Aim
To investigate the effectiveness of over-the-scope-clip (OTSC)-based endoscopic closure in patients with perforated peptic ulcer (PPU).
Methods
One hundred six patients diagnosed with PPU were ...treated with either OTSC (
n
= 26) or conservative treatments (
n
= 80), respectively. The outcome assessments included technical success rate, clinical success rate, post-treatment complications after 1 month, mortality rate, time to resume oral feeding, length of hospital stay, and the administration of antibiotics.
Results
In the OTSC group, technical and clinical success was achieved in 100% of patients without any complications, including death, incomplete closure, duodenal obstruction, and gastrointestinal bleeding, with a median operation time of 10 min. All patients in the OTSC group were discharged, while the mortality rate in the control group was 13.8%. Subsequent surgeries were required in 30% of patients in the control group. The median times to resume oral feeding were 3.5 (interquartile range IQR 2.0–5.25) days in the OTSC group and 7.0 (IQR 5.0–9.0) days in the control group (
p
< 0.001). One month post-procedure, 30% (24/80) of patients in the control group and 0 (0/26) in the OTSC group required additional operations (
p
< 0.001). No significant difference was found in the length of the hospital stay and the administration of antibiotics between the two groups (
p
> 0.05).
Conclusions
OTSC-based endoscopic technique, with a high clinical success rate and a shorter time to resume oral feeding, was effective in achieving closure of PPU with a diameter < 15 mm.
Objective
To investigate the efficacy and safety of endoscopic appendix intubation and irrigation (EAI) on acute uncomplicated appendicitis.
Methods
This prospective non-randomized study examined 169 ...patients with suspected acute uncomplicated appendicitis at The First Affiliated Hospital of Fujian Medical University from October 2015 to 2017. Patients were divided into three groups: endoscopic appendix intubation and irrigation (EAI,
n
= 18), laparoscopic appendectomy (LA,
n
= 87), and antibiotic alone (A,
n
= 64). The treatment success rate, duration of hospitalization, medical costs, operation time, duration of abdominal pain, fasting time, complications, and recurrence were analyzed.
Results
The three groups had no significant differences in baseline characteristics (age, gender, Alvarado score, white blood cell count, and neutrophil count; all
P
> 0.05). Compared to the LA group, the EAI group had shorter durations of the operation, fasting, and abdominal pain; less use of oral and intravenous antibiotics; and lower medical costs (all
P
< 0.05). Compared to the A group, the EAI group had shorter durations of abdominal pain and hospitalization, and less use of intravenous antibiotics (all
P
< 0.05). The EAI group had no complications, but 3 patients (3.4%) in the LA group had surgery-related complications.
Conclusion
EAI is a safe and effective treatment for acute uncomplicated appendicitis. Patients who received EAI had shorter durations of abdominal pain and hospitalization than those who received LA or conservative antibiotic treatment.
Trial registration number and agency
ChiCTR-IPN-15006565, Chinese Clinical Trial Registry
The population distribution grid at fine scales better reflects the distribution of residents and plays an important role in investigating urban systems. The recent years have witnessed a growing ...trend of applying the nighttime light data to the estimation of population at micro levels. However, using the nighttime light data alone to estimate population may cause the overestimation problem due to excessively high light radiance in specific types of areas such as commercial zones and transportation hubs. In dealing with this issue, this study used taxi trajectory data that delineate people's movements, and explored the utility of integrating the nighttime light and taxi trajectory data in the estimation of population in Shanghai at the spatial resolution of 500 m. First, the initial population distribution grid was generated based on the NPP-VIIRS nighttime light data. Then, a calibration grid was created with taxi trajectory data, whereby the initial population grid was optimized. The accuracy of the resultant population grid was assessed by comparing it with the refined survey data. The result indicates that the final population distribution grid performed better than the initial population grid, which reflects the effectiveness of the proposed calibration process.
•This is the first few studies exploring the mechanisms of child abuse by kindergarten teachers (CAKT)•Needling is a relatively common form among CAKT cases in China.•Findings deepen our ...understanding of needling as a social problem rather than a medical problem.•The concealment of tools, locations and discourses creates challenges for detecting CAKT.•Processed spoken terminology prevents children from disclosing the abuse.
