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External use of mirabilite to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis in children:A multicenter randomized controlled trial

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World Journal of Gastrointestinal Surgery 2023年第4期15卷 712-722页

作者： jing-qing zeng Tian-Ao Zhang Kai-Hua Yang Wen-Yu Wang Jia-Yu Zhang Ya-Bin Hu Jian Xiao Zhi-Jian Gu Biao Gong Zhao-Hui Deng Department of Gastroenterology Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Department of Clinical Epidemiology and Biostatistics Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Department of Gastroenterology Shanghai Shuguang HospitalShanghai University of Traditional Chinese MedicineShanghai 200021China

BACKGROUND Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography(ERCP).Currently,there is no suitable treatment for post-ERCP pancreatitis(PEP)prophylaxis.Few studies have prospectively evaluated interventions to prevent PEP in children.AIM To assess the efficacy and safety of the external use of mirabilite to prevent PEP in children.METHODS This multicenter,randomized controlled clinical trial enrolled patients with chronic pancreatitis scheduled for ERCP according to eligibility criteria.Patients were randomly divided into the external use of mirabilite group(external use of mirabilite in a bag on the projected abdominal area within 30 min before ERCP)and blank group.The primary outcome was the incidence of PEP.The secondary outcomes included the severity of PEP,abdominal pain scores,levels of serum inflammatory markers[tumor necrosis factor-alpha(TNF-α)and serum interleukin-10(IL-10)],and intestinal barrier function markers[diamine oxidase(DAO),D-lactic acid,and endotoxin].Additionally,the side effects of topical mirabilite were investigated.RESULTSA total of 234 patients were enrolled,including 117 in the external use of mirabilite group and theother 117 in the blank group.The pre-procedure and procedure-related factors were notsignificantly different between the two groups.The incidence of PEP in the external use ofmirabilite group was significantly lower than that in the blank group(7.7%vs 26.5%,P<0.001).The severity of PEP decreased in the mirabilite group(P=0.023).At 24 h after the procedure,thevisual analog scale score in the external use of mirabilite group was lower than that in the blankgroup(P=0.001).Compared with those in the blank group,the TNF-αexpressions weresignificantly lower and the IL-10 expressions were significantly higher at 24 h after the procedurein the external use of mirabilite group(P=0.032 and P=0.011,respectively).There were nosignificant differences in serum DAO,D-lactic acid,and endotoxin levels before and after ERCPbetween the two g

关键词： Children Endoscopic retrograde cholangiopancreatography Mirabilite Chronic pancreatitis Post-endoscopic retrograde cholangiopancreatography pancreatitis Randomized controlled trial

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Efficacy and safety of endoscopic retrograde cholangiopancreatography in recurrent pancreatitis of pediatric asparaginase-associated pancreatitis

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World Journal of Gastrointestinal Endoscopy 2023年第10期15卷 614-622页

作者： Kai-Hua Yang jing-qing zeng Sheng Ding Tian-Ao Zhang Wen-Yu Wang Jia-Yu Zhang Lan Wang Jian Xiao Biao Gong Zhao-Hui Deng Department of Gastroenterology Shanghai Children’s Medical CenterShanghai Jiao Tong University School of MedicineShanghai 200127China Department of Gastroenterology Shanghai Shuguang HospitalShanghai University of Traditional Chinese MedicineShanghai 200120China

BACKGROUND Asparaginase(ASP)is an important drug in combined chemotherapy regimens for pediatric acute lymphoblastic leukemia(ALL);ASP-associated pancreatitis(AAP)is the main adverse reaction of ASP.Recurrent pancreatitis is a complication of AAP,for which medication is ineffective.AIM To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP)in treating recurrent pancreatitis due to AAP.METHODS From May 2018 to August 2021,ten children(five males and five females;age range:4–13 years)with AAP were treated using ERCP due to recurrent pancreatitis.Clinical data of the ten children were collected,including their sex,age,weight,ALL risk grading,clinical symptoms at the onset of pancreatitis,time from the first pancreatitis onset to ERCP,ERCP operation status,and postoperative complications.The symptomatic relief,weight change,and number of pancreatitis onsets before and after ERCP were compared.RESULTS The preoperative symptoms were abdominal pain,vomiting,inability to eat,weight loss of 2-7 kg,and 2-9 pancreatitis onsets.After the operation,nine of ten patients did not develop pancreatitis,had no abdominal pain,could eat normally;the remaining patient developed three pancreatitis onsets due to the continuous administration of ASP,but eating was not affected.The postoperative weight gain was 1.5-8 kg.There was one case of post ERCP pancreatitis and two cases of postoperative infections;all recovered after medication.CONCLUSION ERCP improved clinical symptoms and reduced the incidence of pancreatitis,and was shown to be a safe and effective method for improving the management of recurrent pancreatitis due to AAP.

