The elaboration of multinutritional blocs (MB) is an alternative that allows supplement energy, protein, vitamins and minerals, and additionally, it can be administered and take natural resources as protein banks, mai...The elaboration of multinutritional blocs (MB) is an alternative that allows supplement energy, protein, vitamins and minerals, and additionally, it can be administered and take natural resources as protein banks, mainly in the dry season, raising their cost and the concentrates decreasing profitability to producers. An aid is green or dried foliage of the tree-shrub of the Mixteca Poblana that drop their leaves to the ground (dry hay) in the dry season, thus becomes valuable forage consumed by goats, being great for your protein content and low cost in diets of small ruminants in silvopastoral production systems, at the dwindle the foliage of woody perennials in a time of the year. The aim of this study was to develop and meet production costs multinutrient blocks with goatee sheets (Pithecellobium acatlense) consumed by goats in the Mixteca Puebla. The study was done in the community of Tehuaxtla, belonging to the municipality Piaxtla in the Mixteca Poblana, which shows a secondary vegetation (arboreal, shrubby) that is consumed by goats in that region. 8 multinutritional blocks were used with Pithecellobium acatlense into two groups of 30 goats. Chemical analysis threw goatee 11.7% CP during the dry season and 14.8% CP for rains regarding consumption of BM group A showed 20% less compared to Group B, with respect to consumption of the block multinutrient the group A was 56 g/day/goat, whilst the group B has consumed 73 g/day/goat, where he converted ±0.14 g/goat/day for this preparation (MB), with a cost /goat when consuming block/8 days 0.14 USD.展开更多
BACKGROUND Underwater endoscopic mucosal resection(UEMR)has been shown to be a good treatment option for the management of nonpedunculated polyps≥10 mm since its introduction.However,there is a paucity of randomized ...BACKGROUND Underwater endoscopic mucosal resection(UEMR)has been shown to be a good treatment option for the management of nonpedunculated polyps≥10 mm since its introduction.However,there is a paucity of randomized controlled trials(RCTs)in Asia.AIM To compare the efficacy and safety of UEMR with those of conventional EMR(CEMR)in treating nonpedunculated colorectal lesions.METHODS We carried out this RCT at a tertiary hospital from October 2022 to July 2024.Patients with nonpedunculated colorectal neoplasms ranging from 10 mm to 30 mm in size were randomly assigned to either the UEMR or CEMR group.The primary outcome was the curative resection(R0)rate.The secondary outcomes included en bloc resection,procedure time,adverse events,and the number of clips used for defect closure.RESULTS A total of 260 patients with 260 lesions(130 in each UEMR and CEMR group)were recruited.The median age was 58(27-85)years,the male/female ratio was 1.74,and the median lesion size was 20(10-30 mm)mm.Compared with CEMR,UEMR was associated with a significantly greater curative resection(R0)rate(98.4%vs 90.3%;P=0.007),greater en bloc resection rate(100%vs 94.6%;P=0.014),shorter procedure time(65 vs 185 seconds;P<0.001),lower rate of bleeding complications(1.5%vs 10%;P=0.003),and fewer clips used(2 vs 3;P<0.001).No perforations were observed in either group.CONCLUSION Compared with CEMR,UEMR has a higher R0 rate,greater en bloc resection rate,shorter procedure time,fewer bleeding complications,and clips used in the management of nonpedunculated colorectal neoplasms.展开更多
Endoscopic submucosal dissection(ESD)has emerged as a pivotal therapeutic modality for early gastrointestinal(GI)cancers,providing a minimally invasive approach with curative potential.This technique enables the en bl...Endoscopic submucosal dissection(ESD)has emerged as a pivotal therapeutic modality for early gastrointestinal(GI)cancers,providing a minimally invasive approach with curative potential.This technique enables the en bloc resection of neoplastic lesions confined to the mucosa and submucosa,thereby preserving organ function and reducing the need for more radical surgical interventions.ESD provides diagnostic clarity and enhances patient survival rates when performed by skilled practitioners in the early stages of GI cancers such as esophageal,gastric,and colorectal carcinomas.This article examines the indications,procedural advancements,technical considerations,and outcomes associated with ESD in early GI cancers.The challenges and complications that can arise are also highlighted.Additionally,we discuss the evolving role of novel techniques and adjunctive therapies to improve safety and efficacy.As the field progresses,ESD remains a cornerstone in managing early GI cancers,offering patients a promising option for organ preservation and long-term survival.展开更多