Institutional abuse (IA) committed by professionals outside the family is an important form of child abuse. As one type of IA, while cases of child abuse by kindergarten teachers (CAKT) in China are increasing, research on the characteristics and mechanism remains scarce. The objective of this study was to address this research gap. Data were extracted from 35 criminal judicial documents involving 48 kindergarten teachers (nurses) and 247 victims aged 2–6 years. Statistical analysis was used to describe the characteristics of CAKT; qualitative thematic analysis of the stakeholders’ statements was used to disclose the mechanisms. The findings revealed the following: (a) The nature of CAKT was that by trying to control children’s conduct through physical force to achieve a desired order, teachers adopted a teacher-centered educational concept, requiring children to obey them rather than by organizing teaching activities based on the children's development stages; (b) The three most common means of committing CAKT were needling (42.9%), dragging and pressing the body (34.3%), and slapping (31.4%); (c) These abusers were relatively young and had a low level of education; (d) Teachers evaded monitoring through the concealment of abuse tools (e.g., needles, water, mustard) and abuse locations (e.g., corners of classrooms, bathrooms, storage rooms), and the perpetrators utilized strategies such as word substitution (e.g., replacing “needling” with “injection”, replacing “splashing” with “bathing”), making CAKT hard to discern, and a spoken terminology of “finger pointing” to shift the responsibility from themselves to the children, which made the children reluctant to disclose the abuse. The implications for the research and practice are discussed.
This review provides an overview of the treatment options available for gastric varices (GV) with a focus on endoscopic methods. Various minimally invasive techniques, including endoscopic band ...ligation, endoscopic cyanoacrylate injection, and transjugular intrahepatic portosystemic shunt, can be applied to the treatment of GV. Endoscopic cyanoacrylate injection is now recognized as a first‐line treatment for GV. Endoscopic ultrasound‐guided cyanoacrylate injection combined with coils has shown good security and effectiveness. Thrombin injection therapy is a promising treatment, with a similar hemostasis rate to cyanoacrylate injection but with fewer serious complications. With the deepening understanding of the hemodynamics of the GV system, various treatment methods and their combination are gradually evaluated to provide patients with safer and more effective treatment options.
Summary
Nodulation begins with the initiation of infection threads (ITs) in root hairs. Though mutual recognition and early symbiotic signaling cascades in legumes are well understood, molecular ...mechanisms underlying bacterial infection processes and successive nodule organogenesis remain largely unexplored.
We functionally investigated a novel pectate lyase enzyme, GmNPLa, and its transcriptional regulator GmPTF1a/b in soybean (Glycine max), where their regulatory roles in IT development and nodule formation were elucidated through investigation of gene expression patterns, bioinformatics analysis, biochemical verification of genetic interactions, and observation of phenotypic impacts in transgenic soybean plants.
GmNPLa was specifically induced by rhizobium inoculation in root hairs. Manipulation of GmNPLa produced remarkable effects on IT and nodule formation. GmPTF1a/b displayed similar expression patterns as GmNPLa, and manipulation of GmPTF1a/b also severely influenced nodulation traits. LI soybeans with low nodulation phenotypes were nearly restored to HI nodulation level by complementation of GmNPLa and/or GmPTF1a. Further genetic and biochemical analysis demonstrated that GmPTF1a can bind to the E‐box motif to activate transcription of GmNPLa, and thereby facilitate nodulation.
Taken together, our findings potentially reveal novel mediation of cell wall gene expression involving the basic helix–loop–helix transcription factor GmPTF1a/b acts as a key early regulator of nodulation in soybean.
Whereas monthly and annual nighttime light (NTL) composite datasets are being increasingly used to estimate socioeconomic status, use of the National Polar-orbiting Partnership Visible Infrared ...Imaging Radiometer Suite (NPP-VIIRS) Day/Night Band (DNB) daily data has been limited for detecting and assessing the impact of short-term disastrous events. This study explores the application of daily NPP-VIIRS DNB data in assessing the impact of three types of natural disasters: earthquakes, floods, and storms. Daily DNB images one month prior to and 10 days after a disastrous event were collected and a Percent of Normal Light (PNL) image was produced as the ratio of the mean DNB radiance of the pre- and post-disaster images. Areas with a PNL value lower than one were considered as being affected by the event. The results were compared with the damaged proxy map and the flood proxy map generated using synthetic aperture radar data as well as the reported power outage rates. Our analyses show that overall NPP-VIIRS DNB daily data are useful for detecting damages and power outages caused by earthquake, storm, and flood events. Cloud coverage was identified as a major limitation in using the DNB daily data; rescue activities, traffic, and socioeconomic status of the areas also affect the use of DNB daily data in assessing the impact of natural disasters. Our findings offer new insight into the use of the daily DNB data and provide a practical guide for researchers and practitioners who may consider using such data in different situations or regions.
