systems to the environment, while vertical greening technology and its socio-economic benefits receive insufficient attention. In order to study the vertical greening field in depth, this paper comprehensively and systematically summarizes vertical greening technology and functions. Meanwhile, based on the Web of Science (WOS), CiteSpace was used to analyze the relevant literature in the vertical greening field from 2012 to 2022, to explore the hot spots, development status and future trends of vertical greening technology, and to build a knowledge map in the vertical greening field. The research shows that as a low impact development technology, the vertical greening system has received the most extensive attention in the past few years. Air quality, microclimate regulation and energy have always been the focus and hot issues of people’s attention. The future research directions are cooling effect, active system and indoor space. This study is aimed at promoting the future development of vertical greening system technology and providing reference and direction for researchers, planners and developers, as well as individuals interested in future urban and rural planning

Effects of low dietary cation-anion difference induced by ruminal ammonium chloride infusion on performance, serum, and urine metabolites of lactating dairy cows

Objective The objective of the present study was to determine ammonium chloride tolerance of lactating dairy cows, by examining effects of negative dietary cation anion difference (DCAD) induced by ruminal ammonium chloride infusion on performance, serum and urine minerals, serum metabolites and enzymes of lactating dairy cows. Methods Four primiparous lactating Chinese Holstein cows fitted with ruminal cannulas were infused with increasing amounts (0, 150, 300, or 450 g/d) of ammonium chloride in a crossover design. The DCAD of the base diet was 279 mEq/kg dry matter (DM) using the DCAD formula (Na + K – Cl – S)/kg of DM. Ammonium chloride infusion added the equivalent of 0, 128, 330, and 536 mEq/kg DM of Cl in treatments. According to the different dry matter intakes (DMI), the resulting actual DCAD of the four treatments was 279, 151, −51, and −257 mEq/kg DM, respectively. Results DMI decreased linearly as DCAD decreased. Yields of milk, 4% fat-corrected milk, energy-corrected milk, milk fat, and milk protein decreased linearly as DCAD decreased. Concentrations of milk protein and milk urea nitrogen increased linearly with decreasing DCAD. Concentration of Cl− in serum increased linearly and concentration of PO43- in serum increased quadratically as DCAD decreased. Urine pH decreased linearly and calculated urine volume increased linearly with decreasing DCAD. Linear increases in daily urinary excretion of Cl−, Ca2+, PO43−, urea N, and ammonium were observed as DCAD decreased. Activities of alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transferase in serum and urea N concentration in serum increased linearly as DCAD decreased. Conclusion In conclusion, negative DCAD induced by ruminal ammonium chloride infusion resulted in a metabolic acidosis, had a negative influence on performance, and increased serum enzymes indicating potential liver and kidney damage in lactating dairy cows. Daily ammonium chloride intake by lactating dairy cows should not exceed 300 g, and 150 g/d per cow may be better

The “Light Knife” for Gastric Cancer: Photodynamic Therapy

Photodynamic therapy (PDT) has been used clinically to treat cancer for more than 40 years. Some solid tumors, including esophageal cancer, lung cancer, head and neck cancer, cholangiocarcinoma, and bladder cancer, have been approved for and managed with PDT in many countries globally. Notably, PDT for gastric cancer (GC) has been reported less and is not currently included in the clinical diagnosis and treatment guidelines. However, PDT is a potential new therapeutic modality used for the management of GC, and its outcomes and realization are more and more encouraging. PDT has a pernicious effect on tumors at the irradiation site and can play a role in rapid tumor shrinkage when GC is combined with cardiac and pyloric obstruction. Furthermore, because of its ability to activate the immune system, it still has a specific effect on systemic metastatic lesions, and the adverse reactions are mild. In this Review, we provide an overview of the current application progress of PDT for GC; systematically elaborate on its principle, mechanism, and the application of a new photosensitizer in GC; and focus on the efficacy of PDT in GC and the prospect of combined use with other therapeutic methods to provide a theoretical basis for clinical application

