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World Journal of Gastroenterology 2005年第43期11卷 6823-6827页

作者： Tai-An Chen Gin-Ho Lo kwok-hung lai Whey-Jen Lin Division of Gastroenterology

AIM: To compare the efficacy and safety of single daily amikacin vs. cefotaxime in the 5-d treatment of spontaneous bacterial peritonitis (SBP).METHODS: Thirty-seven cirrhotic patients with SBP,19 in group A and 18 in group B, were studied. Group A received 1 g of cefotaxime every 6 h, and group B received 500 mg of amikacin qd. Both antibiotics were administered up to 5 d and the responses were ***: Infection was cured in 15 of 19 patients (78.9%) treated with cefotaxime and in 11 of 18 (61.1%)treated with amikacin. Four patients of the Cefotaxime group (21.1%) and five patients of the Amikacin group (27.8%) died. Two in each group (10.5% vs 11.1%)had renal impairment during study period. One in each group (5.3% vs 5.6%) may be considered to suffer from nephrotoxicity due to increased urinary β2-microglobulin ***: In this study, single daily doses of amikacin in the treatment of SBP in cirrhotics were not associated with an increased incidence of renal impairment or nephrotoxicity. However, a 5-d regimen of amikacin is less effective than a 5-d regimen of cefotaxime in the SBP treatment.

关键词： Spontaneous bacterial peritonitis Amikacin Cefotaxime

Reappraisal of endoscopic papillary balloon dilation for the management of common bile duct stones

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World Journal of Gastrointestinal Endoscopy 2015年第2期7卷 77-86页

作者： kwok-hung lai Hoi-hung Chan Tzung-Jiun Tsai Jin-Shiung Cheng Ping-I Hsu Division of Gastroenterology Department of Internal Medicine Kaohsiung Veterans General Hospital School of Medicine National Yang-Ming University

Although endoscopic sphincterotomy(EST) is still considered as a gold standard treatment for common bile duct(CBD) stones in western guideline, endoscopic papillary balloon dilation(EPBD) is commonly used by the endoscopists in Asia as the first-line treatment for CBD stones. Besides the advantages of a technical easy procedure, endoscopic papillary large balloon dilation(EPLBD) can facilitate the removal of large CBD *** indication of EPBD is now extended from removal of the small stones by using traditional balloon, to removal of large stones and avoidance of lithotripsy by using large balloon alone or after EST. According to the reports of antegrade papillary balloon dilatation, balloon dilation itself is not the cause of pancreatitis. On the contrary, adequate dilation of papillary orifice can reduce the trauma to the papilla and pancreas by the basket or lithotripter during the procedure of stone extraction. EPLBD alone is as effective as EPLBD with limited EST. Longer ballooning time may be beneficial in EPLBD alone to achieve adequate loosening of papillary orifice. The longer ballooning time does not increase the risk of pancreatitis but may reduce the bleeding episodes in patients with coagulopathy. Slowly inflation of the balloon, but not exceed the diameter of bile duct and tolerance of the patients are important to prevent the complication of perforation. EPBLD alone or with EST are not the sphincter preserved procedures, regular follow up is necessary for early detection and management of CBD stones recurrence.

关键词： Common bile duct stones Complications Endoscopic balloon dilation Endoscopic large balloondilation Endoscopic sphincterotomy

Malignant lymphoma of spleen presenting as acute pancreatitis: A case report

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World Journal of Gastroenterology 2007年第27期13卷 3773-3775页

作者： Chao-Ming Wu Lung-Chih Cheng Gin-Ho Lo kwok-hung lai Chia-Ling Cheng Wen-Cheng Pan Department of Gastroenterology Tian-Sheng Memorial Hospital Taiwan 813 China Division of Gastroenterology Department of Medicine.Kaohsiung Veterans General Hospital Taiwan 813 China Deputy Superintedent Kaohsiung Veterans General Hospital Taiwan 813 China

This is a case report of a patient who presented with acute pancreatitis without the common causes. A pancreatic biopsy revealed large B cell lymphoma. Spleen lymphoma with pancreatic involvement inducing acute pancreatitis, which is a rare disorder, was diagnosed. Here we also review the few similar cases reported in the literature.

