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Endoscopic salvage therapy after failed biliary cannulation using advanced techniques:A concise review

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World Journal of Gastroenterology 2022年第29期28卷 3803-3813页

作者： Yung-Kuan Tsou Kuang-Tse Pan Mu Hsien Lee cheng-hui lin Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalTaoyuan 333Taiwan Department of Medicine Chang Gung UniversityTaoyuan 333Taiwan Department of Medical Imaging and Intervention Chang Gung Memorial HospitalTaoyuan 333Taiwan

Therapeutic endoscopic retrograde cholangiopancreatography(ERCP)begins with successful biliary ***,it is not always be *** failure of the initial ERCP is attributed to two main aspects:the papilla/biliary orifice is endoscopically accessible,or it is *** the papilla/biliary orifice is accessible,bile duct cannulation failure can occur even with advanced cannulation techniques,including double guidewire techniques,transpancreatic sphincterotomy,needle-knife precut papillotomy,or *** is currently no consensus on the next steps of treatment in this ***,this review aims to propose and discuss potential endoscopic options for patients who have failed ERCP due to difficult bile duct *** options include interval ERCP,percutaneous-transhepatic-endoscopic rendezvous procedures(PTE-RV),and endoscopic ultrasound-assisted rendezvous procedures(EUS-RV).The overall success rate for interval ERCP was 76.3%(68%-79% between studies),and the overall adverse event rate was 7.5%(0-15.9% between studies).The overall success rate for PTE-RV was 88.7%(80.4%-100%between studies),and the overall adverse event rate was 13.2%(4.9%-19.2% between studies).For EUS-RV,the overall success rate was 82%-86.1%,and the overall adverse event rate was 13%-15.6%.Because interval ERCP has an acceptably high success rate and lower adverse event rate and does not require additional expertise,facilities,or other specialists,it can be considered the first choice for salvage ***-RV can also be considered if local experts are *** patients in urgent need of biliary drainage,PTE-RV should be considered.

关键词： Difficult biliary cannulation Endoscopic ultrasound Rendezvous Endoscopic retrograde cholangiopancreatography Percutaneous transhepatic biliary drainage Interval

Acute cholangitis: Does malignant biliary obstruction vs choledocholithiasis etiology change the clinical presentation and outcomes?

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World Journal of Clinical Cases 2023年第29期11卷 6984-6994页

作者： Yung-Kuan Tsou Yi-Tse Su cheng-hui lin Nai-Jen Liu Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalTaoyuan 333TaiwanChina

BACKGROUND Whether clinical outcomes of acute cholangitis(AC)vary by etiology is *** To compare outcomes in AC caused by malignant biliary obstruction(MBO)and common bile duct stones(CBDS).METHODS This retrospective study included 516 patients undergoing endoscopic retrograde cholangiopancreatography(ERCP)due to AC caused by MBO(MBO group,n=56)and CBDS(CBDS group,n=460).Clinical and laboratory parameters were compared between the *** score matching(PSM)created 55 matched *** used in the PSM analysis were age,sex,time to ERCP,and technical success of *** primary outcome comparison was 30-d *** secondary outcome comparisons were intensive care unit(ICU)admission rate,length of hospital stay(LOHS),and 30-d readmission *** Compared with the CBDS group,the MBO group had significantly lower body temperature,percentage of abnormal white blood cell counts,and serum levels of aspartate aminotransferase,alanine aminotransferase,and *** temperature,percent abnormal white blood cell count,and serum aspartate aminotransferase levels remained significantly lower in the MBO group in the PSM *** count,prothrombin time/international normalized ratio,and serum levels of alkaline phosphatase and total bilirubin were significantly higher in the MBO *** MBO group had a significantly higher percentage of severe AC(33.9%vs 22.0%,P=0.045)and received ERCP later(median,92.5 h vs 47.4 h,P<0.001).However,the two differences were not found in the PSM *** 30-d mortality(5.4%vs 0.7%,P=0.019),ICU admission rates(12.5%vs 4.8%,P=0.028),30-d readmission rates(23.2%vs 8.0%,P<0.001),and LOHS(median,16.5 d vs 7.0 d,P<0.001)were significantly higher or longer in the MBO ***,only LOHS remained significant in the PSM *** analysis revealed that time to ERCP and multiple organ dysfunction were independent factors associated with 30-d *** MBO patients underwent ERC

关键词： Malignant biliary obstruction Common bile duct stones Endoscopic retrograde cholangiopancreatography Acute cholangitis Mortality Etiology

Neuromyelitis Optica Spectrum Disorder Associated with Cervical Spondylosis

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Chinese Medical Journal 2015年第22期128卷 3112-3113页

作者： Yuan Zhou lin Zhu hui-lin cheng Yi-Xing lin Department of Neurosurgery Jinling Hospital School of Medicine Nanjing University Nanjing Jiangsu 210002 China

Neuromyelitis optica spectrum disease （NMOSD） refers to a group of related disease, in which potential pathogenesis is similar to neuromyelitis optica （NMO）, but clinical involvement does not exactly correspond to the diagnosis of NMO. Owing to varied clinical manifestations, it is apt to be misdiagnosed. We report a case of NMOSD with cervical spondylosis and discuss the experience of diagnosis.

