Starting from a reading of Jonathan Edwards＇ famous sermon ＂Sinners in the Hands of an Angry God＂, this paper first analyzes the powerful image of ＂sinner＂ in the sermon, then goes on to give a definition of a Ch...Starting from a reading of Jonathan Edwards＇ famous sermon ＂Sinners in the Hands of an Angry God＂, this paper first analyzes the powerful image of ＂sinner＂ in the sermon, then goes on to give a definition of a Christian conception of sin. It is found that while sin is a central conception in the religious system of Christianity, Emptiness is a central idea in Buddhist＇s doctrine. Understanding this conception is a key step on one＇s road to the enlightenment. Buddha＇s emphasis on emptiness is to warn people not to hold everything tight in this world, to stop their craving and grasping, finally to end people＇s suffering in life. Human beings get salvation through the redemption of their sin in a Christian doctrine, while in a Buddhist doctrine, people can only get enlightened and salvation when they are aware of the empty nature of this world, the universe, and themselves展开更多
Self-assembly is deemed to be an effective and inspiring strategy to construct programmable and innovative super-ordered structures.Here,we have,for the first time,achieved the large-area super-ordered two-dimensional...Self-assembly is deemed to be an effective and inspiring strategy to construct programmable and innovative super-ordered structures.Here,we have,for the first time,achieved the large-area super-ordered two-dimensional(2D)emptiness arrays in graphene by silicon dioxide self-assembly pre-occupancy.The prominent uniform periodicity of 2D emptiness arrays in graphene can be flexibly adjusted.The synergistic interaction between the pre-occupancy structural unit and graphene contributes to the successful acquisition of 2D emptiness arrays.The realization of 2D emptiness arrays by self-assembly pre-occupancy strategy would shed light on the rational redaction,fabrication and research of complex 2D super-ordered structure systems and facilitate their applications for various fields,such as highly integrated functional devices,precise location acquisition systems,sensing,separation,and so on.展开更多
In this article, I will examine the concept of xujing 虚静 （emptiness and stillness） in Daoism and its relationship with the aesthetic appreciation of nature and environmental ethics. Firstly, I will examine the Chi...In this article, I will examine the concept of xujing 虚静 （emptiness and stillness） in Daoism and its relationship with the aesthetic appreciation of nature and environmental ethics. Firstly, I will examine the Chinese philosophical understanding of nature through the concept of qi. I point out that qi is characterized by four interrelated features, which are emptiness, creativity, vitality, and stillness. Xujing are also aesthetically appreciated as the objective features of qi. Secondly, ! will discuss why, as the objective features of qi, xujing are considered to be features that have aesthetic value. I argue that empathy is the reason why emptiness as the objective feature of qi is regarded as having aesthetic value. Thirdly, I will discuss how the aesthetic concept of emptiness helps contribute to the construction of place-based environmental ethics.展开更多
BACKGROUND The clinical effectiveness of magnetically controlled capsule endoscopy(MCE)is well established.However,problems,such as abdominal distension,insufficient gastric filling,and prolonged gastric retention tim...BACKGROUND The clinical effectiveness of magnetically controlled capsule endoscopy(MCE)is well established.However,problems,such as abdominal distension,insufficient gastric filling,and prolonged gastric retention time,persist with MCE gastric preparations.AIM To compare gastric filling using a carbonated soft drink with that using pure water during MCE.METHODS We performed an open-label randomised controlled trial at the Endoscopy Centre of Changhai Hospital in Shanghai.Patients aged 18-80 years,with or without gastrointestinal symptoms,scheduled for MCE were consecutively recruited.Those who provided informed consent were randomly assigned to the carbonated soft drink group(C group)or water group(W group)in a 1:1 ratio.For patients in the W group,1000 mL of water was ingested to distend the stomach,whereas for patients in the C group,550 mL of carbonated soft drink was provided,and patients were required to drink quickly while minimising burping.The primary endpoint was the number of patients with a gastric filling score of≥4 within 5 minutes after the capsule entered the stomach.RESULTS From December 3,2020 to May 17,2021,252 patients(141 men),aged 18-77 years,were assigned to the C(n=126)and W(n=126)groups.For the primary outcome,123 patients in the C group achieved a gastric filling score of≥4(97.62%vs 80.16%,P<0.0001).More patients in the C group had the highest gastric filling scores within the first 5 min(78.57%vs 29.37%,P<0.0001)and 10 minutes(54.76%vs 13.49%,P<0.0001)after the capsule entered the stomach.More patients in the W group required extra liquid for gastric refilling(1.59%vs 16.67%,P<0.0001).Transpyloric passage of the capsule under magnetic control was successfully performed in 43 patients in the C group(P<0.0001),accompanied by a shorter gastric transit time(53.27±53.83 minutes vs 71.12±52.19 minutes,P=0.001).CONCLUSION Carbonated soft drinks demonstrated superior and more sustained gastric filling compared with those of water alone,with the potential to promote gastric emptying.展开更多
Gastroparesis is a severe diabetic complication,caused by a progressive multifactorial enteric neuropathy.To make an early diagnosis in patients at risk of diabetic gastroparesis is crucial for slow down its progressi...Gastroparesis is a severe diabetic complication,caused by a progressive multifactorial enteric neuropathy.To make an early diagnosis in patients at risk of diabetic gastroparesis is crucial for slow down its progression towards full-blown disease source of further complications and requesting effective,but unsafe,drugs as well as invasive surgical treatments.This aim can be achieved by detecting its first signal represented by the gastric emptying(GE)delay,by using,among the tests to measure GE,the simple,safe,reliable,and easily available one,that is realtime ultrasonography,possibly done annually.Once the GE delay has been identified,it is necessary to evaluate with endoluminal functional lumen imaging probe or manometry whether it depends on pylorospasm,which should be treated by means of non-surgical endoscopic therapies.If,instead,it depends on initial gastropathy,detected by electrogastrograhic body surface gastric mapping,it should be treated with the safest prokinetic drugs and with the newly emerging treatments,thus distancing heavy medical and surgical treatments,while waiting for future solutions.展开更多
BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain...BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain placement,identify the most effective drain type,and determine the optimal timing for drain removal.METHODS A systematic review of electronic databases,including PubMed,MEDLINE,PubMed Central,and Google Scholar,was conducted using Medical Subject Headings and keywords until December 2023.From an initial pool of 1910 articles,48 were included after exclusion and screening.The primary outcomes analyzed were clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying(DGE),overall morbidity,and mortality.Subgroup analyses were performed for pancreaticoduodenectomy and distal pancreatectomy.RESULTS Routine use of drains is associated with a statistically significant increase in the risk of CR-POPF and DGE.Conversely,patients who did not have drains placed experienced a significant reduction in morbidity,readmission rates,and reoperations.No significant differences were observed between active and passive drain types.Early drain removal(<3 days)yielded favorable outcomes compared to delayed removal.CONCLUSION Analysis of randomized controlled trials and cohort studies did not demonstrate an advantage of routine drain placement following pancreatic resection,potentially contributing to increased morbidity and mortality.The decision to use drains should be left to the discretion of the operating surgeon.However,early drain removal can substantially reduce morbidity.展开更多
BACKGROUND Middle pancreatectomy(MP)is a surgical procedure that removes non-invasive lesions in the pancreatic neck and body,allowing for the preservation of pan-creatic function.However,MP is associated with a highe...BACKGROUND Middle pancreatectomy(MP)is a surgical procedure that removes non-invasive lesions in the pancreatic neck and body,allowing for the preservation of pan-creatic function.However,MP is associated with a higher risk of postoperative complications,and there’s no clear consensus on which anastomotic method is preferable.In recent years,our team has developed a new method called inter-locking main pancreatic duct-jejunal(IMPD-J)internal bridge drainage to MP.AIM To compare perioperative and postoperative outcomes in patients who underwent IMPD-J bridge drainage and those underwent traditional duct-to-mucosa pancreatojejunostomy.METHODS Patients who underwent MP in our hospital between October 1,2011 and July 31,2023 were enrolled in this study.Patients were divided into two groups based on their pancreatojejunostomy technique:IMPD-J bridge drainage group and duct-to-mucosa pancreatojejunostomy group.Demographic data(age,gender,body mass index,hypertension,diabetes,etc.)and perioperative indicators[operation time,intraoperative bleeding,clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying,etc.]were recorded and analyzed statist-ically.RESULTS A total of 53 patients were enrolled in this study,including 23 in the IMPD-J Bridge Drainage group and 30 in the traditional duct-to-mucosa pancreatojejun-ostomy group.There were no significant differences in demographic or preope-rative characteristics between the groups.Compared to traditional duct-to-mucosa pancreaticojejunostomy,IMPD-J bridge drainage had a significant shorter operation time(4.3±1.3 hours vs 5.8±1.8 hours,P=0.002),nasogastric tube retention days(5.3±1.7 days vs 6.5±2.0 days,P=0.031),lower incidence of delayed gastric emptying(8.7%vs 36.7%,P=0.019),and lower incidence of CR-POPF(39.1%vs 70.0%,P=0.025).Multivariate logistic regression analysis showed that pancreaticojejunostomy type(odds ratio=4.219,95%confidence interval=1.238-14.379,P=0.021)and plasma prealbumin(odds ratio=1.132,95%confidence interval=1.001-1.281,P=0.049)were independent risk factor for CR-POPF.In IMPD-J bridge drainage group,only one patient experienced recurrent pancreatitis due to the large diameter of the silicone tube and had it removed six months after surgery.CONCLUSION Compared to traditional duct-to-mucosa pancreatojejunostomy,IMPD-J bridge drainage has the advantages of simplicity and fewer perioperative complications,with favorable long-term outcomes.展开更多
Obesity is a chronic,multifactorial disease closely linked to a spectrum of cardiometabolic disorders,with its global prevalence rising at an alarming rate.In recent years,minimally invasive,safe,and effective endosco...Obesity is a chronic,multifactorial disease closely linked to a spectrum of cardiometabolic disorders,with its global prevalence rising at an alarming rate.In recent years,minimally invasive,safe,and effective endoscopic bariatric therapies have gained significant attention as alternatives to conventional surgical interventions.This review provides a comprehensive overview of various endoscopic weight-loss procedures,evaluating their advantages and limitations in comparison to surgical approaches to assist clinicians in optimizing patientspecific treatment strategies.Endoscopic bariatric therapies,including intragastric balloons,duodenal-jejunal bypass sleeves,endoscopic sleeve gastroplasty,gastric remodeling procedures,and interventions aimed at delaying gastric emptying are systematically reviewed.The efficacy,safety profiles,and clinical applicability are all synthesized.Endoscopic bariatric therapies exhibit distinct advantages and limitations,with varying indications and contraindications.As part of a multidisciplinary approach to obesity management,these procedures should be integrated with lifestyle modifications and nutritional counseling to maximize therapeutic benefits.Future research should focus on the long-term efficacy,safety,and patient-reported outcomes to refine clinical practice and optimize the role of endoscopic interventions in obesity treatment.展开更多
Diabetic gastrointestinal neuropathy is a diabetes-related complication,associated with a complex interplay of hyperglycemic damage,autoimmune responses,oxidative stress,gastrointestinal hormones,and vascular insuffic...Diabetic gastrointestinal neuropathy is a diabetes-related complication,associated with a complex interplay of hyperglycemic damage,autoimmune responses,oxidative stress,gastrointestinal hormones,and vascular insufficiency.Patients with diabetes should be monitored and therapeutic intervention introduced to prevent neuropathy due to diabetes prior to“the point of no return”.Determining gastric bioelectrical activity by body surface gastric mapping may be a promising option to monitor diabetic gastrointestinal neuropathy.展开更多
Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associate...Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associated with an increased length of hospital stay, increased healthcare costs, and a high readmission rate. We reviewed published studies on various technical modifications to reduce the incidence of DGE. Data sources: Studies were identified by searching Pub Med for relevant articles published up to December 2022. The following search terms were used: “pancreaticoduodenectomy”, “pancreaticojejunostomy”, “pancreaticogastrostomy”, “gastric emptying”, “gastroparesis” and “postoperative complications”. The search was limited to English publications. Additional articles were identified by a manual search of references from key articles. Results: In recent years, various surgical procedures and techniques have been explored to reduce the incidence of DGE. Pyloric resection, Billroth II reconstruction, Braun's enteroenterostomy, and antecolic reconstruction may be associated with a decreased incidence of DGE, but more high-powered studies are needed in the future. Neither laparoscopic nor robotic surgery has demonstrated superiority in preventing DGE, and the use of staplers is controversial regarding whether they can reduce the incidence of DGE. Conclusions: Despite many innovations in surgical techniques, there is no surgical procedure that is superior to others to reduce DGE. Further larger prospective randomized studies are needed.展开更多
Background:Jianqu has been used to alleviate symptoms in patients with functional dyspepsia,but its specific anti-functional dyspepsia effect is still unclear.Therefore,our study aimed to investigate the impact of Jia...Background:Jianqu has been used to alleviate symptoms in patients with functional dyspepsia,but its specific anti-functional dyspepsia effect is still unclear.Therefore,our study aimed to investigate the impact of Jianqu on functional dyspepsia in mice.Methods:The phytochemical profile of Jianqu was analyzed by UPLC-Q-TOF-MS.Subsequently,Kunming mice were fed a high-calorie or high-protein diet(HCHP)for 7 days,and then orally treated with vehicle or Jianqu(1.62 g/kg body weight(b.w.)and 3.25 g/kg b.w.)for 10 days.A carbon powder solution was used to detect the gastric emptying and intestinal transit rate.The pathological changes in stomach and duodenum were evaluated by hematoxylin-eosin staining.The occludin,claudin-1,ZO-1 and CD45 expression was measured by immunocytochemical staining.Importantly,the serum gastrointestinal hormones were detected by ELISA.In addition,the gut microbiota composition was determined using 16S rRNA gene sequencing.The cecal short chain fatty acids were assessed by gas chromatography.Results:In general,17 phytochemical compounds were identified from Jianqu,which significantly improved the gastric emptying rate and intestinal transit rate(p<0.01),increased the body weight and food intake(p<0.0001)in HCHP mice as well.Though HCHP did not cause significant pathological lesions in the gastrointestinal tract,increased the expression of CD45 in the duodenum(p<0.05)was observed.Notably,Jianqu attenuated this abnormal expression of CD45(p<0.05).The levels of serum gastrointestinal hormones were significantly normalized by Jianqu intervention(p<0.05).Moreover,Jianqu increased the relative abundance of Roseburia as well as short chain fatty acids levels in cecum(p<0.05).Conclusion:The present results showed that Jianqu alleviated dyspeptic symptoms in HCHP mice possibly through reducing the duodenal leukocyte infiltration,and regulating the expression of gastrointestinal hormones.These effects may be partly related to the increasing cecal short chain fatty acids levels probably via gut microbial modulation.展开更多
Gestational diabetes mellitus(GDM)represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term.Lifestyle intervention...Gestational diabetes mellitus(GDM)represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term.Lifestyle intervention remains the mainstay for the management of GDM.The efficacy of nutritional approaches(e.g.calorie restriction and small frequent meals)to improving the maternal-neonatal outcomes of GDM was attested to by Chinese population data,discussed in two articles in recent issues of this journal.However,a specific focus on the relevance of postprandial glycaemic control was lacking.Postprandial rather than fasting hyperglycaemia often represents the predominant manifestation of disordered glucose homeostasis in Chinese women with GDM.There is now increasing appreciation that the rate of gastric emptying,which controls the delivery of nutrients for digestion and absorption in the small intestine,is a key determinant of postprandial glycaemia in both health,type 1 and 2 diabetes.It remains to be established whether gastric emptying is abnormally rapid in GDM,particularly among Chinese women,thus contributing to a predisposition to postprandial hyperglycaemia,and if so,how this influences the therapeutic response to nutritional interventions.It is essential that we understand the role of gastric emptying in the regulation of postprandial glycaemia during pregnancy and the potential for its modulation by nutritional strategies in order to improve postprandial glycaemic control in GDM.展开更多
This editorial is stimulated by the article by Alqifari et al published in the World Journal of Diabetes(2024).Alqifari et al focus on practical advice for the clinical use of glucagon-like-peptide-1(GLP-1)receptor ag...This editorial is stimulated by the article by Alqifari et al published in the World Journal of Diabetes(2024).Alqifari et al focus on practical advice for the clinical use of glucagon-like-peptide-1(GLP-1)receptor agonists(GLP-1RAs)in the management of type 2 diabetes and this editorial provides complementary information.We initially give a brief historical perspective of the development of GLP-1RAs stimulated by recognition of the‘incretin effect’,the substantially greater insulin increase to enteral when compared to euglycaemic intravenous glucose,and the identification of the incretin hormones,GIP and GLP-1.In addition to stimulating insulin,GLP-1 reduces postprandial glucose levels by slowing gastric emptying.GLP-1RAs were developed because native GLP-1 has a very short plasma half-life.The majority of current GLP-1RAs are administered by subcutaneous injection once a week.They are potent in glucose lowering without leading to hypoglycaemia,stimulate weight loss in obese individuals and lead to cardiovascular and renal protection.The landscape in relation to GLP-1RAs is broadening rapidly,with different formulations and their combination with other peptides to facilitate both glucose lowering and weight loss.There is a need for more information relating to the effects of GLP-1RAs to induce gastrointestinal symptoms and slow gastric emptying which is likely to allow their use to become more effective and personalised.展开更多