关键词： Primary lymphoma of spleen Large B cell lymphoma Acute pancreatitis Splenomegaly Idiopathic pancreatitis

Clinical application of dip-assisted endoscopic method for nasoenteric feeding in patients with gastroparesis and gastroesophageal wounds

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World Journal of Gastroenterology 2005年第24期11卷 3714-3718页

作者： Chung-Jen Wu Ping-I Hsu Gin-Ho Lo Chang-Bih Shie Ching-Chu Lo E-Ming Wang Chiun-Ku Lin Wen-Chi Chen Lung-Chin Cheng Hsien-Chung Yu Yi-Chun Chan kwok-hung lai Division of Gastroenterology

AIM: To report the clinical experiences in the application of clip-assisted endoscopic method for nasoenteric feeding in patients with gastroparesis and patients with gastroesophageal wounds, and to compare the efficacy of nasoenteric feeding in these two indications. METHODS: From April 2002 to January 2004,21 consecutive patients with gastroparesis or gastroesophageal wounds were enrolled and received nasoenteric feeding for nutritional support. A clip-assisted method was used to place the nasoenteric tubes. Outcomes in the two groups were compared with respect to the successful rate of enteral feeding, percentage of recommended energy intake (REI), and complication rates. RESULTS: The gastroparesis group included 13 patients with major burns (n = 7), trauma (n = 2), congestive heart failure (n = 2) and post-surgery gastric stasis syndrome (n = 2). The esophageogastric wound group included eight patients with tracheoesophageal fistula (n = 2) and wound leakage following gastric surgery (n = 6). Two study groups were similar in feeding successful rates (84.6% vs 75.0%). There were also no differences in the percentage of REI between groups (79.4% vs 78.6%). Additionally, no complications occurred in any of the study groups. CONCLUSION: Nasoenteric feeding is a useful method to provide nutritional support to most of the patients with gastroparesis who cannot tolerate nasogastric tube feeding and to the cases who need bypass feeding for esophageogastric wounds.

关键词： Enteral feeding Nasoenteric tube Endoscopic Hemoclip

Composition of common bile duct stones in Chinese patients during and after endoscopic sphincterotomy

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World Journal of Gastroenterology 2005年第27期11卷 4246-4249页

作者： Wei-Lun Tsai kwok-hung lai Chiun-Ku Lin Hoi-hung Chan Ching-Chu Lo Ping-I Hsu Wen-Chi Chen Jin-Shiung Cheng Gin-Ho Lo Division of Gastroenterology Department of InternalMedicine Kaohsiung Veterans General Hospital School of MedicineNational Yang Ming University Taiwan China

AIM： Endoscopic sphincterotomy （ES） is a well-established therapeutic modality for the removal of common bile duct （CBD） stones. Alter ES there are still around 10% of patients that experience recurrent CBD stones. The aim of this study is to investigate the composition of CBD stones before and alter ES and its clinical significance in Chinese ***： From January 1996 to December 2003, 735 patients with CBD stones received ES at Kaohsiung Veterans General Hospital and stone specimens from 266 patients were sent for analysis. Seventy-five patients had recurrent CBD stones and stone specimens from 44 patients were sent for analysis. The composition of the stones was analyzed by infrared （IR） spectrometry and they were classified as cholesterol or bilirubinate stones according to the predominant composition. Clinical data were ***： In the initial 266 stone samples, 217 （82%） were bilirubinate stones, 42 （16%） were cholesterol stones,3 were calcium carbonate stones, 4 were mixed cholesterol and bilirubinate stones. Patients with bilirubinate stones were significantly older than patients with cholesterol stones （66＋13 years vs 56＋17 years, P = 0.001）. In the 44 recurrent stone samples, 38 （86%） were bilirubinate stones, 3 （7%） were cholesterol stones, and 3 were mixed cholesterol and bilirubinate stones. In 27 patients, both initial and recurrent stone specimens can be obtained,23 patients had bilirubinate stones initially and 2 became cholesterol stones in the recurrent attack. In the four patients with initial cholesterol stones, three patients had bilirubinate stones and one patient had a cholesterol stone in the recurrent ***： Bilirubinate stone is the predominant composition of initial or recurrent CBD stone in Chinese patients, The composition of CBD stones may be different from initial stones afl：er ES,

关键词： Endoscopic sphincterotomy Common bile ductstone Bilirubinate stone Cholesterol stone

Intravenous pantoprazole versus ranitidine for prevention of rebleeding after endoscopic hemostasis of bleeding peptic ulcers

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World Journal of Gastroenterology 2004年第24期10卷 3666-3669页

作者： Ping-IHsu Gin-HoLo Ching-ChuLo Chiun-KuLin Hoi-hungChan Chung-JenWu Chang-BihShie Pei-MinTsai Deng-ChyangWu Wen-MingWang kwok-hung lai Division of Gastroenterology Department of Internal MedicineKaohsiung Veterans General HospitalNational Yang-Ming University Kaohsiung TaiwanChina Division of Gastroenterology Department of Internal MedicineKaohsiung Medical CollegeKaohsiungTaiwanChina