关键词： Acute lymphoblastic leukemia Asparaginase Endoscopic retrograde cholangiopancreatography Pancreatic pseudocyst Recurrent pancreatitis Children

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Endoscopic retrograde cholangiopancreatography in children with symptomatic pancreaticobiliary maljunction: A retrospective multicenter study

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World Journal of Gastroenterology 2019年第40期25卷 6107-6115页

作者： jing-qing zeng Zhao-Hui Deng Kai-Hua Yang Tian-Ao Zhang Wen-Yu Wang Jian-Mei Ji Ya-Bin Hu Chun-Di Xu Biao Gong Department of Pediatric Digestive Diseases Shanghai Children’s Medical CenterShanghai Jiao Tong University School of MedicineShanghai 200127China Department of Digestive Diseases Shanghai Shuguang HospitalShanghai University of Traditional Chinese MedicineShanghai 201203China Department of Clinical Epidemiology and Biostatistics Shanghai Children’s Medical CenterShanghai Jiao Tong University School of MedicineShanghai 200127China Department of Pediatrics Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)has been widely used in pediatric patients with cholangiopancreatic diseases.AIM To evaluate the efficacy,safety,and long-term follow-up results of ERCP in symptomatic pancreaticobiliary maljunction(PBM).METHODS A multicenter,retrospective study was conducted on 75 pediatric patients who were diagnosed with PBM and underwent therapeutic ERCP at three endoscopy centers between January 2008 and March 2019.They were divided into four PBM groups based on the fluoroscopy in ERCP.Their clinical characteristics,specific ERCP procedures,adverse events,and long-term follow-up results were retrospectively reviewed.RESULTS Totally,112 ERCPs were performed on the 75 children with symptomatic PBM.Clinical manifestations included abdominal pain(62/75,82.7%),vomiting(35/75,46.7%),acholic stool(4/75,5.3%),fever(3/75,4.0%),acute pancreatitis(47/75,62.7%),hyperbilirubinemia(13/75,17.3%),and elevated liver enzymes(22/75,29.3%).ERCP interventions included endoscopic sphincterotomy,endoscopic retrograde biliary or pancreatic drainage,stone extraction,etc.Procedure-related complications were observed in 12 patients and included post-ERCP pancreatitis(9/75,12.0%),gastrointestinal bleeding(1/75,1.3%),and infection(2/75,2.7%).During a mean follow-up period of 46 mo(range:2 to 134 mo),ERCP therapy alleviated the biliary obstruction and reduced the incidence of pancreatitis.The overall effective rate of ERCP therapy was 82.4%;seven patients(9.3%)were lost to follow-up,eight(11.8%)re-experienced pancreatitis,and eleven(16.2%)underwent radical surgery,known as prophylactic excision of the extrahepatic bile duct and hepaticojejunostomy.CONCLUSION ERCP is a safe and effective treatment option to relieve biliary or pancreatic obstruction in symptomatic PBM,with the characteristics of minor trauma,fewer complications,and repeatability.

关键词： Cholangiopancreatic diseases Endoscopic retrograde cholangiopancreatography Pancreaticobiliary maljunction Pancreatitis Pediatric patients Follow-up

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Enterocyte dendritic cell-specific intercellular adhesion molecule-3-grabbing non-integrin expression in inflammatory bowel disease

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World Journal of Gastroenterology 2015年第1期21卷 187-195页

作者： jing-qing zeng Chun-Di Xu Tong Zhou jing Wu Kai Lin Wei Liu Xin-Qiong Wang Department of Pediatrics Ruijin HospitalShanghai Jiao Tong University School of Medicine Department of Pediatrics Shanghai Children’s Medical CenterShanghai Jiao Tong University School of Medicine