[Objectives]To explore the effects of Polygona fallax Hemsl water extract on gastrointestinal motility in normal mice and gastric motility disorder model mice and approximate mechanism.[Methods]Using normal mice and m...[Objectives]To explore the effects of Polygona fallax Hemsl water extract on gastrointestinal motility in normal mice and gastric motility disorder model mice and approximate mechanism.[Methods]Using normal mice and mice with gastric motility disorders(modeled with atropine),the effects of different mass concentration groups of P.fallax Hemsl water extract(0.125,0.250,0.500 g/mL)and domperidone groups on gastric residual rate,small intestine propulsion rate,serum motilin(MLT),vasoactive intestinal peptide(VIP),and tissue morphology were studied.[Results]There was a highly significant difference(P<0.01)in the small intestine propulsion rate of liquid in normal mice among the different concentration groups of P.fallax Hemsl water extract compared to the blank group.The small intestine propulsion rate and gastric residue rate of semi-solid paste were statistically significant compared to the blank group(P<0.05).Among them,there was a highly significant difference between the high concentration group(67.75%±7.65%,46.5%±10.62%)and the medium concentration group(60.90%±5.87%,59.27%±7.82%)(P<0.01).There was statistical significance in normal mouse serum MLT content in the high concentration group(P<0.05).There was no effect on serum VIP levels in normal mice;no effect on the morphology of stomach and intestinal tissues of normal mice.The small intestine propulsion rate and gastric residue rate of liquid and semi-solid paste in mice with gastric motility disorders were statistically significant compared to the atropine group,with extremely significant differences(P<0.01).[Conclusions]P.fallax Hemsl water extract has a promoting effect on gastrointestinal motility.One of the specific mechanisms by which P.fallax Hemsl promotes gastrointestinal motility in normal mice may be related to the content of MLT in mouse serum.The mechanism of action in atropine induced gastric paresis mice may be related to the reactivation of M receptors,and the action mechanism of P.fallax Hemsl does not change the original histological basis.It can be inferred that P.fallax Hemsl water extract has a synergistic effect on promoting gastrointestinal motility through other mechanisms,but it is not fully understood and further in-depth research is needed.展开更多
T.S.Eliot,a great American poet in the twentieth century,is a spokesman of the Imagist Movement.He emphasizes describing the rotten Western civilization and the decayed morals after the First World War.Prufrock that T...T.S.Eliot,a great American poet in the twentieth century,is a spokesman of the Imagist Movement.He emphasizes describing the rotten Western civilization and the decayed morals after the First World War.Prufrock that T.S.Eliot described in his early poems is timid,hesitant,sensitive,anxious,lack of will and confidence;This paper will analyze the detailed behaviors of the characters in Eliot's early poems and reveal the major image of modern men more clearly.展开更多
This paper first proposes that a physical entity such as an electron and a cosmological entity such as a photon belong to two different levels of the Universe. When declaring that space is a vacuum, we are referring t...This paper first proposes that a physical entity such as an electron and a cosmological entity such as a photon belong to two different levels of the Universe. When declaring that space is a vacuum, we are referring to the physical vacuum, and not the cosmological vacuum. The paper propounds that the space we observe is a fabric of cosmological substances. We cannot presume that something fills the emptiness of space. This paper posits that the fab-ric of cosmological substances creates this emptiness to facilitate physical activities such as electromagnetic waves and gravitational pull. Second, the space fabric is a spatial cosmo-logical phenomenon, whereas time is a physical phenomenon operated by a physical entity. The spacetime continuum is created by physical time acquiring the cosmological space fab-ric. The third part of this paper explains the structure and ingredients of the space fabric. The structure itself explains several cosmological phenomena, including electromagnetic waves, gravitation, light, magnetism, dark matter, and dark energy. The philosophical cor-rectness of the paper is validated through the unification of multidisciplinary aspects, and its scientific correctness is validated by its logical consistency with the results of well-known experiments.展开更多
Happiness, as much a poetic as a philosophical, sociological, and psychological concept, has been, through the ages, at the heart of the needs each individual seeks to fulfil. But today, in a world dominated by techno...Happiness, as much a poetic as a philosophical, sociological, and psychological concept, has been, through the ages, at the heart of the needs each individual seeks to fulfil. But today, in a world dominated by technology, driven by productivity and dictated by efficiency, what about Happiness？ Does it feature in works of fiction in any significant way？ May it not have adopted different guises？ ls that ＂duty of happiness＂ that Pascal Bruckner was talking about present in the French novel of the 20th-21th centuries？ And if it is, has its force strengthened or weakened？ This article will discuss the French Novels （of the 20th-21th centuries） that are devoted to or associated with Happiness in a direct or indirect manner. It will contextualize and analyze the transformation of Happiness, within the context of the historical and social events that influenced that period： the Holocaust, consumerism, postmodernism, structural social changes, the various as yet unarticulated new modes of life they created, and so on. To that end, this article will explore the discursive philosophical concept of happiness and its influence on the formation of the French novel. In so doing it will focus on the explicit discourse behind the motifs, the choices made in the process of writing, and the attitudes taken, considering the theme of happiness. Doing so, a significant discussion will be included regarding the paths of happiness, its agents, and the nature of the motifs and metaphors linked to the theme of happiness. The author will also address the dialectical role of the happiness theme in the constitution of an emerging literary discourse reflected in the French novel. By exploring the manifestation of the dogmas, ideas of the intellectual leaders of the 20th century （e.g., Jean-Paul Sartre, Simone De Beauvoir, Albert Camus） as well as the ones of the 21th century （e.g., Pascal Bruckner, Andr6 Comte-Sponville, Gilles Lipovetsky） new insights concerning the hybrid nature of the supposedly ＂authentic happiness＂ will be revealed. The author intend to inspect the theme of Happiness around four dialectical axes as a relevant ethical basis for delimiting the various fields of research： （1） Love, passion, and conjugality; （2） Ageing; （3） ＂The experience of everydayness＂; and （4） ＂The era of emptiness＂. Focusing on the narratives, the article takes into account their specificity in the four distinct fields, all connected to existential and ethical issues, Finally, this article will attempt to analyse the assumed role of literature as a conduit of cultural awareness.展开更多
