A Miniature 3-DoF Flexible Parallel Robotic Wrist Using NiTi Wires for Gastrointestinal Endoscopic Surgery

Gastrointestinal endoscopic surgery (GES) has high requirements for instruments' size and distal dexterity, because of the narrow endoscopic channel and long, tortuous human gastrointestinal tract. This paper utilized Nickel-Titanium (NiTi) wires to develop a miniature 3-DoF (pitch-yaw-translation) flexible parallel robotic wrist (FPRW). Additionally, we assembled an electric knife on the wrist's connection interface and then teleoperated it to perform an endoscopic submucosal dissection (ESD) on porcine stomachs. The effective performance in each ESD workflow proves that the designed FPRW has sufficient workspace, high distal dexterity, and high positioning accuracy.Comment: IEEE International Conference on Robotics and Automation (ICRA) 2022 workshop: Frontiers of Endoluminal Intervention: Clinical opportunities and technical challenge

Effect of tenofovir disoproxil and telbivudine on the growth and development of infants by blocking mother-to-child transmission of hepatitis B virus

Purpose: To investigate the effect of tenofovir disoproxil and telbivudine on the growth and development of infants after blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV). Methods: Seventy pregnant women with chronic hepatitis B (CHB) were recruited and allocated to tenofovir disoproxil group (n = 35) and telbivudine group (n = 35) using random number table method. Tenofovir disoproxil group was given 300 mg tenofovir disoproxil orally four times daily, while telbivudine group was given telbivudine 600 mg orally four times daily. Results: After treatment, both groups showed no significant differences in serum HBV-DNA and ALT levels before delivery and 3 months after delivery (p > 0.05). Both groups showed no remarkable differences in the incidence of hypohydramnios, cholestasis, hypothyroidism, anemia, prolonged labor, fetal distress, and placental adhesions (p > 0.05). Both groups showed no significant differences in the rates of premature rupture of membranes, preterm birth, vaginal delivery, and cesarean section (p > 0.05). Both groups showed no significant differences in neonatal sex, gestational age at birth, weight, length, and Apgar scores (p > 0.05). The differences in the positive rates of HBVsAg, HBsAb, and HBeAg at birth and at 12 months were not statistically noticeable (p > 0.05). Conclusion: Tenofovir disoproxil and telbivudine reduce HBV-DNA levels, effectively blocks MTCT, and have a similar safety profile for infants. Further investigations to confirm t

学会抄録

Risk of bias. (TIF 107 kb

Combination TIGIT/PD-1 blockade enhances the efficacy of neoantigen vaccines in a model of pancreatic cancer

BackgroundCancer neoantigens are important targets of cancer immunotherapy and neoantigen vaccines are currently in development in pancreatic ductal adenocarcinoma (PDAC) and other cancer types. Immune regulatory mechanisms in pancreatic cancer may limit the efficacy of neoantigen vaccines. Targeting immune checkpoint signaling pathways in PDAC may improve the efficacy of neoantigen vaccines.MethodsWe used KPC4580P, an established model of PDAC, to test whether neoantigen vaccines can generate therapeutic efficacy against PDAC. We focused on two immunogenic neoantigens associated with genetic alterations in the CAR12 and CDK12 genes. We tested a neoantigen vaccine comprised of two 20-mer synthetic long peptides and poly IC, a Toll-like receptor (TLR) agonist. We investigated the ability of neoantigen vaccine alone, or in combination with PD-1 and TIGIT signaling blockade to impact tumor growth. We also assessed the impact of TIGIT signaling on T cell responses in human PDAC.ResultsNeoantigen vaccines induce neoantigen-specific T cell responses in tumor-bearing mice and slow KPC4580P tumor growth. However, KPC4580P tumors express high levels of PD-L1 and the TIGIT ligand, CD155. A subset of neoantigen-specific T cells in KPC4580P tumors are dysfunctional, and express high levels of TIGIT. PD-1 and TIGIT signaling blockade in vivo reverses T cell dysfunction and enhances neoantigen vaccine-induced T cell responses and tumor regression. In human translational studies, TIGIT signaling blockade in vitro enhances neoantigen-specific T cell function following vaccination.ConclusionsTaken together, preclinical and human translational studies support testing neoantigen vaccines in combination with therapies targeting the PD-1 and TIGIT signaling pathways in patients with PDAC

Dual therapy for Helicobacter pylori infection

Abstract. Bismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication

Ramosetron for the treatment of irritable bowel syndrome with diarrhea: a systematic review and meta-analysis of randomized controlled trials

