The scope of management of malignant gastric outlet obstruction is ever-expanding.The therapeutic use of endoscopy is gaining popularity not just owing to its technical advancement and satisfactory patient outcomes.Wi...The scope of management of malignant gastric outlet obstruction is ever-expanding.The therapeutic use of endoscopy is gaining popularity not just owing to its technical advancement and satisfactory patient outcomes.With technical success rates close to 96%,stent placement for palliating gastric obstruction has ensured a median survival of about 2 months post-deployment of gastro-duodenal stents.Understanding the correct concept of palliation is the need of the hour in management.Identifying the right patient for palliation,selecting the appropriate intervention and auditing the outcome are vital in delivering optimal care.Also,newer procedures such as endoscopic gastro-enterostomy offer promising outcomes in palliative care.展开更多
Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojeju...Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.展开更多
BACKGROUND Obesity remains a significant global health concern,and intragastric balloons(IGBs)offer a minimally invasive weight loss option for patients who fail lifestyle and pharmacotherapy interventions.IGBs can ca...BACKGROUND Obesity remains a significant global health concern,and intragastric balloons(IGBs)offer a minimally invasive weight loss option for patients who fail lifestyle and pharmacotherapy interventions.IGBs can cause complications ranging from mild symptoms to severe issues like gastric outlet obstruction(GOO).This report discusses a 39-year-old woman who presented with clinical and radiological features of GOO post Silimed IGB placement.CASE SUMMARY A 39-year-old woman presented to our institution with two-week history of abdominal pain,nausea and vomiting post prandially.This was in the context of a Silimed IGB placement two weeks prior to presentation for weight loss in the context of obesity.A computed tomography of the abdomen demonstrated the IGB device in the body and prepyloric region,with proximal dilatation of the body and fundus of the stomach which contained gastric contents.Due to concerns for GOO,the IGB was removed endoscopically with subsequent symptom alleviation.In addition to this,we performed a literature search of cases of IGB related GOO using the PubMed and Web of Science databases from inception date to the August 26,2024.A total of 27 articles were included in the analysis,identifying 29 cases of IGB-related GOO.These patients commonly presented with nausea,vomiting and abdominal pain,with symptom onset varying from 3 days to 18 months post IGB insertion.Abdominal computed tomography was the primary diagnostic tool and endoscopic removal was the standard treatment modality.CONCLUSION This is the first reported case of GOO caused by Silimed IGB.While effective for weight reduction,IGB-related GOO is a rare but serious complication,usually requiring endoscopic retrieval.Future research should aim to identify patient factors linked to this complication to enhance clinical-decision making and outcomes.展开更多
Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,...Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,shorter hospita-lization,and earlier chemotherapy initiation.However,its long-term efficacy is limited by stent occlusion,which typically occurs 2-4 months post-procedure,due to tumor ingrowth,overgrowth,or food impaction.Covered stents can reduce tumor ingrowth but increase the migration risk,particularly in patients receiving chemotherapy.This review provides a comprehensive comparison of duodenal stenting,surgical gastrojejunostomy,and endoscopic ultrasound-guided gastroen-terostomy,by discussing their clinical outcomes,advantages,and limitations.We further explore stent selection based on stricture characteristics,optimal placement techniques,post-procedural management,and for handling complic-ations including occlusion,migration,bleeding,and perforation.Additionally,we address technical challenges and troubleshooting strategies,including mana-gement of guidewire-induced perforation,incomplete stent expansion,and bile duct obstruction for overlapping biliary and duodenal stricture cases.Despite its widespread clinical use,no prior review has comprehensively covered both the technical and clinical aspects of duodenal stenting so extensively.By providing a clinically oriented,practical guide,this review serves as a valuable resource for endoscopists and gastroenterologists,facilitating optimized decision-making and improved outcomes for patients with GOO in real-world practice.展开更多