关键词： Anti-aquaporin-4 Antibody Cervical Spondylosis Magnetic Resonance Imaging Neuromyelitis Optica Spectrum Disorder

Matrix metalloproteinase 2 degrades collagen I to regulate ovarian development by association with an insulin-like peptide

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Insect Science 2024年第4期31卷 1090-1106页

作者： Yi Wei Xiao-lin Zhou Peng Chen Tai-Hang Liu cheng Lu Min-hui Pan State Key Laboratory of Silkworm Genome Biology Southwest UniversityChongqingChina Key Laboratory for Sericulture Functional Genomics and Biotechnology of Agricultural Ministry Southwest UniversityChongqingChina Wenzhou Institute University of Chinese Academy of SciencesWenzhouZhejiang ProvinceChina

The ovary generally undergoes tissue remodeling during larval to pupal transition,which includes membrane degeneration and ovariole *** the same time,the hormones produced by insects significantly change during ***,the regulatory mechanism for ovarian development and hormones is not fully understood in ***,we found that matrix metalloproteinase 2(MMP2)was highly expressed in the ovarian capsules and ovarioles,and the development was abnormal after knocking out MMP2 in Bombyx *** process of abnormal degradation of collagen I due to MMP2 deletion,which resulted in abnormal development of ovarioles and eggs,was analyzed in *** proteomics of ovaries in the MMP2-knock out and wild type strains showed a critically significant difference in the expression of a protein,insulin-like peptide(ILP).Additional analysis revealed significant alteration of ILP during ovarian development,and abnormal expression of ILP significantly affected ovarian development in vivo and MMP2 expression in vitro and in *** results showed that MMP2 regulation of ovarian tissue remodeling is closely related to ILP *** study provides new insights into the regulatory mechanism of MMP2 and ovarian development in ***.

关键词： Bombyx mori collagen I insulin-like peptide matrix metalloproteinase ovarian development

Optimization of the co-closing law of guide vanes and blades for bulb turbines based on CFD

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Journal of Hydrodynamics 2024年第2期36卷 363-377页

作者： hui Liu Yun-fa lin Yong-guang cheng Song Xue Mao-jia Tang Jian Zhang Jia-yi Fan State Key Laboratory of Water Resources Engineering and Management Wuhan UniversityWuhan430072China Dongfang Electric Machinery Co. Ltd.Deyang618000China

The load rejection transient process of bulb turbine units is critical to safety of hydropower stations,and determining appropriate closing laws of guide vanes(GVs)and runner blades(RBs)for this process is of *** this study,we proposed a procedure to optimize the co-closing law of GVs and RBs by using computational fluid dynamics(CFD),combined with the design of experiment(DOE)method,approximation model,and genetic optimization *** sensitivity of closing law parameters on the histories of head,speed,and thrust was analyzed,and a two-stage GVs’closing law associating with a linear RBs’closing law was *** results show that GVs dominate the transient characteristics by controlling the change of *** GVs’first-stage closing speed while shortening first-stage closing time can not only significantly reduce the maximum rotational speed but also suppress the water hammer pressure;slowing GVs’second-stage closing speed is conducive to controlling the maximum reverse axial *** directly affect the runner *** RBs’closing speed can further reduce the rotational speed and the maximum reverse axial *** safety margin of each control parameter,flow patterns,and pressure pulsations of a practical hydropower station were all improved after optimization,demonstrating the effectiveness of this method.

关键词： Bulb turbine load rejection transient process double regulation closing law optimization computational fluid dynamics(CFD)

The Minimum Centroid Branch Spanning Tree Problem

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Journal of the Operations Research Society of China 2024年第2期12卷 528-539页

作者： Hao lin cheng He School of Science Henan University of TechnologyZhengzhou450001HenanChina

For a spanning tree T of graph G,the centroid of T is a vertex v for which the largest component of T-v has as few vertices as *** number of vertices of this component is called the centroid branch weight of *** minimum centroid branch spanning tree problem is to find a spanning tree T of G such that the centroid branch weight is *** application to design of communication networks,the loads of all branches leading from the switch center should be as balanced as *** this paper,we prove that the problem is strongly NP-hard even for bipartite ***,the problem is shown to be polynomially solvable for split graphs,and exact formulae for special graph familis,say Kn_(1),n_(2),...,n_(k)and P_(m)×P_(n),are presented.