Abstract Background Ramosetron is a potent and selective serotonin type 3 receptor antagonist. This meta-analysis aimed to analyze the efficacy and safety of ramosetron for irritable bowel syndrome with diarrhea (IBS-D). Methods Pubmed, MEDLINE, EMBASE and the Cochrane Library were searched for randomized controlled trials investigating the efficacy and safety of ramosetron for IBS-D. Risk of bias was assessed as described in the Cochrane handbook. A random effects model was used to calculate the effects of ramosetron vs placebo on symptomatic improvements, including relief of overall IBS symptoms, relief of abdominal discomfort/pain, improvement in abnormal bowel habits, and improvement in stool consistency, expressed as pooled relative risks (RRs) with 95% confidence interval (CI). Adverse events data were also summarized with RRs. Results Four randomized controlled trials involving 1623 participants were included. Compared with placebo, ramosetron could lead to relief of overall IBS symptoms (RR 1.70; 95%CI 1.48, 1.95), relief of abdominal discomfort/pain (RR 1.41; 95%CI, 1.24, 1.59), improvement in abnormal bowel habits (RR 1.72; 95%CI, 1.50, 1.98) and improvement in stool consistency (RR 1.71; 95%CI 1.40, 2.08). Ramosetron could lead to relief of overall IBS symptoms in both male and female patients (RR; 95%CI: 1.94; 1.58, 2.38 and 1.49; 1.25, 1.79). The RR (95%CI) for reported adverse events of ramosetron vs placebo was 1.10 (0.97, 1.26) across all studies. No serious adverse events (e.g., ischemic colitis) were reported. The incidences of hard stool and constipation were higher in ramosetron group compared with placebo group (RR; 95%CI: 4.74; 3.00, 7.51 and 2.53; 1.57, 4.10, respectively). Conclusions Ramosetron had beneficial effects to both male and female IBS-D patients. Treatment with ramosetron could cause more hard stool and constipation, without severe adverse events

Complete genome sequence of bile-isolated Enterococcus avium strain 352

Abstract Background Enterococcus avium is a Gram-positive pathogenic bacterium belonging to the family Enterobacteriaceae. E. avium can cause bacteremia, peritonitis, and intracranial suppurative infection. However, the mechanism of its pathogenesis and its adaptation to a special niche is still unclear. Results In this study, the E. avium strain 352 was isolated from human bile and whole genome sequencing was performed. The E. avium strain 352 consists of a circular 4,794,392 bp chromosome as well as an 87,705 bp plasmid. The GC content of the chromosome is 38.98%. There are 4905 and 99 protein coding sequences in the chromosome and the plasmid, respectively. The genome of the E. avium strain 352 contains number of genes reported to be associated with bile adaption, including bsh, sbcC, mutS, nifI, galU, and hupB. There are also several virulence-associated genes including esp, fss1, fss3, ecbA, bsh, lap, clpC, clpE, and clpP. Conclusions This study demonstrates the presence of various virulence factors of the E. avium strain 352, which has the potential to cause infections. Moreover, the genes involved in bile adaption might contribute to its ability to live in bile. Further comparative genomic studies would help to elucidate the evolution of pathogenesis of E. avium

Specific alterations in mucosa-associated bacterial composition in ulcerative colitis (UC) patients with different degrees of inflammation

AbstractThe aim of this study is to evaluate the specific bacterial communities and alterations and to explore the method predicting the microbiological evolution tendency of ulcerative colitis (UC) patients. A total of 29 UC patients and 18 healthy subjects (HS) were enrolled. UC patients were grouped into mild, moderate and severe UC based on the Mayo Score. The bacterial types of the groups were distinctly different with each other on different classification levels. Interestingly, the bacterial composition of severe UC was distinctly different from others. The Chao and Ace indices of bacterial microbiota were significantly higher in the severe UC group. The main phyla in UC and HS were Firmicutes, Bacteroidetes and Proteobacteria. The percentage of the 3 main phyla in severe UC was lower than that in non-severe UC. Similar to the other groups, the main genera in severe UC were Bacteroides and Escherichia-Shigella. However, Parabacteroides and a type of Prevotella disappeared in the severe UC group. Some types, such as Faecalibacterium and Fusobacterium, decreased. On the contrary, the other types increased. The abundance of the putative pathogenic bacteria in mild UC, moderate UC and severe UC showed an increasing trend (9:11:115). Moreover, Bacillus, Lactococcus and Alloprevotella disappeared in UC. Parabacteroides and a type of Prevotella disappeared in severe UC. Serious dysbacteriosis and abundant putative pathogenic bacteriа are the two important features of severe UC. The percentage phyla and the abundance of putative pathogenic bacteria could be used to predict the evolution tendency

Introducing participatory curriculum development in China's higher education : the case of Community-Based Natural Resource Management

This article describes and reflects on a novel course developed at China Agricultural University to introduce Community-Based Natural Resource Management at the postgraduate level. This course, part of a larger educational renewal initiative addressing the current reform of China’s higher education system, was developed through a participatory curriculum development methodology bringing together teachers and researchers from five different organizations, as well as a dynamic group of MSc and PhD students. The course development process and the actual delivery in the classroom and in the field were guided by insights from adult teaching and learning theory. These were adapted to the Chinese reality. Results assessed to date from the experimentation with this completely new approach in China encompass conceptual, attitudinal, methodological, and practical changes. The experiences and insights accumulated so far serve as entry points for the expansion of participatory curriculum development practice in China. They also provide a ground for deepening learning theory