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Evaluating effectiveness and safety of combined percutaneous transhepatic gallbladder drainage and laparoscopic cholecystectomy in acute cholecystitis patients:Meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1407-1419页

作者： Yu Li Wei-Ke xiao xiao-jun Li Hui-Yuan Dong Department of General Surgery No.942 Hospital of PLAYinchuan 750004Ningxia Hui Autonomous RegionChina

BACKGROUND Acute cholecystitis(AC)is a common disease in general surgery.Laparoscopic cholecystectomy(LC)is widely recognized as the"gold standard"surgical procedure for treating AC.For low-risk patients without complications,LC is the recommended treatment plan,but there is still controversy regarding the treatment strategy for moderate AC patients,which relies more on the surgeon's experience and the medical platform of the visiting unit.Percutaneous transhepatic gallbladder puncture drainage(PTGBD)can effectively alleviate gallbladder inflammation,reduce gallbladder wall edema and adhesion around the gallbladder,and create a"time window"for elective surgery.AIM To compare the clinical efficacy and safety of LC or PTGBD combined with LC for treating AC patients,providing a theoretical basis for choosing reasonable surgical methods for AC patients.METHODS In this study,we conducted a clinical investigation regarding the combined use of PTGBD tubes for the treatment of gastric cancer patients with AC.We performed searches in the following databases:PubMed,Web of Science,EMBASE,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Database.The search encompassed literature published from the inception of these databases to the present.Subsequently,relevant data were extracted,and a meta-analysis was conducted using RevMan 5.3 software.RESULTS A comprehensive analysis was conducted,encompassing 24 studies involving a total of 2564 patients.These patients were categorized into two groups:1371 in the LC group and 1193 in the PTGBD+LC group.The outcomes of the meta-analysis revealed noteworthy disparities between the PTGBD+LC group and the LC group in multiple dimensions:(1)Operative time:Mean difference(MD)=17.51,95%CI:9.53-25.49,P<0.01;(2)Conversion to open surgery rate:Odds ratio(OR)=2.95,95%CI:1.90-4.58,P<0.01;(3)Intraoperative bleeding loss:MD=32.27,95%CI:23.03-41.50,P<0.01;(4)Postoperative hospital stay:MD=1.44,95%CI:0.14-2.73,P=0.03;(5)Overall postoperative compli-cation rate:OR=1.88,95%CI:1.45-2

关键词： Acute cholecystitis Laparoscopic cholecystectomy Percutaneous transhepatic gallbladder drainage Metaanalysis Efficacy

A CAD-BEM geometry transformation method for face-based primary geometric input based on closed contour recognition

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Building Simulation 2024年第2期17卷 335-354页

作者： jun xiao Hao Zhou Shiji Yang Deyin Zhang Borong Lin Department of Building Science School of ArchitectureTsinghua UniversityBeijing100084China Key Laboratory of Eco Planning&Green Building Ministry of EducationTsinghua UniversityBeijing100084China Institute for Urban Governance and Sustainable Development Tsinghua UniversityBeijing100084China

Performance analysis during the early design stage can significantly reduce building energy consumption.However,it is difficult to transform computer-aided design(CAD)models into building energy models(BEM)to optimize building performance.The model structures for CAD and BEM are divergent.In this study,geometry transformation methods was implemented in BES tools for the early design stage,including auto space generation(ASG)method based on closed contour recognition(CCR)and space boundary topology calculation method.The program is developed based on modeling tools SketchUp to support the CAD format(like*.stl,*.dwg,*.ifc,etc.).It transforms face-based geometric information into a zone-based tree structure model that meets the geometric requirements of a single-zone BES combined with the other thermal parameter inputs of the elements.In addition,this study provided a space topology calculation method based on a single-zone BEM output.The program was developed based on the SketchUp modeling tool to support additional CAD formats(such as*.stl,*.dwg,*.ifc),which can then be imported and transformed into*.obj.Compared to current methods mostly focused on BIM-BEM transformation,this method can ensure more modeling flexibility.The method was integrated into a performance analysis tool termed MOOSAS and compared with the current version of the transformation program.They were tested on a dataset comprising 36 conceptual models without partitions and six real cases with detailed partitions.It ensures a transformation rate of two times in any bad model condition and costs only 1/5 of the time required to calculate each room compared to the previous version.