BACKGROUND Groove pancreatitis(GP)is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics.However,it is often difficult to differentiate from pancreatic o...BACKGROUND Groove pancreatitis(GP)is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics.However,it is often difficult to differentiate from pancreatic or periampullary cancers.In this study,we report a case of GP with the rare symptom of severe gastric outlet obstruction.CASE SUMMARY A 68-year-old man presented to our institution with severe gastric outlet obstruction accompanied by vomiting persisted for 3 days,severe electrolyte imbalance,and altered mental status with cardiac arrest.Differential diagnosis of cancers of the ampulla of Vater or duodenum was difficult due to discordant findings from preoperative imaging and an endoscopic biopsy of the lesion.In addition,the gastric outlet obstruction did not improve with conservative treatment;therefore,pancreatoduodenectomy was performed.Postoperatively,the histological findings revealed multiple cystic lesions in the duodenal wall that were collectively diagnosed as GP.The patient underwent a follow-up 3 years postoperatively and was found to have no postoperative sequelae.CONCLUSION In this case of GP,pancreatoduodenectomy safely treated severe gastric outlet obstruction when a cancer diagnosis could not be excluded.展开更多
Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has emerged as an effective and minimally invasive alternative for treating gastric outlet obstruction.Compared to traditional options,including duodenal stenting ...Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has emerged as an effective and minimally invasive alternative for treating gastric outlet obstruction.Compared to traditional options,including duodenal stenting and surgical gastrojejunostomy,EUS-GE offers comparable technical and clinical success while providing longer-lasting patency,fewer adverse events,and lower reintervention rates.The technique has expanded beyond malignant obstruction to include benign etiologies and complex conditions such as afferent loop syndrome.EUSGE enables rapid recovery and early resumption of oral intake,which is crucial for oncologic patients.However,the procedure remains technically demanding,and optimal techniques,device selection,and management of complications are still under investigation.This mini-review summarizes current evidence,compares EUS-GE with alternative therapies,discusses patient selection and procedural aspects,and outlines key areas for future research.展开更多
Objective:To observe the effect of Xipayimaizibizi oral liquid(XP)in an overactive bladder(OAB)experimental rat model and to explore its pharmacological mechanisms.Methods:Network pharmacology was used to explore the ...Objective:To observe the effect of Xipayimaizibizi oral liquid(XP)in an overactive bladder(OAB)experimental rat model and to explore its pharmacological mechanisms.Methods:Network pharmacology was used to explore the potential mechanisms of action of XP.The rats underwent bladder outlet obstruction surgery and were administered the corresponding drug concentrations by gavage for 4 weeks.The study observed the body weight,water intake,bladder and kidney indices(to evaluate their general status),urination behavior pattern(to observe frequency and urgency),and urodynamics(to measure bladder parameters).Hematoxylin and eosin and Masson's trichome staining were used to observe changes in the bladder structure.Enzyme-linked immunosorbent assay was used to measure the levels of nerve growth factor,brain-derived neurotrophic factor,and acetylcholine in the urine.The key targets involved in these mechanisms were validated using reverse transcription-quantitative polymerase chain reaction,immunohistochemistry,and western blot in vivo/vitro experiments.Result:Network pharmacological analysis predicted that XP may alleviate OAB by affecting the cholinergic synapse and calcium signaling pathways.XP treatment significantly reduced the bladder index,improved urine behavior and urodynamic parameters,decreased the neurotransmitters in urine,and reduced the thickness of the bladder wall and collagen ratio.These results indicate that XP can alleviate OAB symptoms and improve the bladder structure.In vivo/vitro experiments further demonstrated that XP can inhibit targets,such as muscarinic acetylcholine receptor 2,and participate in cholinergic synapses to further regulate the parasympathetic nervous system.It can also reduce the overexpression of Ca^(2+) caused by agonists,inhibit targets such as transient receptor potential vanilloid type 1,and participate in calcium signaling pathways to maintain Ca^(2+) homeostasis.Conclusion:These results suggest that XP inhibited bladder overactivity by maintaining Ca^(2+) homeostasis and regulating the parasympathetic nervous system.展开更多
Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions...Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions of strengthening“Yang Qi”(one of the fundamental concept in TCM,representing the active,warming,and energizing force within the body.It governs physiological functions,maintains body temperature,and promotes vitality.Balanced“Yang Qi”supports immunity and metabolism,while deficiency may lead to fatigue,cold intolerance,or weakened resilience),promoting blood circulation,and removing blood stasis,and nourishing yin based on the TCM theory.Previous studies have found that it significantly improved BPH and regulate urinary function in estrogen and androgen-induced rats.However,it is unclear whether DZQE has an inhibitory effect on BOO rats.Methods:Male Wistar rats underwent retropubic partial bladder neck ligation to induce BOO.DZQE extract(2.7/5.4 g/kg)was administered orally for 35 days.Anesthetized rats underwent cystometry to assess BOO and treatment effects on urinary parameters.Bladder histopathology,fibrosis,and PCNA expression were evaluated via HE,Masson’s,and IHC staining.Western blot quantified bladder tissue levels of choline acetyltransferase(ChAT),rho-associated protein kinase 1(ROCK1),myosin light chain kinase(MLCK),myosin light chain 2(MLC-2),extracellular signal-regulated kinase(ERK),proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax).Primary bladder smooth muscle cells were cultured,exposed to hydrostatic pressure(HP,3 h/24 h)using a custom apparatus to mimic BOO,and treated with DZQE components for Western blot analysis of ROCK1,MLCK,ERK,PCNA,and Bax.Results:The bladder hyperplasia,bladder index(BI)increased,and histopathological alteration were easily observed in BOO group,which were significantly inhibited by DZQE administration.DZQE also significantly inhibited the up-regulation of maximum voiding pressure(MVP)and down-regulation of residual urine volume(RV)observed in BOO rats.The expressions of ChAT and MLCK and the activation of ERK were much increased,while the expressions of ROCK1,MLC-2 and Bax were obviously decreased in BOO rats,all of which were then significantly inhibited by DZQE.In rat bladder smooth muscle cells(RBSMC),3 h or 24 h duration of HP successfully simulated the BOO compensation and decompensation respectively in vitro.DZQE or its active components reduced the abnormal gene expressions in HP stimulated RBSMC.Conclusion:DZQE improves the urinary function in BOO rats mainly through the activation of ERK.Bakuchiol,salvianolic acid A,kaempferol,and tanshinoneⅡA are possibly the important active components of its therapeutic effects.展开更多
To provide advanced diagnostic techniques for diagnosing the outlet temperature distribution and species concentrations of future advanced combustors,this study focuses on a dual-swirl single-dome rectangular combusto...To provide advanced diagnostic techniques for diagnosing the outlet temperature distribution and species concentrations of future advanced combustors,this study focuses on a dual-swirl single-dome rectangular combustor.Through the integration of multiple diagnostics,simultaneous measurement of outlet temperature distribution and species concentrations was achieved.The study validates the engineering applicability of these simultaneous measurements using tungsten-rhenium(W-Re)thermocouples and Coherent Anti-Stokes Raman Scattering(CARS),CARS and Tunable Diode Laser Absorption Spectroscopy(TDLAS),as well as Gas Analysis(GA)and Mass Spectrometry(MS).The results demonstrate that measurements by thermocouples and CARS exhibit good consistency and repeatability,with a relative deviation of less than 4%,fully meeting the requirements of engineering experiments.The spatial distribution reconstruction results of TDLAS can reflect the temperature distribution characteristics at the combustor outlet.Temperature comparison between TDLAS and CARS at single-point positions shows consistent results,with a relative deviation of less than 11%and 7%under both conditions,respectively.Simultaneous measurements by integrating GA and MS show high engineering applicability for the first time,meeting the requirements for measuring both inorganic species and free radicals at the combustor outlet.Under C_(1)condition,the