Colonoscopic titanium clipping to address appendiceal stump leakage: a case report

The incidence of appendiceal stump leakage (ASL) is extremely low and heterogeneous, which has been reported to be approximately 0.5%–1.0%. It is a catastrophic complication with high mortality rate despite its low morbidity. Once it occurs, it will put the doctor in a passive position because dealing with the leakage is much more cumbersome than appendectomy. We extensively reviewed the literature on ASL, focusing on the management and prognosis. Unsurprisingly, all of the physicians advocated extended resection, which apparently gave them sufficient confidence. However, partial cecum resection, cecostomy, or terminal ileectomy is extremely invasive and destructive. So, the patients had to experience great mental and physical trauma, longer hospital stays, higher rates of wound infection, more costs, and even a third surgery. Therefore, are there any better approaches for ASL? In this article, we report a case of ASL who successfully underwent endoscopic treatment. A 70-year-old male was admitted with gangrenous perforated appendicitis with a large iliopsoas abscess. Appendectomy, iliopsoas abscess debridement and sufficient drainage, appendicular stump repair and closure, and terminal ileostomy were performed. Three months later, the patient was readmitted and the stoma reversal was performed as scheduled. Seven days later, ASL was found when a liquid diet was applied routinely due to right lower quadrant pain and low fever. Finally, with the periappendiceal abscess completely drained, we clamped the appendiceal orifice with five titanium clips under an electronic colonoscope, which eventually sealed the leakage and avoided extended resection

A recyclable solid catalyst of KF/Ca-Mg-Al-O using for biodiesel production from jatropha seed oil: preparation, characterization, and methanolysis process optimization

A recyclable heterogeneous KF/Ca-Mg-Al-O catalyst was prepared by co-precipitation and calcination processes. The characteristics of the catalyst were investigated using FTIR, XRD, TG-DTG and SEM. Response surface methodology was utilized to obtain the best most extreme biodiesel production yield. The ideal biodiesel production conditions were: the amount of catalyst was 3 wt%; the reaction temperature was 65 °C; the alcohol oil molar ratio 9.8:1, the reaction time was 3.5 h. Under these amended conditions, the average biodiesel yield was 95.19%, which is well in close concurrence with the worth anticipated by the model. The repeatability of catalysts was studied. After using the catalyst seven times, the catalytic efficiency was only reduced by 2.7%. These results indicate that the catalyst has good catalytic efficiency and is recyclable

Efficient Estimation for the Derivative of Nonparametric Function by Optimally Combining Quantile Information

In this article, we focus on the efficient estimators of the derivative of the nonparametric function in the nonparametric quantile regression model. We develop two ways of combining quantile regression information to derive the estimators. One is the weighted composite quantile regression estimator based on the quantile weighted loss function; the other is the weighted quantile average estimator based on the weighted average of quantile regression estimators at a single quantile. Furthermore, by minimizing the asymptotic variance, the optimal weight vector is computed, and consequently, the optimal estimator is obtained. Furthermore, we conduct some simulations to evaluate the performance of our proposed estimators under different symmetric error distributions. Simulation studies further illustrate that both estimators work better than the local linear least square estimator for all the symmetric errors considered except the normal error, and the weighted quantile average estimator performs better than the weighted composite quantile regression estimator in most situations

Efficient Estimation for the Derivative of Nonparametric Function by Optimally Combining Quantile Information

In this article, we focus on the efficient estimators of the derivative of the nonparametric function in the nonparametric quantile regression model. We develop two ways of combining quantile regression information to derive the estimators. One is the weighted composite quantile regression estimator based on the quantile weighted loss function; the other is the weighted quantile average estimator based on the weighted average of quantile regression estimators at a single quantile. Furthermore, by minimizing the asymptotic variance, the optimal weight vector is computed, and consequently, the optimal estimator is obtained. Furthermore, we conduct some simulations to evaluate the performance of our proposed estimators under different symmetric error distributions. Simulation studies further illustrate that both estimators work better than the local linear least square estimator for all the symmetric errors considered except the normal error, and the weighted quantile average estimator performs better than the weighted composite quantile regression estimator in most situations

Genomic and biological characterization of a new cypovirus isolated from Dendrolimus punctatus.

A novel cypovirus (designated DpCPV-MC) was isolated from the pine moth Dendrolimus punctatus using serial in vivo cloning procedures. DpCPV-MC occurs in typical polyhedral occlusion bodies, containing a number of spherical virions. Laboratory bioassays indicated that the infectivity of DpCPV-MC against second-instar Spodoptera exigua larvae does not differ significantly from that of Dendrolimus punctatus cypovirus 1. Full-length amplification of the DpCPV-MC cDNAs identified 16 dsRNA genome segments. Each segment encodes one open reading frame with unique conserved terminal sequences at the 5' and 3' ends, which differ from those of all previously reported cypoviruses. On a phylogenetic tree based on the amino acid sequences of the polyhedrin of 19 cypovirus species, DpCPV-MC was closest to the type-4 cypoviruses. Homology searches showed that ten segments of DpCPV-MC (S1, S2, S3, S4, S5, S7, S8, S9, S12, and S13) encode putative CPV structural and nonstructural proteins, three segments (S6, S10 and S14) encode putative insect proteins or other viral proteins, and the other three segments (S11, S15, and S16) encode proteins that have no obvious sequence similarity to any known protein. Based on RNA secondary structures analysis, two segments of them (S11 and S16) were predicted to possibly transcript less efficiently than the other segments. We speculate that DpCPV-MC is composed of several genotypes. The ten CPV-related segments constantly exist in all genotypes, and one or two of the six CPV-unrelated segments co-exist with the ten CPV-related segments in one DpCPV-MC genotype, thus each virion contains no more than 12 segments. Based on our results and the literature, DpCPV-MC is a new cypovirus (Cypovirus 22, strain DpCPV-22)

Folding of the 5′ and 3′ NCRs of the DpCPV-MC genome segments.

<p>The RNAfold program was used to predict the secondary structures formed by the 16 DpCPV-MC genome segments. The panhandle structure was formed by base-pairing between the 5′ and 3′ ends, and the stem–loop structure was formed by either the 5′ or 3′ terminal sequence. The panhandle structure and the stem–loop structure are marked with long brackets.</p

Median lethal concentrations (LC₅₀) of DpCPV-MC and DpCPV-1 against second-instar <i>S. exigua</i> larvae.

a<p>Potency ratio was calculated by dividing the LC₅₀ of DpCPV-MC by that of DpCPV-1. Significant difference was based on whether the 95% confidence interval (CI) of the potency ratio included the value 1.0 <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0113201#pone.0113201-Robertson2" target="_blank">[47]</a>.</p><p>Median lethal concentrations (LC₅₀) of DpCPV-MC and DpCPV-1 against second-instar <i>S. exigua</i> larvae.</p