Carbendazim (CBD) is widely used as a fungicide that acts as a pesticide in farming to prevent crop diseases. However, CBD can remain on crops for a long time. When consumed by humans and animals, it ...produces a range of toxic symptoms and poses a serious threat to their health. Therefore, the detection of CBD is necessary. Traditional assay strategies for CBD detection, although sensitive and practical, can hardly achieve fast, robust monitoring during food processing and daily life. Here, we designed a novel electrochemical sensor for CBD detection. In this method, iron oxyhydroxide nanomaterial (β-FeOOH) was first prepared by hydrothermal method. Then, a molecularly imprinted polymer (MIP) layer was electropolymerized on the surface using CBD as the template and resorcinol (RC) as the functional monomer. The synergistic interaction between β-FeOOH and MIP endows the MIP/β-FeOOH/CC-based electrochemical sensor with high specificity and sensitivity. Under optimal conditions, the MIP/β-FeOOH/CC-based sensor showed a wide linear range of 39 pM–80 nM for CBD and a detection limit as low as 25 pM. Therefore, the as-prepared sensor can be a practical and effective tool for pesticide residue detection.
Graphical abstract
Background
Stroke could lead to serious morbidity, of which ischemic stroke counts for majority of the cases. Inflammation plays an important role in the pathogenesis of ischemic stroke, thus drugs ...targeting inflammation could be potentially neuroprotective. Estradiol was shown to be neuroprotective as well as anti‐inflammatory in animal models of ischemic stroke with unclear mechanism. We hypothesize that the anti‐inflammatory and neuroprotective effect of estradiol is mediated by the estradiol receptor G protein‐coupled estrogen receptor 1 (GPER) expressed on microglia.
Methods
We have generated the rat global cerebral ischemic model and the primary microglia culture to study the neuroprotective and anti‐inflammatory effect of estradiol. We have further used pharmacological methods and siRNA knockdown approach to study the underlying mechanism.
Results
We found that estradiol reduced the level of proinflammatory cytokines including IL‐1β and TNF‐α, both in vivo and in vitro. We also found that the specific GPER agonist G1 could reduce the level of IL‐1β (P = 0 P = 0.0017, one‐way ANOVA and post hoc test) and TNF‐α (P < 0.0001) in the primary microglia culture. Moreover, the specific GPER antagonist G15 was able to abolish the anti‐inflammatory effect of estradiol. Estradiol failed to reduce the level of IL‐1β (P = 0.4973, unpaired Student's t‐test) and TNF‐α (P = 0.1627) when GPER was knocked down.
Conclusions
Our studies have suggested that GPER expressed on microglia mediated the anti‐inflammatory effect of estradiol after ischemic stroke. Our studies could potentially help to develop more specific drugs to manage inflammation postischemic stroke.
GPER was highly expressed in activated microglia after ischemia and estradiol. The specific GPER agonist G1 could inhibit the secretion of proinflammatory cytokines including IL‐1β and TNF‐α, which the anti‐inflammatory effect of G1 and E2 were both abolished by the specific GPER antagonist G15.
Mechanisms to use nanoparticles to separate sunlight into photovoltaic useful range and thermally useful range to increase the efficiency of solar cells and to dissipate heat radiatively are ...discussed based on lessons that we learnt from photosynthesis. We show that the dual-band maxima in the absorption spectrum of bacterial light harvestors not only are due to the bacteriochlorophylls involved but also come from the geometry of the light harvestor. Being able to manipulate these two bands arbitrarily enables us to fabricate the nanoparticles required. Such mechanisms are also useful for the design of remote power charging and light sensors.
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