relative deviations of four key species(Unburned Hydrocarbon(UHC),NO,O_(2),and CO_(2))remain within 2%,while that of NO_(2)is slightly higher at approximately 8%.Under C_(2)condition,the overall deviations increase for most species,with only O_(2)and CO_(2)maintaining relatively low deviations.The primary species of UHCs at the combustor outlet under both conditions are small molecular hydrocarbons(C_(3)-C_(8))and RO_(2)radicals,accounting for over 90%of total UHC.Specifically,RO_(2)species(R is C_(1)-C_(2)alkyl groups)are the predominant species,accounting for 74.3%and 82.1%of total RO_(2)under both conditions,respectively.These integrated diagnostic methods for temperature and species concentrations at the combustor outlet serve as a crucial reference for its engineering applications.展开更多
By using the meteorological data in the pollution boundary layer which was observed in two ground observation sites:coast and land in the river outlet area of Grand Liao River during January-February in 2007,the daily...By using the meteorological data in the pollution boundary layer which was observed in two ground observation sites:coast and land in the river outlet area of Grand Liao River during January-February in 2007,the daily change characteristics of pollute boundary layer in winter in the area were discussed. The results showed that the pollute boundary layer in the river outlet area of Grand Liao River was affected by the sea and land. In the certain weather condition,maybe the sea-land breeze appeared in the low altitude which was below 200 m in the coastal zone. The stability change in the different height in the coastal zone was more stable than in the land zone,and the wind field change in the area was mainly in 300 m low altitude. At night,the temperature inversion often appears in the area,and the thickness of temperature inversion layer is stably during 200-300 m. The thermal internal boundary layer penetrated deeply into the land about 10 km,and the height could reach 800 m. The atmospheric diffusion ability in the coastal area was weaker and stronger in the land area.展开更多
To compare the impact of transurethral resection of prostate （TURP） on symptom scores and maximal flow rates （Qmax） in patients with equivocal bladder outlet obstruction （BOO） and definite BOO and to assess the ...To compare the impact of transurethral resection of prostate （TURP） on symptom scores and maximal flow rates （Qmax） in patients with equivocal bladder outlet obstruction （BOO） and definite BOO and to assess the relationship between the surgical outcomes and degree of preoperative BOO, we prospectively evaluated men with lower urinary tract symptoms and bladder outlet obstruction index （BOO1） greater than 20, who were refractory to conventional medical treatment and underwent TURP. Urodynamic evaluation, International Prostate Symptom Score （IPSS）, uroflowmetry, post-void residual volume （PVR） check and transrectal ultrasound were performed. 20〈B001〈40 was defined as equivocal BOO and BOO1 〉~40 as definite BOO. Changes of IPSS, Qmax, PVR and correlation analysis was performed between the degree of improvement of Qmax, subdomains of I PSS and BOO1. Fifty-four patients showed equivocal BOO and 80 patients showed definite BOO. Preoperatively equivocal BOO group and definite BOO group showed significant differences in maximal bladder capacity and prevalence of detrusor overactivity, whereas no difference was noted in prostate volume. Postoperatively both groups showed improvements in Qmax, obstructive （IPSSO） and irritative （IPSSI） subdomain of IPSS, but the degree of improvement in Qmax and IPSSI subdomain was statistically significantly greater in definite BOO group. The degree of improvement of Qmax and IPSSI showed weak correlation with preoperative BOO1. As a weak correlation was identified between preoperative degree of BOO and outcome of TURP, other factors other than BOO1 such as severity of patients＇ symptoms should be considered in deciding treatment modality.展开更多