Objective:Esophageal carcinoma(EC)is a primary global health concern,ranking as the eighth most common cancer and the sixth leading cause of cancer-related mortality.Endoscopic mucosal resection(EMR)and endoscopic sub...Objective:Esophageal carcinoma(EC)is a primary global health concern,ranking as the eighth most common cancer and the sixth leading cause of cancer-related mortality.Endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)are widely used to manage early-stage EC and Barrett’s esophagus.However,their comparative efficacyand safety remain debated.This study aims to systematically compare the safety and efficacyof ESD and EMR in the treatment of early EC and Barrett’s esophagus.Methods:A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines.Databases,including MEDLINE(via PubMed),Google Scholar,and the Cochrane Library were searched for studies published up to October 2024.Twenty-two studies involving 3309 patients(1425 with ESD and 1884 with EMR)met the inclusion criteria.The outcomes assessed included en bloc resection,R0 resection,curative resection,local recurrence,bleeding,perforation,and stricture formation.Risk ratios(RR)with 95%CIs were calculated via a random-effects model via RevMan 5.4.Results:ESD significantlyoutperformed EMR in en bloc resection(RR=2.22,95%CI:1.69–2.90;p<0.001),R0 resection(RR=1.93,95%CI:1.28–2.91;p=0.002),and curative resection rates(RR=2.29,95%CI:1.52–3.46;p<0.001).ESD was associated with lower local recurrence in patients with squamous cell carcinoma(SCC)(RR=0.13,95%CI:0.06–0.30;p<0.001),whereas recurrence was greater in patients with Barrett’s esophagus(RR=1.67,95%CI:1.30–2.14;p<0.001).No significant difference was observed in bleeding rates;however,ESD was associated with a greater risk of perforation(RR=2.94,95%CI:1.31–6.60;p=0.009).Conclusion:ESD is more effective than EMR in achieving complete and curative resections for early EC and SCC,particularly for lesions>20 mm.However,it has a higher complication rate,especially perforation.Careful patient selection and procedural expertise are essential when choosing between the two techniques.展开更多
The management of rectal lesions has been significantly enhanced by advancements in endoscopic and minimally invasive surgical techniques.Endoscopic submucosal dissection(ESD),transanal endoscopic microsurgical submuc...The management of rectal lesions has been significantly enhanced by advancements in endoscopic and minimally invasive surgical techniques.Endoscopic submucosal dissection(ESD),transanal endoscopic microsurgical submucosal dissection(TEM-ESD),and transanal minimally invasive surgery(TAMIS)offer precision and reduced morbidity for treating these conditions.This minireview evaluates the efficacy,safety,and clinical outcomes of ESD,TEM-ESD,and TAMIS,highlighting their roles in the contemporary management of rectal lesions.A desktop research study with a particular focus on ESD,TEM-ESD,and TAMIS for rectal lesions was conducted.Key outcomes assessed include complete resection rates,complication rates,recurrence rates,and functional outcomes following the procedure.ESD is noted for its high rate of en bloc resection with minimal invasiveness,suitable for large or flat lesions.TEM-ESD has demonstrated similar efficacy,with additional benefits including shorter procedure times and a more favorable learning curve,compared to traditional ESD,as evidenced by recent comparative studies.TAMIS offers a less invasive option with enhanced visualization and accessibility,supporting its use in a broader range of rectal lesion cases.ESD,TEM-ESD,and TAMIS are all effective therapeutic options for rectal lesions,each presenting unique advantages depending on lesion characteristics and patient factors.展开更多
With the identification of more than a dozen novel Hermansky-Pudlak Syndrome （HPS） proteins in vesicle trafficking in higher eukaryotes, a new class of trafficking pathways has been described. It mainly consists of ...With the identification of more than a dozen novel Hermansky-Pudlak Syndrome （HPS） proteins in vesicle trafficking in higher eukaryotes, a new class of trafficking pathways has been described. It mainly consists of three newly-defined protein com- plexes, BLOC-l, -2, and -3. Compelling evidence indicates that these complexes together with two other well-known complexes, AP3 and HOPS, play important roles in endosomal transport. The interactions between these complexes form a network in protein trafficking via endosomes and cytoskeleton. Each node of this network has intra-complex and extra-complex interactions. These complexes are connected by direct interactions between the subunits from different complexes or by indirect interactions through coupling nodes that interact with two or more subunits from different complexes. The dissection of this network facilitates the understanding of a dynamic but elaborate transport machinery in protein/membrane trafficking. The disruption of this network may lead to abnormal trafficking or defective organellar development as described in patients with Hermansky-Pudlak syndrome.展开更多