Loop quantum gravity is considered to be one of the two major candidates for a theory of quantum gravity. The most appealing aspect about this theory is it predicts that spacetime is not continuous;both space and time...Loop quantum gravity is considered to be one of the two major candidates for a theory of quantum gravity. The most appealing aspect about this theory is it predicts that spacetime is not continuous;both space and time have a discrete nature. Simply, space is not infinitely divisible, but it has a granular structure, and time does not flow continuously like a smooth river. This paper demonstrates a review for two missed (unnoted) observations that support the discreteness of the spacetime. The content of this paper does not validate the specific model of quantized geometry of the spacetime which is predicted by the theory itself. Instead, it proves that time does not flow continuously. But it flows in certain, discrete steps, like a ticking of a clock, due to a simple observation which is absence of any possible value of time that can exist between the present and the future. Regarding space, it validates the spatial discreteness, and the existence of spatial granules (space quanta) due to a simple observation which is the existence of the origin position in a coordinates system. All of this is achieved by reviewing the concept of discreteness itself, and applied directly to the observations.展开更多
文摘Starting from a reading of Jonathan Edwards＇ famous sermon ＂Sinners in the Hands of an Angry God＂, this paper first analyzes the powerful image of ＂sinner＂ in the sermon, then goes on to give a definition of a Christian conception of sin. It is found that while sin is a central conception in the religious system of Christianity, Emptiness is a central idea in Buddhist＇s doctrine. Understanding this conception is a key step on one＇s road to the enlightenment. Buddha＇s emphasis on emptiness is to warn people not to hold everything tight in this world, to stop their craving and grasping, finally to end people＇s suffering in life. Human beings get salvation through the redemption of their sin in a Christian doctrine, while in a Buddhist doctrine, people can only get enlightened and salvation when they are aware of the empty nature of this world, the universe, and themselves
基金supported by the National Natural Science Foundation of China(22025303 and 21905210)the Sino-German Center for Research Promotion(GZ 1400)。
文摘Self-assembly is deemed to be an effective and inspiring strategy to construct programmable and innovative super-ordered structures.Here,we have,for the first time,achieved the large-area super-ordered two-dimensional(2D)emptiness arrays in graphene by silicon dioxide self-assembly pre-occupancy.The prominent uniform periodicity of 2D emptiness arrays in graphene can be flexibly adjusted.The synergistic interaction between the pre-occupancy structural unit and graphene contributes to the successful acquisition of 2D emptiness arrays.The realization of 2D emptiness arrays by self-assembly pre-occupancy strategy would shed light on the rational redaction,fabrication and research of complex 2D super-ordered structure systems and facilitate their applications for various fields,such as highly integrated functional devices,precise location acquisition systems,sensing,separation,and so on.
文摘In this article, I will examine the concept of xujing 虚静 （emptiness and stillness） in Daoism and its relationship with the aesthetic appreciation of nature and environmental ethics. Firstly, I will examine the Chinese philosophical understanding of nature through the concept of qi. I point out that qi is characterized by four interrelated features, which are emptiness, creativity, vitality, and stillness. Xujing are also aesthetically appreciated as the objective features of qi. Secondly, ! will discuss why, as the objective features of qi, xujing are considered to be features that have aesthetic value. I argue that empathy is the reason why emptiness as the objective feature of qi is regarded as having aesthetic value. Thirdly, I will discuss how the aesthetic concept of emptiness helps contribute to the construction of place-based environmental ethics.
基金Supported by Shanghai Municipal Hospital Emerging Frontier Technology Joint Project,No.SHDC12019105Shanghai Science and Technology Development Funds,No.24YF2758200National Natural Science Foundation of China,No.82100699.
文摘BACKGROUND The clinical effectiveness of magnetically controlled capsule endoscopy(MCE)is well established.However,problems,such as abdominal distension,insufficient gastric filling,and prolonged gastric retention time,persist with MCE gastric preparations.AIM To compare gastric filling using a carbonated soft drink with that using pure water during MCE.METHODS We performed an open-label randomised controlled trial at the Endoscopy Centre of Changhai Hospital in Shanghai.Patients aged 18-80 years,with or without gastrointestinal symptoms,scheduled for MCE were consecutively recruited.Those who provided informed consent were randomly assigned to the carbonated soft drink group(C group)or water group(W group)in a 1:1 ratio.For patients in the W group,1000 mL of water was ingested to distend the stomach,whereas for patients in the C group,550 mL of carbonated soft drink was provided,and patients were required to drink quickly while minimising burping.The primary endpoint was the number of patients with a gastric filling score of≥4 within 5 minutes after the capsule entered the stomach.RESULTS From December 3,2020 to May 17,2021,252 patients(141 men),aged 18-77 years,were assigned to the C(n=126)and W(n=126)groups.For the primary outcome,123 patients in the C group achieved a gastric filling score of≥4(97.62%vs 80.16%,P<0.0001).More patients in the C group had the highest gastric filling scores within the first 5 min(78.57%vs 29.37%,P<0.0001)and 10 minutes(54.76%vs 13.49%,P<0.0001)after the capsule entered the stomach.More patients in the W group required extra liquid for gastric refilling(1.59%vs 16.67%,P<0.0001).Transpyloric passage of the capsule under magnetic control was successfully performed in 43 patients in the C group(P<0.0001),accompanied by a shorter gastric transit time(53.27±53.83 minutes vs 71.12±52.19 minutes,P=0.001).CONCLUSION Carbonated soft drinks demonstrated superior and more sustained gastric filling compared with those of water alone,with the potential to promote gastric emptying.