关键词： geometry transformation building energy model computer aid design closed contour recognition

Subarachnoid hemorrhage misdiagnosed as acute coronary syndrome leading to catastrophic neurologic injury: A case report

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World Journal of Clinical Cases 2024年第1期12卷 148-156页

作者： jun-Ming Lin xiao-jun Yuan Guang Li Xin-Rong Gan Wen-Hua Xu Department of Orthopaedic Surgery People's Hospital of Yichun CityYichun 336000Jiangxi ProvinceChina

BACKGROUND Elevated levels of cardiac troponin and abnormal electrocardiogram changes are the primary basis for clinical diagnosis of acute coronary syndrome(ACS).Troponin levels in ACS patients can often be more than 50 times the upper reference limit.Some patients with subarachnoid hemorrhage(SAH)also show electrocardiogram abnormalities,myocardial damage,and elevated cardiac biomarkers.Unlike ACS patients,patients with SAH only have a slight increase in troponin,and the use of anticoagulants or antiplatelet drugs is prohibited.Because of the opposite treatment modalities,it is essential for clinicians to distinguish between SAH and ACS.CASE SUMMARY A 56-year-old female patient was admitted to the emergency department at night with a sudden onset of severe back pain.The final diagnosis was intraspinal hematoma in the thoracic spine.We performed an emergency thoracic spinal canal hematoma evacuation procedure with the assistance of a microscope.Intraoperatively,diffuse hematoma formation was found in the T7-T10 spinal canal,and no obvious spinal vascular malformation changes were observed.Postoperative head and spinal magnetic resonance imaging(MRI)showed a small amount of SAH in the skull,no obvious abnormalities in the cervical and thoracic spinal canals,and no abnormal signals in the lumbar spinal canal.Thoracoab-dominal aorta computed tomography angiography showed no vascular malfor-mation.Postoperative motor system examination showed Medical Research Council Scale grade 1/5 strength in both lower extremities,and the patient experienced decreased sensation below the T12 rib margin and reported a Visual Analog Scale score of 3.CONCLUSION Extremely elevated troponin levels(more than 50 times the normal range)are not unique to coronary artery disease.SAH can also result in extremely high troponin levels,and antiplatelet drugs are contraindicated in such cases.Emergency MRI can help in the early differential diagnosis,as a misdiagnosis of ACS can lead to catastrophic neurological damage in patients with spontane

关键词： Acute coronary syndrome Spontaneous spinal subdural hematoma Misdiagnosis Catastrophic neurological injury Case report

Present situation of minimally invasive surgical treatment for early gastric cancer

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1154-1165页

作者： Chun-Yan Li Yi-Feng Wang Li-Kang Luo xiao-jun Yang The First Clinical Medical School Lanzhou UniversityLanzhou 730000Gansu ProvinceChina The First Clinical Medicine College Gansu University of Chinese MedicineLanzhou 730000Gansu ProvinceChina General Surgery Clinical Centre Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina The Second Department of General Surgery Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina Lanzhou University People's Clinical Hospital Lanzhou 730000Gansu ProvinceChina Gansu Research Center of Prevention and Control Project for Digestive Oncology Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina

Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.

关键词： Minimally invasive surgery Early gastric cancer Endoscopic mucosal resection Endoscopic full-thickness resection Laparoscopic and endoscopic cooperative surgery

Refractory autoimmune hemolytic anemia in a patient with systemic lupus erythematosus and ulcerative colitis:A case report

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World Journal of Clinical Cases 2024年第13期12卷 2286-2292页

作者： Dai-Xing Chen Yue Wu Sui-Feng Zhang xiao-jun Yang Department of Digestive System Chongqing Traditional Chinese Medicine HospitalChongqing 400021China

BACKGROUND Ulcerative colitis(UC)and systemic lupus erythematosus(SLE)are both systemic immunoreactive diseases,and their pathogenesis depends on the interaction between genes and environmental factors.There are no reports of UC with SLE in China,but six cases of SLE with UC have been reported in China.The combination of these two diseases has distinct effects on the pathogenesis of both diseases.CASE SUMMARY A female patient(30 years old)came to our hospital due to dull umbilical pain,diarrhea and mucous bloody stool in August 2018 and was diagnosed with UC.The symptoms were relieved after oral administration of mesalazine(1 g po tid)or folic acid(5 mg po qd),and the patient were fed a control diet.On june 24,2019,the patient was admitted for treatment due to anemia and tinnitus.During hospitalization,the patient had repeated low-grade fever and a progressively decreased Hb level.Blood tests revealed positive antinuclear antibody test,positive anti-dsDNA antibody,0.24 g/L C3(0.9-1.8 g/L),0.04 g/L C4(0.1-0.4 g/L),32.37 g/L immunoglobulin(8-17 g/L),and 31568.1 mg/24 h total 24-h urine protein(0-150 mg/24 h).The patient was diagnosed with SLE involving the joints,kidneys and blood system.Previously reported cases of SLE were retrieved from PubMed to characterize clinicopathological features and identify prognostic factors for SLE.CONCLUSION The patient was discharged in remission after a series of treatments,such as intravenous methylprednisolone sodium succinate,intravenous human immunoglobulin,cyclophosphamide injection,and plasma exchange.After discharge,the patient took oral prednisone acetate tablets,cyclosporine capsules,hydroxychloroquine sulfate tablets and other treatments for symptoms and was followed up regularly for 1 month,after which the patient's condition continued to improve and stabilize.