AIM: To investigate dendritic cell-specific intercellular adhesion molecule-3-grabbing non-integrin(DC-SIGN) expression in intestinal epithelial cells(IECs) in inflammatory bowel disease(IBD).METHODS: The expression of DC-SIGN in IECs was examined by immunohistochemistry of intestinal mucosal biopsies from 32 patients with IBD and 10 controls.Disease activity indices and histopathology scores were used to assess the tissue lesions and pathologic damage.Animal studies utilized BALB/c mice with dextran sodium sulfate(DSS)-induced colitis treated with anti-P-selectin lectin-EGF domain monoclonal antibody(PsL-EGFmA b).Controls,untreated and treated mice were sacrificed after 7 d,followed by isolation of colon tissue and IECs.Colonic expression of DC-SIGN,CD80,CD86 and MHC Ⅱ was examined by immunohistochemistry or flow cytometry.The capacity of mouse enterocytes or dendritic cells to activate T cells was determined by coculture with naive CD4+ T cells.Culture supernatant and intracellular levels of interleukin(IL)-4 and interferon(IFN)-γ were measured by enzyme-linked immunosorbent assay and flow cytometry,respectively.The ability of IECs to promote T cell proliferation was detected by flow cytometry staining with carboxyfluorescein diacetate succinimidyl ester.RESULTS: Compared with controls,DC-SIGN expression was significantly increased in IECs from patients with Crohn's disease(P < 0.01) or ulcerative colitis(P < 0.05).DC-SIGN expression was strongly correlated with disease severity in IBD(r = 0.48; P < 0.05).Similarly,in the DSS-induced colitis mouse model,IECs showed upregulated expression of DC-SIGN,CD80,CD86 and MHC,and DC-SIGN expression was positively correlated with disease activity(r = 0.62: P < 0.01).IECs from mouse colitis stimulated naive T cells to generate IL-4(P < 0.05).Otherwise,dendritic cells promoted a T-helper-1-skewing phenotype by stimulating IFN-γ secretion.However,DC-SIGN expression and T cell differentiation were suppressed following treatment of mice with DSS-induced colitis with Ps L-EGFm

关键词： Dendritic cell-specific intercellular adhesion mol

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A newly proposed heatstroke-induced coagulopathy score in patients with heat illness: A multicenter retrospective study in China

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Chinese Journal of Traumatology 2024年第2期27卷 83-90页

作者： qing-Wei Lin Lin-Cui Zhong Long-Ping He qing-Bo zeng Wei Zhang qing Song jing-Chun Song Department of Critical Care Medicine The 908th Hospital of Chinese PLA Logistic Support ForcesNanchang360104Jiangsu ProvinceChina Department of Emergency Medicine The 900th Hospital of Chinese PLA Logistic Support ForcesFuzhou350000China Department of Critical Care Medicine Hainan Hospital of Chinese PLA General HospitalSanya572013Hainan ProvinceChina

Purpose:In patients with heatstroke, disseminated intravascular coagulation (DIC) is associated with greater risk of in-hospital mortality. However, time-consuming assays or a complex diagnostic system may delay immediate treatment. Therefore, the present study proposes a new heatstroke-induced coagulopathy (HIC) score in patients with heat illness as an early warning indicator for DIC.Methods:This retrospective study enrolled patients with heat illness in 24 Chinese hospitals from March 2021 to May 2022. Patients under 18 years old, with a congenital clotting disorder or liver disease, or using anticoagulants were excluded. Data were collected on demographic characteristics, routine blood tests, conventional coagulation assays and biochemical indexes. The risk factors related to coagulation function in heatstroke were identified by regression analysis, and used to construct a scoring system for HIC. The data of patients who met the diagnostic criteria for HIC and International Society on Thrombosis and Haemostasis defined-DIC were analyzed. All statistical analyses were performed using SPSS 26.0.Results:The final analysis included 302 patients with heat illness, of whom 131 (43.4%) suffered from heatstroke, including 7 death (5.3%). Core temperature (OR = 1.681, 95% CI 1.291 - 2.189, p < 0.001), prothrombin time (OR = 1.427, 95% CI 1.175 - 1.733, p < 0.001) and D-dimer (OR = 1.242, 95% CI 1.049 - 1.471, p = 0.012) were independent risk factors for heatstroke, and therefore used to construct an HIC scoring system because of their close relation with abnormal coagulation. A total score ≥ 3 indicated HIC, and HIC scores correlated with the score for International Society of Thrombosis and Hemostasis-DIC (r = 0.8848, p < 0.001). The incidence of HIC (27.5%) was higher than that of DIC (11.2%) in all of 131 heatstroke patients. Meanwhile, the mortality rate of HIC (19.4%) was lower than that of DIC (46.7%). When HIC developed into DIC, parameters of coagulation dysfunction changed significantly: platelet count decrea