文摘Gastroparesis is a severe diabetic complication,caused by a progressive multifactorial enteric neuropathy.To make an early diagnosis in patients at risk of diabetic gastroparesis is crucial for slow down its progression towards full-blown disease source of further complications and requesting effective,but unsafe,drugs as well as invasive surgical treatments.This aim can be achieved by detecting its first signal represented by the gastric emptying(GE)delay,by using,among the tests to measure GE,the simple,safe,reliable,and easily available one,that is realtime ultrasonography,possibly done annually.Once the GE delay has been identified,it is necessary to evaluate with endoluminal functional lumen imaging probe or manometry whether it depends on pylorospasm,which should be treated by means of non-surgical endoscopic therapies.If,instead,it depends on initial gastropathy,detected by electrogastrograhic body surface gastric mapping,it should be treated with the safest prokinetic drugs and with the newly emerging treatments,thus distancing heavy medical and surgical treatments,while waiting for future solutions.
文摘BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain placement,identify the most effective drain type,and determine the optimal timing for drain removal.METHODS A systematic review of electronic databases,including PubMed,MEDLINE,PubMed Central,and Google Scholar,was conducted using Medical Subject Headings and keywords until December 2023.From an initial pool of 1910 articles,48 were included after exclusion and screening.The primary outcomes analyzed were clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying(DGE),overall morbidity,and mortality.Subgroup analyses were performed for pancreaticoduodenectomy and distal pancreatectomy.RESULTS Routine use of drains is associated with a statistically significant increase in the risk of CR-POPF and DGE.Conversely,patients who did not have drains placed experienced a significant reduction in morbidity,readmission rates,and reoperations.No significant differences were observed between active and passive drain types.Early drain removal(<3 days)yielded favorable outcomes compared to delayed removal.CONCLUSION Analysis of randomized controlled trials and cohort studies did not demonstrate an advantage of routine drain placement following pancreatic resection,potentially contributing to increased morbidity and mortality.The decision to use drains should be left to the discretion of the operating surgeon.However,early drain removal can substantially reduce morbidity.
文摘BACKGROUND Middle pancreatectomy(MP)is a surgical procedure that removes non-invasive lesions in the pancreatic neck and body,allowing for the preservation of pan-creatic function.However,MP is associated with a higher risk of postoperative complications,and there’s no clear consensus on which anastomotic method is preferable.In recent years,our team has developed a new method called inter-locking main pancreatic duct-jejunal(IMPD-J)internal bridge drainage to MP.AIM To compare perioperative and postoperative outcomes in patients who underwent IMPD-J bridge drainage and those underwent traditional duct-to-mucosa pancreatojejunostomy.METHODS Patients who underwent MP in our hospital between October 1,2011 and July 31,2023 were enrolled in this study.Patients were divided into two groups based on their pancreatojejunostomy technique:IMPD-J bridge drainage group and duct-to-mucosa pancreatojejunostomy group.Demographic data(age,gender,body mass index,hypertension,diabetes,etc.)and perioperative indicators[operation time,intraoperative bleeding,clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying,etc.]were recorded and analyzed statist-ically.RESULTS A total of 53 patients were enrolled in this study,including 23 in the IMPD-J Bridge Drainage group and 30 in the traditional duct-to-mucosa pancreatojejun-ostomy group.There were no significant differences in demographic or preope-rative characteristics between the groups.Compared to traditional duct-to-mucosa pancreaticojejunostomy,IMPD-J bridge drainage had a significant shorter operation time(4.3±1.3 hours vs 5.8±1.8 hours,P=0.002),nasogastric tube retention days(5.3±1.7 days vs 6.5±2.0 days,P=0.031),lower incidence of delayed gastric emptying(8.7%vs 36.7%,P=0.019),and lower incidence of CR-POPF(39.1%vs 70.0%,P=0.025).Multivariate logistic regression analysis showed that pancreaticojejunostomy type(odds ratio=4.219,95%confidence interval=1.238-14.379,P=0.021)and plasma prealbumin(odds ratio=1.132,95%confidence interval=1.001-1.281,P=0.049)were independent risk factor for CR-POPF.In IMPD-J bridge drainage group,only one patient experienced recurrent pancreatitis due to the large diameter of the silicone tube and had it removed six months after surgery.CONCLUSION Compared to traditional duct-to-mucosa pancreatojejunostomy,IMPD-J bridge drainage has the advantages of simplicity and fewer perioperative complications,with favorable long-term outcomes.
基金Supported by National Natural Science Foundation of China,No.81602056 and No.82273393the Young Talents Promotion Project of Shandong Medical Association in 2023,No.2023-GJ-0087.
文摘Obesity is a chronic,multifactorial disease closely linked to a spectrum of cardiometabolic disorders,with its global prevalence rising at an alarming rate.In recent years,minimally invasive,safe,and effective endoscopic bariatric therapies have gained significant attention as alternatives to conventional surgical interventions.This review provides a comprehensive overview of various endoscopic weight-loss procedures,evaluating their advantages and limitations in comparison to surgical approaches to assist clinicians in optimizing patientspecific treatment strategies.Endoscopic bariatric therapies,including intragastric balloons,duodenal-jejunal bypass sleeves,endoscopic sleeve gastroplasty,gastric remodeling procedures,and interventions aimed at delaying gastric emptying are systematically reviewed.The efficacy,safety profiles,and clinical applicability are all synthesized.Endoscopic bariatric therapies exhibit distinct advantages and limitations,with varying indications and contraindications.As part of a multidisciplinary approach to obesity management,these procedures should be integrated with lifestyle modifications and nutritional counseling to maximize therapeutic benefits.Future research should focus on the long-term efficacy,safety,and patient-reported outcomes to refine clinical practice and optimize the role of endoscopic interventions in obesity treatment.
文摘Diabetic gastrointestinal neuropathy is a diabetes-related complication,associated with a complex interplay of hyperglycemic damage,autoimmune responses,oxidative stress,gastrointestinal hormones,and vascular insufficiency.Patients with diabetes should be monitored and therapeutic intervention introduced to prevent neuropathy due to diabetes prior to“the point of no return”.Determining gastric bioelectrical activity by body surface gastric mapping may be a promising option to monitor diabetic gastrointestinal neuropathy.