在3D混合虚拟场景的构建过程中,信号的传输和接收非常重要.确保信号的传输和接收达到要求的关键是信号接收模块React building block的建立.文中主要讨论如何使用Microsoft Visual studio2005和Virtools 4.0进行信号接收模块React build...在3D混合虚拟场景的构建过程中,信号的传输和接收非常重要.确保信号的传输和接收达到要求的关键是信号接收模块React building block的建立.文中主要讨论如何使用Microsoft Visual studio2005和Virtools 4.0进行信号接收模块React building block(或简称BB)的创建.展开更多
文摘The elaboration of multinutritional blocs (MB) is an alternative that allows supplement energy, protein, vitamins and minerals, and additionally, it can be administered and take natural resources as protein banks, mainly in the dry season, raising their cost and the concentrates decreasing profitability to producers. An aid is green or dried foliage of the tree-shrub of the Mixteca Poblana that drop their leaves to the ground (dry hay) in the dry season, thus becomes valuable forage consumed by goats, being great for your protein content and low cost in diets of small ruminants in silvopastoral production systems, at the dwindle the foliage of woody perennials in a time of the year. The aim of this study was to develop and meet production costs multinutrient blocks with goatee sheets (Pithecellobium acatlense) consumed by goats in the Mixteca Puebla. The study was done in the community of Tehuaxtla, belonging to the municipality Piaxtla in the Mixteca Poblana, which shows a secondary vegetation (arboreal, shrubby) that is consumed by goats in that region. 8 multinutritional blocks were used with Pithecellobium acatlense into two groups of 30 goats. Chemical analysis threw goatee 11.7% CP during the dry season and 14.8% CP for rains regarding consumption of BM group A showed 20% less compared to Group B, with respect to consumption of the block multinutrient the group A was 56 g/day/goat, whilst the group B has consumed 73 g/day/goat, where he converted ±0.14 g/goat/day for this preparation (MB), with a cost /goat when consuming block/8 days 0.14 USD.
文摘BACKGROUND Underwater endoscopic mucosal resection(UEMR)has been shown to be a good treatment option for the management of nonpedunculated polyps≥10 mm since its introduction.However,there is a paucity of randomized controlled trials(RCTs)in Asia.AIM To compare the efficacy and safety of UEMR with those of conventional EMR(CEMR)in treating nonpedunculated colorectal lesions.METHODS We carried out this RCT at a tertiary hospital from October 2022 to July 2024.Patients with nonpedunculated colorectal neoplasms ranging from 10 mm to 30 mm in size were randomly assigned to either the UEMR or CEMR group.The primary outcome was the curative resection(R0)rate.The secondary outcomes included en bloc resection,procedure time,adverse events,and the number of clips used for defect closure.RESULTS A total of 260 patients with 260 lesions(130 in each UEMR and CEMR group)were recruited.The median age was 58(27-85)years,the male/female ratio was 1.74,and the median lesion size was 20(10-30 mm)mm.Compared with CEMR,UEMR was associated with a significantly greater curative resection(R0)rate(98.4%vs 90.3%;P=0.007),greater en bloc resection rate(100%vs 94.6%;P=0.014),shorter procedure time(65 vs 185 seconds;P<0.001),lower rate of bleeding complications(1.5%vs 10%;P=0.003),and fewer clips used(2 vs 3;P<0.001).No perforations were observed in either group.CONCLUSION Compared with CEMR,UEMR has a higher R0 rate,greater en bloc resection rate,shorter procedure time,fewer bleeding complications,and clips used in the management of nonpedunculated colorectal neoplasms.
文摘Endoscopic submucosal dissection(ESD)has emerged as a pivotal therapeutic modality for early gastrointestinal(GI)cancers,providing a minimally invasive approach with curative potential.This technique enables the en bloc resection of neoplastic lesions confined to the mucosa and submucosa,thereby preserving organ function and reducing the need for more radical surgical interventions.ESD provides diagnostic clarity and enhances patient survival rates when performed by skilled practitioners in the early stages of GI cancers such as esophageal,gastric,and colorectal carcinomas.This article examines the indications,procedural advancements,technical considerations,and outcomes associated with ESD in early GI cancers.The challenges and complications that can arise are also highlighted.Additionally,we discuss the evolving role of novel techniques and adjunctive therapies to improve safety and efficacy.As the field progresses,ESD remains a cornerstone in managing early GI cancers,offering patients a promising option for organ preservation and long-term survival.