关键词： Heat illness Heatstroke Coagulation disorders Diagnosis Disseminated intravascular coagulation

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Clinical observation of gastrointestinal function recovery in patients after hepatobiliary surgery

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 76-84页

作者： Hua-Jun zeng jing-jing Liu Ying-Chun Yang Department of General Practice Nanyang First People's HospitalNanyang 473000Henan ProvinceChina Department of Anesthesiology Chinese People’s Armed Police Force Hospital of BeijingBeijing 100027China Department of Anesthesiology Beijing Fengtai HospitalBeijing 100071China

BACKGROUND The liver is an important metabolic and digestive organ in the human body,ca-pable of producing bile,clotting factors,and vitamins.AIM To investigate the recovery of gastrointestinal function in patients after hepato-biliary surgery and identify effective rehabilitation measures.METHODS A total of 200 patients who underwent hepatobiliary surgery in our hospital in 2022 were selected as the study subjects.They were divided into a control group and a study group based on the extent of the surgery,with 100 patients in each group.The control group received routine treatment,while the study group re-ceived targeted interventions,including early enteral nutrition support,drinking water before gas discharge,and large bowel enema,to promote postoperative gastrointestinal function recovery.The recovery of gastrointestinal function was compared between the two groups.RESULTS Compared with the control group,patients in the study group had better recovery of bowel sounds and less accumulation of fluids in the liver bed and gallbladder fossa(P<0.05).They also had shorter time to gas discharge and first meal(P<0.05),higher overall effective rate of gastrointestinal function recovery(P<0.05),and lower incidence of postoperative complications(P<0.05).CONCLUSION Targeted nursing interventions(early nutritional support,drinking water before gas discharge,and enema)can effectively promote gastrointestinal function recovery in patients undergoing hepatobiliary surgery and reduce the incidence of complications,which is worthy of promotion.

关键词： Liver and gallbladder patients Gastrointestinal function Postoperative recovery

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Switching,explosion,and chaos of multi-wavelength soliton states in ultrafast fiber lasers

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Science China(Physics,Mechanics & Astronomy) 2024年第7期67卷 82-90页

作者： Zhi-zeng Si Yue-Yue Wang Chao-qing Dai College of Optical Mechanical and Electrical EngineeringZhejiang A&F UniversityLin’an 311300China

Because of the complexity and difficulty of realizing a multi-wavelength soliton state,reports on its internal dynamic characteristics are scarce.In this study,the switching and periodic soliton explosion processes of the multi-wavelength soliton state in a negative dispersion passively mode-locked fiber laser are realized.The generation of the multi-wavelength soliton state undergoes the process of noise,oscillation,and stable mode-locking,and the splitting and annihilation of solitons with different group velocities directly impact the generation and disappearance of three wavelengths.Positive and negative dispersion lead to different group velocities of solitons.The presence and displacement of solitons with different group velocities cause soliton collisions,which lead to soliton explosions.A soliton experiences relative phase oscillation,chaos,and oscillation,as well as convergence and separation before and after an explosion.With an increase in parameters related to pump power,single-soliton oscillation,multi-wavelength solitons,and chaos are found in experiments and simulations,proving the relevance and reliability between simulation and experimental results.This work promotes the dynamical study of multi-soliton collisions in nonlinear science and the development of chaos theory in multi-comb lasers.

关键词： multi-wavelength fiber laser soliton explosion chaos state switching real-time dynamics

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Chromosome-scale genomes of Quercus sichourensis and Quercus rex provide insights into the evolution and adaptation of Fagaceae

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Journal of Genetics and Genomics 2024年第5期51卷 554-565页

作者： Xue Liu Weixiong Zhang Yongting Zhang jing Yang Peng zeng Zunzhe Tian Weibang Sun jing Cai Shaanxi Key Laboratory of Qinling Ecological Intelligent Monitoring and Protection School of Ecology and EnvironmentNorthwestern Polytechnical UniversityXi'anShaanxi 710072China Yunnan Key Laboratory for Integrative Conservation of Plant Species with Extremely Small Populations Kunming Institute of BotanyChinese Academy of SciencesKunmingYunnan 650201China