关键词： Spanning tree optimization Centroid branch-NP-hardness Polynomial-time algorithm

Weak Merging Scenario of CLASH Cluster A209

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Research in Astronomy and Astrophysics 2024年第4期24卷 174-182页

作者： Wen-cheng Feng Heng Yu Hai-hui Zhao Xiao-Lan Hou Shu-Mei Jia cheng-Kui Li Yu-lin cheng Paolo Tozzi Ming Sun Yong Chen Department of Physics and Institute of Theoretical Physics Nanjing Normal UniversityNanjing 210023China Key Laboratory of Particle Astrophysics Institute of High Energy PhysicsChinese Academy of SciencesBeijing 100049China Department of Astronomy Beijing Normal UniversityBeijing 100875China Department of Astronomy Yunnan UniversityKunming 650091China INAF—Osservatorio Astrofisico di Arcetri Largo E.Fermi50122 FirenzeItaly Department of Astronomy University of VirginiaP.O.Box 400325CharlottesvilleVA 22904-4325USA

We study the structural and dynamical properties of A209 based on Chandra and XMM-Newton *** obtain detailed temperature,pressure,and entropy maps with the contour binning method,and find a hot region in the NW *** X-ray brightness residual map and corresponding temperature profiles reveal a possible shock front in the NW direction and a cold front feature in the SE *** with the galaxy luminosity density map we propose a weak merger scenario.A young sub-cluster passing from the SE to NW direction could explain the optical subpeak,the intracluster medium temperature map,the X-ray surface brightness excess,and the X-ray peak offset together.

关键词： X rays:galaxies:clusters galaxies:clusters:intracluster medium galaxies:clusters:Abell 209

Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity

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World Journal of Gastroenterology 2022年第38期28卷 5602-5613页

作者： Yao-Chi Huang Chi-Huan Wu Mu Hsien Lee Sheng Fu Wang Yung-Kuan Tsou cheng-hui lin Kai-Feng Sung Nai-Jen Liu Department of Medicine College of MedicineChang Gung UniversityTaoyuan 333Taiwan Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalTaoyuan 333Taiwan

BACKGROUND The optimal timing of endoscopic retrograde cholangiopancreatography(ERCP)in acute cholangitis(AC) is uncertain,especially in patients with AC of varying *** To report whether the timing of ERCP is associated with outcomes in AC patients with different *** According to the 2018 Tokyo guidelines,683 patients who met the definite diagnostic criteria for AC were retrospectively *** results were first compared between patients receiving ERCP ≤ 24 h and>24 h and then between patients receiving ERCP ≤ 48 h and>48 *** analyses were performed in patients with grade Ⅰ,Ⅱ or Ⅲ *** primary outcome was 30-d *** outcomes were intensive care unit(ICU) admission rate,length of hospital stay(LOHS) and 30-d readmission *** Taking 24 h as the critical value,compared with ERCP>24 h,malignant biliary obstruction as a cause of AC was significantly less common in the ERCP ≤ 24 h group(5.2% vs 11.5%).The proportion of cardiovascular dysfunction(11.2% vs 2.6%),respiratory dysfunction(14.2% vs 5.3%),and ICU admission(11.2% vs 4%)in the ERCP ≤ 24 h group was significantly higher,while the LOHS was significantly shorter(median,6 d vs 7 d).Stratified by the severity of AC,higher ICU admission was only observed in grade Ⅲ AC and shorter LOHS was only observed in grade Ⅰ and Ⅱ *** were no significant differences in 30-d mortality between groups,either in the overall population or in patients with grade Ⅰ,Ⅱ or Ⅲ *** 48 h as the critical value,compared with ERCP>48 h,the proportion of choledocholithiasis as the cause of AC was significantly higher in the ERCP ≤ 48 h group(81.5% vs 68.3%).The ERCP ≤ 48 h group had significantly lower 30-d mortality(0 vs 1.9%) and shorter LOHS(6 d vs 8 d).Stratified by AC severity,lower 30-d mortality(0 vs 6.1%) and higher ICU admission rates(22.2% vs 10.2%) were only observed in grade Ⅲ AC,and shorter LOHS was only observed in grade I and Ⅱ *** the multivariate analysis,cardi

关键词： Acute cholangitis Endoscopic retrograde cholangiopancreatography severity Timing Thirtyday mortality Length of hospital stay

Dual-curvilinear beam enabled tunable manipulation of high-and low-refractive-index particles

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Photonics Research 2024年第7期12卷 1427-1436页

作者： ZHENG YUAN CHENCHEN ZHANG YUAN GAO WENXIANG YAN XIAN LONG ZHI-cheng REN XI-lin WANG JIANPING DING hui-TIAN WANG National Laboratory of Solid State Microstructures and School of Physics Nanjing UniversityNanjing 210093China Collaborative Innovation Center of Advanced Microstructures Nanjing 210093China Collaborative Innovation Center of Solid-State Lighting and Energy-Saving Electronics Nanjing 210093China

We present an innovative approach for the simultaneous agile manipulation of high-refractive-index(HRI) and low-refractive-index(LRI) particles. Our method involves introducing a dual-curvilinear optical vortex beam(DC-OVB) generated by superimposing a pair of curved beams: HRI and LRI particles are controlled by the bright curve and the dark channel between the two curves, respectively. The proposed DC-OVB provides customizable motion paths and velocities for both LRI and HRI particles. Each curve of the DC-OVB can support a distinct orbital flow density(OFD), enabling the application of torques to HRI and LRI particles, guiding them to orbit along specified trajectories and prompting them to execute various curvilinear motions simultaneously,including curvilinear movement, revolution, and rotation.

关键词： tunable refractive beam