文摘Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associated with an increased length of hospital stay, increased healthcare costs, and a high readmission rate. We reviewed published studies on various technical modifications to reduce the incidence of DGE. Data sources: Studies were identified by searching Pub Med for relevant articles published up to December 2022. The following search terms were used: “pancreaticoduodenectomy”, “pancreaticojejunostomy”, “pancreaticogastrostomy”, “gastric emptying”, “gastroparesis” and “postoperative complications”. The search was limited to English publications. Additional articles were identified by a manual search of references from key articles. Results: In recent years, various surgical procedures and techniques have been explored to reduce the incidence of DGE. Pyloric resection, Billroth II reconstruction, Braun's enteroenterostomy, and antecolic reconstruction may be associated with a decreased incidence of DGE, but more high-powered studies are needed in the future. Neither laparoscopic nor robotic surgery has demonstrated superiority in preventing DGE, and the use of staplers is controversial regarding whether they can reduce the incidence of DGE. Conclusions: Despite many innovations in surgical techniques, there is no surgical procedure that is superior to others to reduce DGE. Further larger prospective randomized studies are needed.
基金supported by the Traditional Chinese Medicine Science and technology research Project of Sichuan Province Science and Technology Department(grant number 2021MS113)"Xinglin Scholar"Talent Research Promotion Plan of Chengdu University of Traditional Chinese Medicine(grant number ZYTS2019022).
文摘Background:Jianqu has been used to alleviate symptoms in patients with functional dyspepsia,but its specific anti-functional dyspepsia effect is still unclear.Therefore,our study aimed to investigate the impact of Jianqu on functional dyspepsia in mice.Methods:The phytochemical profile of Jianqu was analyzed by UPLC-Q-TOF-MS.Subsequently,Kunming mice were fed a high-calorie or high-protein diet(HCHP)for 7 days,and then orally treated with vehicle or Jianqu(1.62 g/kg body weight(b.w.)and 3.25 g/kg b.w.)for 10 days.A carbon powder solution was used to detect the gastric emptying and intestinal transit rate.The pathological changes in stomach and duodenum were evaluated by hematoxylin-eosin staining.The occludin,claudin-1,ZO-1 and CD45 expression was measured by immunocytochemical staining.Importantly,the serum gastrointestinal hormones were detected by ELISA.In addition,the gut microbiota composition was determined using 16S rRNA gene sequencing.The cecal short chain fatty acids were assessed by gas chromatography.Results:In general,17 phytochemical compounds were identified from Jianqu,which significantly improved the gastric emptying rate and intestinal transit rate(p<0.01),increased the body weight and food intake(p<0.0001)in HCHP mice as well.Though HCHP did not cause significant pathological lesions in the gastrointestinal tract,increased the expression of CD45 in the duodenum(p<0.05)was observed.Notably,Jianqu attenuated this abnormal expression of CD45(p<0.05).The levels of serum gastrointestinal hormones were significantly normalized by Jianqu intervention(p<0.05).Moreover,Jianqu increased the relative abundance of Roseburia as well as short chain fatty acids levels in cecum(p<0.05).Conclusion:The present results showed that Jianqu alleviated dyspeptic symptoms in HCHP mice possibly through reducing the duodenal leukocyte infiltration,and regulating the expression of gastrointestinal hormones.These effects may be partly related to the increasing cecal short chain fatty acids levels probably via gut microbial modulation.
文摘Gestational diabetes mellitus(GDM)represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term.Lifestyle intervention remains the mainstay for the management of GDM.The efficacy of nutritional approaches(e.g.calorie restriction and small frequent meals)to improving the maternal-neonatal outcomes of GDM was attested to by Chinese population data,discussed in two articles in recent issues of this journal.However,a specific focus on the relevance of postprandial glycaemic control was lacking.Postprandial rather than fasting hyperglycaemia often represents the predominant manifestation of disordered glucose homeostasis in Chinese women with GDM.There is now increasing appreciation that the rate of gastric emptying,which controls the delivery of nutrients for digestion and absorption in the small intestine,is a key determinant of postprandial glycaemia in both health,type 1 and 2 diabetes.It remains to be established whether gastric emptying is abnormally rapid in GDM,particularly among Chinese women,thus contributing to a predisposition to postprandial hyperglycaemia,and if so,how this influences the therapeutic response to nutritional interventions.It is essential that we understand the role of gastric emptying in the regulation of postprandial glycaemia during pregnancy and the potential for its modulation by nutritional strategies in order to improve postprandial glycaemic control in GDM.
文摘This editorial is stimulated by the article by Alqifari et al published in the World Journal of Diabetes(2024).Alqifari et al focus on practical advice for the clinical use of glucagon-like-peptide-1(GLP-1)receptor agonists(GLP-1RAs)in the management of type 2 diabetes and this editorial provides complementary information.We initially give a brief historical perspective of the development of GLP-1RAs stimulated by recognition of the‘incretin effect’,the substantially greater insulin increase to enteral when compared to euglycaemic intravenous glucose,and the identification of the incretin hormones,GIP and GLP-1.In addition to stimulating insulin,GLP-1 reduces postprandial glucose levels by slowing gastric emptying.GLP-1RAs were developed because native GLP-1 has a very short plasma half-life.The majority of current GLP-1RAs are administered by subcutaneous injection once a week.They are potent in glucose lowering without leading to hypoglycaemia,stimulate weight loss in obese individuals and lead to cardiovascular and renal protection.The landscape in relation to GLP-1RAs is broadening rapidly,with different formulations and their combination with other peptides to facilitate both glucose lowering and weight loss.There is a need for more information relating to the effects of GLP-1RAs to induce gastrointestinal symptoms and slow gastric emptying which is likely to allow their use to become more effective and personalised.
基金2022 National College Student Innovation and Entrepreneurship Training Program(202210599004).