关键词： Plasma exchange Autoimmune hemolytic anemia Systemic lupus erythematosus Ulcerative colitis Case report

Distribution of oxide inclusions in H13 castings under super-gravity field with multi-stage rotation speeds

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Journal of Iron and Steel Research(International) 2024年第1期31卷 121-133页

作者： Shao-ying Li xiao-jun Xi Xing-ming Zhao Han-jie Guo Jing Guo School of Metallurgical and Ecological Engineering University of Science and Technology Beijing(USTB)Beijing100083China Beijing Key Laboratory of Special Melting and Preparation of High-End Metal Materials Beijing100083China Beijing Beiye Functional Materials Corporation Beijing100192China Shandong Tianwu Forming Technology Co. Ltd.Liaocheng252024ShandongChina

The 42 kg industrial H13 castings were prepared by different super-gravity fields with multi-rotation speeds,and the distribution of oxide inclusions in the castings was studied.In addition,the inward movement Reynolds number and inward movement time of oxide inclusions as well as the solidification time of molten steel at different positions in the castings were calculated to clarify the removal mechanism of oxide inclusions in super-gravity field.The results show that the large size(i.e.,greater than 10μm)oxide inclusions are mainly concentrated in the inner and outer parts of the super-gravity castings with constant rotation speed(500 r min^(-1))and five-stage rotation speeds(500,600,750,850,and 950 r min^(-1)),respectively,while there are no large oxide inclusions in the super-gravity castings with three-stage rotation speeds(500,600,and 750 r min^(-1)).Although an increase in the particle size of inclusion and the rotation speed in super-gravity field is conducive to the increase in the inward movement Reynolds number of oxide inclusions and reduction in the inward movement time of oxide inclusions,it will reduce the local solidification time of molten steel.In the range of the rotation speed studied,the super-gravity field with three-stage rotation speeds has the best effect on the removal of inclusions in H13 molten steel.

关键词： Distribution Oxide inclusion H13 casting Super-gravity field Rotation speed

Mechanisms of tumor immunosuppressive microenvironment formation in esophageal cancer

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World Journal of Gastroenterology 2024年第16期30卷 2195-2208页

作者： xiao-jun Zhang Yan Yu He-Ping Zhao Lei Guo Kun Dai Jing Lv Department of Clinical Laboratory Honghui HospitalXi’an Jiaotong UniversityXi’an 710054Shaanxi ProvinceChina Department of Spinal Surgery Honghui HospitalXi’an Jiaotong UniversityXi’an 710054Shaanxi ProvinceChina Department of Clinical Laboratory Yanliang Railway Hospital of Xi’anXi’an 710089Shaanxi ProvinceChina

As a highly invasive malignancy,esophageal cancer(EC)is a global health issue,and was the eighth most prevalent cancer and the sixth leading cause of cancerrelated death worldwide in 2020.Due to its highly immunogenic nature,emerging immunotherapy approaches,such as immune checkpoint blockade,have demonstrated promising efficacy in treating EC;however,certain limitations and challenges still exist.In addition,tumors may exhibit primary or acquired resistance to immunotherapy in the tumor immune microenvironment(TIME);thus,understanding the TIME is urgent and crucial,especially given the importance of an immunosuppressive microenvironment in tumor progression.The aim of this review was to better elucidate the mechanisms of the suppressive TIME,including cell infiltration,immune cell subsets,cytokines and signaling pathways in the tumor microenvironment of EC patients,as well as the downregulated expression of major histocompatibility complex molecules in tumor cells,to obtain a better understanding of the differences in EC patient responses to immunotherapeutic strategies and accurately predict the efficacy of immunotherapies.Therefore,personalized treatments could be developed to maximize the advantages of immunotherapy.