文摘Objective:Esophageal carcinoma(EC)is a primary global health concern,ranking as the eighth most common cancer and the sixth leading cause of cancer-related mortality.Endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)are widely used to manage early-stage EC and Barrett’s esophagus.However,their comparative efficacyand safety remain debated.This study aims to systematically compare the safety and efficacyof ESD and EMR in the treatment of early EC and Barrett’s esophagus.Methods:A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines.Databases,including MEDLINE(via PubMed),Google Scholar,and the Cochrane Library were searched for studies published up to October 2024.Twenty-two studies involving 3309 patients(1425 with ESD and 1884 with EMR)met the inclusion criteria.The outcomes assessed included en bloc resection,R0 resection,curative resection,local recurrence,bleeding,perforation,and stricture formation.Risk ratios(RR)with 95%CIs were calculated via a random-effects model via RevMan 5.4.Results:ESD significantlyoutperformed EMR in en bloc resection(RR=2.22,95%CI:1.69–2.90;p<0.001),R0 resection(RR=1.93,95%CI:1.28–2.91;p=0.002),and curative resection rates(RR=2.29,95%CI:1.52–3.46;p<0.001).ESD was associated with lower local recurrence in patients with squamous cell carcinoma(SCC)(RR=0.13,95%CI:0.06–0.30;p<0.001),whereas recurrence was greater in patients with Barrett’s esophagus(RR=1.67,95%CI:1.30–2.14;p<0.001).No significant difference was observed in bleeding rates;however,ESD was associated with a greater risk of perforation(RR=2.94,95%CI:1.31–6.60;p=0.009).Conclusion:ESD is more effective than EMR in achieving complete and curative resections for early EC and SCC,particularly for lesions>20 mm.However,it has a higher complication rate,especially perforation.Careful patient selection and procedural expertise are essential when choosing between the two techniques.
文摘The management of rectal lesions has been significantly enhanced by advancements in endoscopic and minimally invasive surgical techniques.Endoscopic submucosal dissection(ESD),transanal endoscopic microsurgical submucosal dissection(TEM-ESD),and transanal minimally invasive surgery(TAMIS)offer precision and reduced morbidity for treating these conditions.This minireview evaluates the efficacy,safety,and clinical outcomes of ESD,TEM-ESD,and TAMIS,highlighting their roles in the contemporary management of rectal lesions.A desktop research study with a particular focus on ESD,TEM-ESD,and TAMIS for rectal lesions was conducted.Key outcomes assessed include complete resection rates,complication rates,recurrence rates,and functional outcomes following the procedure.ESD is noted for its high rate of en bloc resection with minimal invasiveness,suitable for large or flat lesions.TEM-ESD has demonstrated similar efficacy,with additional benefits including shorter procedure times and a more favorable learning curve,compared to traditional ESD,as evidenced by recent comparative studies.TAMIS offers a less invasive option with enhanced visualization and accessibility,supporting its use in a broader range of rectal lesion cases.ESD,TEM-ESD,and TAMIS are all effective therapeutic options for rectal lesions,each presenting unique advantages depending on lesion characteristics and patient factors.
基金This work was supported in part by the National Science Fund for Distinguished Young Scholars (No. 30525007)National Basic Research Program of China (No. 2006CB504103+1 种基金 No. 2006CB500704)Hi-Tech Research and Development Program of China (No. 2006AA02Z322)
文摘With the identification of more than a dozen novel Hermansky-Pudlak Syndrome （HPS） proteins in vesicle trafficking in higher eukaryotes, a new class of trafficking pathways has been described. It mainly consists of three newly-defined protein com- plexes, BLOC-l, -2, and -3. Compelling evidence indicates that these complexes together with two other well-known complexes, AP3 and HOPS, play important roles in endosomal transport. The interactions between these complexes form a network in protein trafficking via endosomes and cytoskeleton. Each node of this network has intra-complex and extra-complex interactions. These complexes are connected by direct interactions between the subunits from different complexes or by indirect interactions through coupling nodes that interact with two or more subunits from different complexes. The dissection of this network facilitates the understanding of a dynamic but elaborate transport machinery in protein/membrane trafficking. The disruption of this network may lead to abnormal trafficking or defective organellar development as described in patients with Hermansky-Pudlak syndrome.
文摘在3D混合虚拟场景的构建过程中,信号的传输和接收非常重要.确保信号的传输和接收达到要求的关键是信号接收模块React building block的建立.文中主要讨论如何使用Microsoft Visual studio2005和Virtools 4.0进行信号接收模块React building block(或简称BB)的创建.