文摘[Objectives]To explore the effects of Polygona fallax Hemsl water extract on gastrointestinal motility in normal mice and gastric motility disorder model mice and approximate mechanism.[Methods]Using normal mice and mice with gastric motility disorders(modeled with atropine),the effects of different mass concentration groups of P.fallax Hemsl water extract(0.125,0.250,0.500 g/mL)and domperidone groups on gastric residual rate,small intestine propulsion rate,serum motilin(MLT),vasoactive intestinal peptide(VIP),and tissue morphology were studied.[Results]There was a highly significant difference(P<0.01)in the small intestine propulsion rate of liquid in normal mice among the different concentration groups of P.fallax Hemsl water extract compared to the blank group.The small intestine propulsion rate and gastric residue rate of semi-solid paste were statistically significant compared to the blank group(P<0.05).Among them,there was a highly significant difference between the high concentration group(67.75%±7.65%,46.5%±10.62%)and the medium concentration group(60.90%±5.87%,59.27%±7.82%)(P<0.01).There was statistical significance in normal mouse serum MLT content in the high concentration group(P<0.05).There was no effect on serum VIP levels in normal mice;no effect on the morphology of stomach and intestinal tissues of normal mice.The small intestine propulsion rate and gastric residue rate of liquid and semi-solid paste in mice with gastric motility disorders were statistically significant compared to the atropine group,with extremely significant differences(P<0.01).[Conclusions]P.fallax Hemsl water extract has a promoting effect on gastrointestinal motility.One of the specific mechanisms by which P.fallax Hemsl promotes gastrointestinal motility in normal mice may be related to the content of MLT in mouse serum.The mechanism of action in atropine induced gastric paresis mice may be related to the reactivation of M receptors,and the action mechanism of P.fallax Hemsl does not change the original histological basis.It can be inferred that P.fallax Hemsl water extract has a synergistic effect on promoting gastrointestinal motility through other mechanisms,but it is not fully understood and further in-depth research is needed.
文摘T.S.Eliot,a great American poet in the twentieth century,is a spokesman of the Imagist Movement.He emphasizes describing the rotten Western civilization and the decayed morals after the First World War.Prufrock that T.S.Eliot described in his early poems is timid,hesitant,sensitive,anxious,lack of will and confidence;This paper will analyze the detailed behaviors of the characters in Eliot's early poems and reveal the major image of modern men more clearly.
文摘This paper first proposes that a physical entity such as an electron and a cosmological entity such as a photon belong to two different levels of the Universe. When declaring that space is a vacuum, we are referring to the physical vacuum, and not the cosmological vacuum. The paper propounds that the space we observe is a fabric of cosmological substances. We cannot presume that something fills the emptiness of space. This paper posits that the fab-ric of cosmological substances creates this emptiness to facilitate physical activities such as electromagnetic waves and gravitational pull. Second, the space fabric is a spatial cosmo-logical phenomenon, whereas time is a physical phenomenon operated by a physical entity. The spacetime continuum is created by physical time acquiring the cosmological space fab-ric. The third part of this paper explains the structure and ingredients of the space fabric. The structure itself explains several cosmological phenomena, including electromagnetic waves, gravitation, light, magnetism, dark matter, and dark energy. The philosophical cor-rectness of the paper is validated through the unification of multidisciplinary aspects, and its scientific correctness is validated by its logical consistency with the results of well-known experiments.
文摘Happiness, as much a poetic as a philosophical, sociological, and psychological concept, has been, through the ages, at the heart of the needs each individual seeks to fulfil. But today, in a world dominated by technology, driven by productivity and dictated by efficiency, what about Happiness？ Does it feature in works of fiction in any significant way？ May it not have adopted different guises？ ls that ＂duty of happiness＂ that Pascal Bruckner was talking about present in the French novel of the 20th-21th centuries？ And if it is, has its force strengthened or weakened？ This article will discuss the French Novels （of the 20th-21th centuries） that are devoted to or associated with Happiness in a direct or indirect manner. It will contextualize and analyze the transformation of Happiness, within the context of the historical and social events that influenced that period： the Holocaust, consumerism, postmodernism, structural social changes, the various as yet unarticulated new modes of life they created, and so on. To that end, this article will explore the discursive philosophical concept of happiness and its influence on the formation of the French novel. In so doing it will focus on the explicit discourse behind the motifs, the choices made in the process of writing, and the attitudes taken, considering the theme of happiness. Doing so, a significant discussion will be included regarding the paths of happiness, its agents, and the nature of the motifs and metaphors linked to the theme of happiness. The author will also address the dialectical role of the happiness theme in the constitution of an emerging literary discourse reflected in the French novel. By exploring the manifestation of the dogmas, ideas of the intellectual leaders of the 20th century （e.g., Jean-Paul Sartre, Simone De Beauvoir, Albert Camus） as well as the ones of the 21th century （e.g., Pascal Bruckner, Andr6 Comte-Sponville, Gilles Lipovetsky） new insights concerning the hybrid nature of the supposedly ＂authentic happiness＂ will be revealed. The author intend to inspect the theme of Happiness around four dialectical axes as a relevant ethical basis for delimiting the various fields of research： （1） Love, passion, and conjugality; （2） Ageing; （3） ＂The experience of everydayness＂; and （4） ＂The era of emptiness＂. Focusing on the narratives, the article takes into account their specificity in the four distinct fields, all connected to existential and ethical issues, Finally, this article will attempt to analyse the assumed role of literature as a conduit of cultural awareness.
文摘Loop quantum gravity is considered to be one of the two major candidates for a theory of quantum gravity. The most appealing aspect about this theory is it predicts that spacetime is not continuous;both space and time have a discrete nature. Simply, space is not infinitely divisible, but it has a granular structure, and time does not flow continuously like a smooth river. This paper demonstrates a review for two missed (unnoted) observations that support the discreteness of the spacetime. The content of this paper does not validate the specific model of quantized geometry of the spacetime which is predicted by the theory itself. Instead, it proves that time does not flow continuously. But it flows in certain, discrete steps, like a ticking of a clock, due to a simple observation which is absence of any possible value of time that can exist between the present and the future. Regarding space, it validates the spatial discreteness, and the existence of spatial granules (space quanta) due to a simple observation which is the existence of the origin position in a coordinates system. All of this is achieved by reviewing the concept of discreteness itself, and applied directly to the observations.