The Fagaceae,a plant family with a wide distribution and diverse adaptability,has garnered significant interest as a subject of study in plant speciation and adaptation.Meanwhile,certain Fagaceae species are regarded as highly valuable wood resources due to the exceptional quality of their wood.In this study,we present two high-quality,chromosome-scale genome sequences for Quercus sichourensis(848.75 Mb)and Quercus rex(883.46 Mb).Comparative genomics analysis reveals that the difference in the number of plant disease resistance genes and the nonsynonymous and synonymous substitution ratio(Ka/Ks)of protein-coding genes among Fagaceae species are related to different environmental adaptations.Interestingly,most genes related to starch synthesis in the investigated Quercoideae species are located on a single chromosome,as compared to the outgroup species,Fagus sylvatica.Furthermore,resequencing and population analysis of Q.sichourensis and Q.rex reveal that Q.sichourensis has lower genetic diversity and higher deleterious mutations compared to Q.rex.The high-quality,chromosome-level genomes and the population genomic analysis of the critically endangered Q.sichourensis and Q.rex will provide an invaluable resource as well as insights for future study in these two species,even the genus Quercus,to facilitate their conservation.

关键词： Adaptation Quercus sichourensis Quercusrex Chromosome-scale genome assembly Tandemduplicationgenes Extremelysmallpopulations

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Flexible tuning of multifocal holographic imaging based on electronically controlled metasurfaces

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Photonics Research 2024年第1期12卷 61-69页

作者： OWEN zeng CHENXIA LI BO FANG ZHI HONG XUFENG jing Institute of Optoelectronic Technology China Jiliang UniversityHangzhou 310018China Centre for THz Research China Jiliang UniversityHangzhou 310018China College of Metrology&Measurement Engineering China Jiliang UniversityHangzhou 310018China

Programmable hyper-coded holography has the advantage of being programmable as well as being flexibly modifiable.Digitally coded metamaterials with excellent electromagnetic modulation capability and the ability to control the phase to modulate the spatial radiation field through external excitation in the form of switching can be used to realize low-cost digital arrays.We design a 1-bit encoded programmable metasurface,which is electrically connected to control the PIN diode in the switching state and to switch the condition of each metasurface cell between“0”and“1.”Using the designed programmable metasurface,we can randomly encode the cell structure to realize single-focus focusing,multi-focusing,and simple holographic letter imaging.Based on the nonlinear holographic model,we employ the Gerchberg-Saxton improvement algorithm to modulate the energy distribution at the focus by adjusting the phase distribution.Importantly,we introduce the Fourier convolution principle to regulate the holographic imaging focus flexibly.

关键词： holographic letter excitation

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Study of deep transportation and plugging performance of deformable gel particles in porous media

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Petroleum Science 2024年第2期21卷 962-973页

作者： Wen-jing Zhao jing Wang Zhong-Yang Qi Hui-qing Liu National Key Laboratory of Petroleum Resources and Engineering China University of PetroleumBeijing102249China MOE Key Laboratory of Petroleum Engineering China University of PetroleumBeijing102249China

Deformable gel particles(DGPs) possess the capability of deep profile control and flooding. However, the deep migration behavior and plugging mechanism along their path remain unclear. Breakage, an inevitable phenomenon during particle migration, significantly impacts the deep plugging effect. Due to the complexity of the process, few studies have been conducted on this subject. In this paper, we conducted DGP flow experiments using a physical model of a multi-point sandpack under various injection rates and particle sizes. Particle size and concentration tests were performed at each measurement point to investigate the transportation behavior of particles in the deep part of the reservoir. The residual resistance coefficient and concentration changes along the porous media were combined to analyze the plugging performance of DGPs. Furthermore, the particle breakage along their path was revealed by analyzing the changes in particle size along the way. A mathematical model of breakage and concentration changes along the path was established. The results showed that the passage after breakage is a significant migration behavior of particles in porous media. The particles were reduced to less than half of their initial size at the front of the porous media. Breakage is an essential reason for the continuous decreases in particle concentration, size, and residual resistance coefficient. However, the particles can remain in porous media after breakage and play a significant role in deep plugging. Higher injection rates or larger particle sizes resulted in faster breakage along the injection direction, higher degrees of breakage, and faster decreases in residual resistance coefficient along the path. These conditions also led to a weaker deep plugging ability. Smaller particles were more evenly retained along the path, but more particles flowed out of the porous media, resulting in a poor deep plugging effect. The particle size is a function of particle size before injection, transport distance, and different injection

关键词： Physical simulation Deformable gel particle Breakage Particle size Residual resistance coefficient

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