关键词： Esophageal cancer Esophageal squamous cell carcinoma Esophageal adenocarcinoma Tumor immune microenvironment Immunosuppression Immunotherapy

Insights into photocatalytic mechanism over a novel Cu2WS4/MoS2 S-scheme heterojunction

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Rare Metals 2024年第7期43卷 3118-3133页

作者： Wei Zhao Ji-Hui Cao jun-Jie Liao Yun Liu xiao-jun Zeng jun-Yu Shen Xue-Kun Hong Yang Guo He-Hua Zeng Ya-Zi Liu School of Materials Engineering Jiangsu Key Laboratory of Advanced Functional MaterialsSchool of Electronic and Information EngineeringChangshu Institute of Technology School of Chemistry and Chemical Engineering Changji University State Environmental Protection Key Laboratory of Soil Environmental Management and Pollution Control Ministry of Ecology and EnvironmentNanjing Institute of Environmental Sciences School of Environment Jiangsu Engineering Lab of Water and Soil Eco-RemediationNanjing Normal University Department of Chemical Engineering Curtin University

A novel efficient Cu2WS4/MoS2step-scheme（S-scheme） heterojunction photocatalyst was constructed for the first time and applied in the removal of environmental pollutants.Among the as-prepared photocatalysts,the Cu2WS4/MoS2-8 % heterojunc tion photoc atalyst demonstrates the optimal photocatalytic performance,with the catalytic oxidation efficiency of tetracycline（TC） and the catalytic reduction efficiency of Cr6+reaching 93.3%and 82.1 %,respectively.The excellent catalytic properties of Cu2WS4/MoS2heterojunction photocatalysts are attributed to the effective separation pathways of charges and the presence of S-scheme heterojunctions,together with stronger redox capabilities.It is speculated that the photogenerated carrier migration path of the Cu2WS4/MoS2catalyst follows the typical S-scheme photocatalytic mechanism,which is verified by the in-depth experimental study and simulated calculations including the electron paramagnetic resonance（EPR） analysis,free radical quenching experiments,charge density distribution,and simulated built-in electric field formation at the interface,which acts as driving force to promote the separation of photoinduced electrons and holes.Finally,the photocatalytic mechanism of S-scheme photogenerated carrier migration for the Cu2WS4/MoS2catalyst is revealed based on the systematic experimental techniques and simulated calculations,accounting for its superior photocatalytic oxidation and reduction activities.This study provides inspiring implications to develop high-efficient S-scheme photocatalytic systems for versatile applications in solarenergy conversion.

关键词： Cu 2 WS 4 /MoS 2 S-scheme Heterojunction Photocatalysis

Yiwei xiaoyu granules for treatment of chronic atrophic gastritis with deficiency syndrome of the spleen and stomach

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World Journal of Clinical Cases 2024年第13期12卷 2201-2209页

作者： Wan-Qun Chen Qing-Feng Fan Yuan-jun He Fei Li Xin Wu Yan-Ping Li xiao-jun Yang Department of Gastroenterology Chongqing Hospital of Traditional Chinese MedicineChongqing 400000China

BACKGROUND The Correa sequence,initiated by Helicobacter pylori(H.pylori),commonly progresses to gastric cancer through the stage of chronic atrophic gastritis(CAG).Although eradication of H.pylori only reduces the risk of gastric cancer,it does not eliminate the risk for neoplastic progression.Yiwei xiaoyu granules(YWXY)are a commonly used composite preparation in Chinese clinics.However,the pursuit of excellence in clinical trials and the establishment of standardized animal experiments are still needed to contribute to full understanding and application of traditional Chinese medicine in the treatment of CAG.AIM To demonstrate the effectiveness of YWXY in patients with CAG and spleenstomach deficiency syndrome(DSSS),by alleviating histological scores,improving response rates for pathological lesions,and achieving clinical efficacy in relieving DSSS symptoms.METHODS We designed a double-blind,randomized,controlled trial.The study enrolled seventy-two H.pylori-negative patients(mean age,52.3 years;38 men)who were randomly allocated to either the treatment group or control group in a 1:1 ratio,and treated with 15 g YWXY or 0.36 g Weifuchun(WFC)tablet combined with the respective dummy for 24 wk.The pre-randomization phase resulted in the exclusion of 72 patients:50 participants did not meet the inclusion criteria,12 participants declined to participate,and 10 participants were excluded for various other reasons.Seven visits were conducted during the study,and histopathological examination with target endoscopic biopsy of narrow-band imaging was requested before the first and seventh visits.We also evaluated endoscopic performance scores,total symptom scores,serum pepsinogen and gastrin-17.RESULTS Six patients did not complete the trial procedures.Treatment with YWXY improved the Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)stage,compared with WFC(P<0.05).YWXY provided better relief from symptoms of DSSS and better improvement in serum gastric function,compared with WFC(P<0.05).CONCLUSION YWXY

关键词： Chronic atrophic gastritis Yiwei xiaoyu granules Randomized clinical trial Weifuchun tablet Traditional Chinese medicine Helicobacter pylori