AIM: The role of intravenous pantoprazole in treatment of patients with high-risk bleeding peptic ulcers following endoscopic hemostasis remains uncertain. We therefore conducted the pilot prospective randomized study to assess whether intravenous pantoprazole could improve the efficacy of H2-antagonist as an adjunct treatment following endoscopic injection therapy for bleeding ***: Patients with active bleeding ulcers or ulcers with major signs of recent bleeding were treated with distilled water injection. After hemostasis was achieved, they were randomly assigned to receive intravenous pantoprazole or ***: One hundred and two patients were enrolled in this prospective trial. Bleeding recurred in 2 patients (4%) in the pantoprazole group (n = 52), as compared with 8 (16%) in the ranitidine group (n = 50). The rebleeding rate was significantly lower in the pantoprazole group (P = 0.04).There were no statistically significant differences between the groups with regard to the need for emergency surgery (0% vs2%), transfusion requirements (4.9+5.9 vs5.7:1:6.8 units), hospital days (5.9+3.2 vs7.5:1:5.0 d) or mortality (2% vs 2%).CONCLUSION: Pantoprozole is superior to ranitidine as an adjunct treatment to endoscopic injection therapy in high-risk bleeding ulcers.

关键词：静脉内疾病相对作用雷尼替丁预防作用消化性出血内窥镜止血法消化性溃疡

Implications of anti-parietal cell antibodies and anti-Helicobacter pylori antibodies in histological gastritis and patient outcome

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World Journal of Gastroenterology 2005年第30期11卷 4715-4720页

作者： Ching-Chu Lo Ping-I Hsu Gin-Ho Lo kwok-hung lai Hui-Hwa Tseng Chiun-Ku Lin Hoi-hung Chan Wei-Lun Tsai Wen-Chi Chen Nan-Jing Peng Division of Gastroenterology Department of Internal Medicine Kaohsiung Veterans General Hospital and St. Martin De Porres HospitalNational Yang-Ming University Kaohsiung Taiwan China Department of Pathology Kaohsiung Veterans General Hospital and National Yang-Ming University KaohsiungTaiwan China Department of Nuclear Medicine Kaohsiung Veterans General Hospital and National Yang-Ming University Kaohsiung Taiwan China

AIM： To develop a serum or histological marker for early discovery of gastric atrophy or intestinal metaplasia. METHODS： This study enrolled 44 patients with gastric adenocarcinoma, 52 patients with duodenal ulcer, 14 patients with gastric ulcer and 42 consecutive healthy adults as controls. Each patient received an endoscopy and five biopsy samples were obtained. The degrees of histological parameters of gastritis were categorized following the Updated Sydney System. Anti-parietal cell antibodies （APCA） and anti- Helicobacter pylori （ H pylori） antibodies （AHPA） were analyzed by immunoassays. Hpyloriinfection was diagnosed by rapid unease test and histological examination. RESULTS： Patients with gastric cancer and gastric ulcer are significantly older than healthy subjects, while also displaying higher frequency of APCA than healthy controls. Patients with positive APCA showed higher scores in gastric atrophy and intestinal metaplasia of corpus than patients with negative APCA. Patients with positive AHPA had higher scores in gastric atrophy, intestinal metaplasia, and gastric inflammation of antrum than those patients with negative AHPA. Elderly patients had greater prevalence rates of APCA. Following multivariant logistic regression analysis, the only significant risk factor for antral atrophy is positive AHPA, while that for corpus atrophy is positive APCA. CONCLUSION： The existence of positive APCA correlates with glandular atrophy in corpus and the presence of positive AHPA correlates with glandular atrophy in antrum. The existence of serum APCA and AHPA betokens glandular atrophy and requires further examination for gastric cancer.

关键词： Glandular atrophy Intestinal metaplasia Gastriccancer Anti-parietal cell antibody Anti-Helicobacter pylori antibodies

Optimizing Fine-Tuning in Quantized Language Models:An In-Depth Analysis of Key Variables

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Computers, Materials & Continua 2025年第1期82卷 307-325页

作者： Ao Shen Zhiquan lai Dongsheng Li Xiaoyu Hu National Key Laboratory of Parallel and Distributed Computing National University of Defense TechnologyChangsha410073China Strategic Assessments and Consultation Institute Academy of Military ScienceBeijing100091China