Surgical management of an enormous subgaleal hematoma accompanying occipital bone's destruction in a 30 years old man with a history of hemophilia A

Enormous enormous subgaleal hematoma with epidural extension, accompanying occipital bone's absorption is an uncommon complication of hemophilia A. A 30 years old man presenting scalp lump was found enormous enormous subgaleal hematoma with epidural extension, accompanying occipital bone's destruction by computed tomography (CT) scan, and laboratory examination indicated that the concentration of his factor VII was 2% of normal level. Further inquiring his medical history found that this patient has been suffering from hemophilia A diagnosed when he was 6 years old. He recovered well after receiving the therapertic methods of factor VII replacement and surgical decompression. This case tells us that patient suffering from enormous enormous subgaleal hematoma with epidural extension, accompanying occipital bone's destruction and hemophilia A could recover well as long as he is well treated. Keywords: Neurosurgery, Factor VII, Enormous subgaleal hematoma with epidural extension, occipital bone's destruction, Hemophilia

Table_1_Coagulation- and fibrinolysis-related genes for predicting survival and immunotherapy efficacy in colorectal cancer.docx

BackgroundColorectal cancer (CRC) is a common cancer and has a poor prognosis. The coagulation system and fibrinolysis system are closely related to the progression of malignant tumors and is also related to the immunotherapy of malignant tumors. Herein, we tried to predict survival and the immunotherapy effect for patients with CRC using a novel potential prognostic model.MethodsThrough online data of TCGA and GEO, we screened significantly differentially expressed genes (DEGs) to construct a prognostic model, followed by obtaining immune-related genes (IRGs) from the ImmPort database and coagulation- and fibrinolysis-related genes (CFRGs) from the GeneCards database. The predictive power of the model is assessed by Kaplan–Meier survival curves as well as the time-dependent ROC curve. Moreover, univariate and multivariate analyses were conducted for OS using Cox regression models, and the nomogram prognostic model was built. In the end, we further studied the possibility that CXCL8 was associated with immunocyte infiltration or immunotherapy effect and identified it by immunohistochemistry and Western blot.ResultsFive DEGs (CXCL8, MMP12, GDF15, SPP1, and NR3C2) were identified as being prognostic for CRC and were selected to establish the prognostic model. Expression of these genes was confirmed in CRC samples using RT-qPCR. Notably, those selected genes, both CFRGs and IRGs, can accurately predict the OS of CRC patients. Furthermore, CXCL8 is highly correlated with the tumor microenvironment and immunotherapy response in CRC.ConclusionOverall, our established IRGPI can very accurately predict the OS of CRC patients. CXCL8 reflects the immune microenvironment and reveals the correlation with immune checkpoints among CRC patients.</p

The Bi-Functional Paxilline Enriched in Skin Secretion of Tree Frogs (<i>Hyla japonica</i>) Targets the KCNK18 and BK_Ca Channels

The skin secretion of tree frogs contains a vast array of bioactive chemicals for repelling predators, but their structural and functional diversity is not fully understood. Paxilline (PAX), a compound synthesized by Penicillium paxilli, has been known as a specific antagonist of large conductance Ca2+-activated K+ Channels (BKCa). Here, we report the presence of PAX in the secretions of tree frogs (Hyla japonica) and that this compound has a novel function of inhibiting the potassium channel subfamily K member 18 (KCNK18) channels of their predators. The PAX-induced KCNK18 inhibition is sufficient to evoke Ca2+ influx in charybdotoxin-insensitive DRG neurons of rats. By forming π-π stacking interactions, four phenylalanines located in the central pore of KCNK18 stabilize PAX to block the ion permeation. For PAX-mediated toxicity, our results from animal assays suggest that the inhibition of KCNK18 likely acts synergistically with that of BKCa to elicit tingling and buzzing sensations in predators or competitors. These results not only show the molecular mechanism of PAX-KCNK18 interaction, but also provide insights into the defensive effects of the enriched PAX