Large-scale Language Models(LLMs)have achieved significant breakthroughs in Natural Language Processing(NLP),driven by the pre-training and fine-tuning *** this approach allows models to specialize in specific tasks with reduced training costs,the substantial memory requirements during fine-tuning present a barrier to broader ***-Efficient Fine-Tuning(PEFT)techniques,such as Low-Rank Adaptation(LoRA),and parameter quantization methods have emerged as solutions to address these challenges by optimizing memory usage and computational *** these,QLoRA,which combines PEFT and quantization,has demonstrated notable success in reducing memory footprints during fine-tuning,prompting the development of various QLoRA *** these advancements,the quantitative impact of key variables on the fine-tuning performance of quantized LLMs remains *** study presents a comprehensive analysis of these key variables,focusing on their influence across different layer types and depths within LLM *** investigation uncovers several critical findings:(1)Larger layers,such as MLP layers,can maintain performance despite reductions in adapter rank,while smaller layers,like self-attention layers,aremore sensitive to such changes;(2)The effectiveness of balancing factors depends more on specific values rather than layer type or depth;(3)In quantization-aware fine-tuning,larger layers can effectively utilize smaller adapters,whereas smaller layers struggle to do *** insights suggest that layer type is a more significant determinant of fine-tuning success than layer depth when optimizing quantized ***,for the same discount of trainable parameters,reducing the trainable parameters in a larger layer is more effective in preserving fine-tuning accuracy than in a smaller *** study provides valuable guidance for more efficient fine-tuning strategies and opens avenues for further research into optimizing LLM

关键词： Large-scale Language Model Parameter-Efficient Fine-Tuning parameter quantization key variable trainable parameters experimental analysis

Structural Modal Parameter Recognition and Related Damage Identification Methods under Environmental Excitations: A Review

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Structural Durability & Health Monitoring 2025年第1期19卷 25-54页

作者： Chao Zhang Shang-Xi lai Hua-Ping Wang School of Civil Engineering and Mechanics Lanzhou UniversityLanzhou730000China Key Laboratory of Special Functional Materials and Structural Design Ministry of EducationLanzhou UniversityLanzhou730000China

Modal parameters can accurately characterize the structural dynamic properties and assess the physical state of the ***,it is particularly signiﬁcant to identify the structural modal parameters according to the monitoring data information in the structural health monitoring(SHM)system,so as to provide a scientiﬁc basis for structural damage identiﬁcation and dynamic model modiﬁ*** view of this,this paper reviews methods for identifying structural modal parameters under environmental excitation and brieﬂy describes how to identify structural damages based on the derived modal *** paper primarily introduces data-driven modal parameter recognition methods(e.g.,time-domain,frequency-domain,and time-frequency-domain methods,etc.),brieﬂy describes damage identiﬁcation methods based on the variations of modal parameters(e.g.,natural frequency,modal shapes,and curvature modal shapes,etc.)and modal validation methods(e.g.,Stability Diagram and Modal Assurance Criterion,etc.).The current status of the application of artiﬁcial intelligence(AI)methods in the direction of modal parameter recognition and damage identiﬁcation is further *** on the pre-vious analysis,the main development trends of structural modal parameter recognition and damage identiﬁcation methods are given to provide scientiﬁc references for the optimized design and functional upgrading of SHM systems.

关键词： Structural health monitoring data information modal parameters damage identiﬁcation AI method

Enhancing Deepfake Detection:Proactive Forensics Techniques Using Digital Watermarking

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Computers, Materials & Continua 2025年第1期82卷 73-102页

作者： Zhimao lai Saad Arif Cong Feng Guangjun Liao Chuntao Wang School of Automation Guangdong University and TechnologyGuangzhou510006China School of Immigration Administration(Guangzhou) China People’s Police UniversityGuangzhou510663China Department of Mechanical Engineering College of EngineeringKing Faisal UniversityAl Ahsa31982Saudi Arabia Cyber Police Division Guangzhou Public Security BureauGuangzhou510030China School of Forensic Science and Technology Guangdong Police CollegeGuangzhou510320China College of Mathematics and Informatics South China Agricultural UniversityGuangzhou510642China

With the rapid advancement of visual generative models such as Generative Adversarial Networks(GANs)and stable Diffusion,the creation of highly realistic Deepfake through automated forgery has significantly *** paper examines the advancements inDeepfake detection and defense technologies,emphasizing the shift from passive detection methods to proactive digital watermarking *** detection methods,which involve extracting features from images or videos to identify forgeries,encounter challenges such as poor performance against unknown manipulation techniques and susceptibility to counter-forensic *** contrast,proactive digital watermarking techniques embed specificmarkers into images or videos,facilitating real-time detection and traceability,thereby providing a preemptive defense againstDeepfake *** offer a comprehensive analysis of digitalwatermarking-based forensic techniques,discussing their advantages over passivemethods and highlighting four key benefits:real-time detection,embedded defense,resistance to tampering,and provision of legal ***,the paper identifies gaps in the literature concerning proactive forensic techniques and suggests future research directions,including cross-domain watermarking and adaptive watermarking *** systematically classifying and comparing existing techniques,this review aims to contribute valuable insights for the development of more effective proactive defense strategies in Deepfake forensics.

关键词： Deepfake proactive forensics digital watermarking traceability detection techniques