As agricultural eco-tourism development played a vital role in promoting rural economic and social development and constructing new harmonious countryside,the paper had analyzed environmental problem produced during i...As agricultural eco-tourism development played a vital role in promoting rural economic and social development and constructing new harmonious countryside,the paper had analyzed environmental problem produced during its development,pointed out that blind development of agricultural eco-tourism had seriously destroyed resources and ecological environment and that tourist infrastructure construction and urbanization had ruined rural unique natural landscape.In view of current situation of environment,it also studied reasons causing environmental disruption,which lied in insufficient guidance and support of government,deficient scientific development planning and management system,and poor environmental consciousness of tourist operators and tourists.On this basis,it summarized that agricultural eco-tourism development should follow principles of sustainable development,synchronization between development and protection,and coordination between tourism development and environmental protection.It concluded proper ways to develop agricultural eco-tourism,and emphasized that it should draw up scientific and reasonable development planning,enhance government's macro-administration,establish and perfect ecological compensation mechanism,and strive to cultivate people's environmental awareness.展开更多
The main goal of the safe power outlet project is to make power outlets smart and integrate it to all old and new electrical wiring of homes and offices to eliminate the costs.Using the designed socket,home and office...The main goal of the safe power outlet project is to make power outlets smart and integrate it to all old and new electrical wiring of homes and offices to eliminate the costs.Using the designed socket,home and office electrical appliances can be smarten and controlled remotely through wireless technology.The device designed in this project,is a smart power outlet that supports Wi-Fi connection and the user can connect directly to it and control it by the specific mobile application.There is no need for any other interfaces such as a modem or router,and the user can connect directly to the device.This is the innovative part of the project making it different from the conventional power outlets on the market.All home and office appliances running on AC power can be connected to a safe outlet directly and without an interface;they can be controlled via wireless network by mobiles.This device smartens all old and conventional outlets without making any changes in wiring.It also enables the control via Wi-Fi on the outlets.展开更多
AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obs...AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study.The patients with rectal prolapse hemorrhoids with outlet obstructioninduced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids(PPH)(n = 54) or conventional surgery(n = 54; control group).Short-term(operative time,postoperative hospital stay,postoperative urinary retention,postoperative perianal edema,and postoperative pain) and long-term(postoperative anal stenosis,postoperative sensory anal incontinence,postoperative recurrence,and postoperative difficulty in defecation) clinical effects were compared between the two groups.The short- and long-term efficacies of the two procedures were determined.RESULTS: In terms of short-term clinical effects,operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group(24.36 ± 5.16 min vs 44.27 ± 6.57 min,2.1 ± 1.4 d vs 3.6 ± 2.3 d,both P < 0.01).The incidence of postoperative urinary retention was higher in the PPH group than in the control group,but the difference was not statistically significant(48.15% vs 37.04%).Theincidence of perianal edema was significantly lower in the PPH group(11.11% vs 42.60%,P < 0.05).The visual analogue scale scores at 24 h after surgery,first defecation,and one week after surgery were significantly lower in the PPH group(2.9 ± 0.9 vs 8.3 ± 1.1,2.0 ± 0.5 vs 6.5 ± 0.8,and 1.7 ± 0.5 vs 5.0 ± 0.7,respectively,all P < 0.01).With regard to long-term clinical effects,the incidence of anal stenosis was lower in the PPH group than in the control group,but the difference was not significant(1.85% vs 5.56%).The incidence of sensory anal incontinence was significantly lower in the PPH group(3.70% vs 12.96%,P < 0.05).The incidences of recurrent internal rectal prolapse and difficulty in defecation were lower in the PPH group than in the control group,but the differences were not significant(11.11% vs 16.67% and 12.96% vs 24.07%,respectively).CONCLUSION: PPH is superior to the traditional surgery in the management of outlet obstructive constipation caused by internal rectal prolapse with circumferential hemorrhoids.展开更多
The existing research of the deep-well centrifugal pump mainly focuses on reduce the manufacturing cost and improve the pump performance, and how to combine above two aspects together is the most difficult and importa...The existing research of the deep-well centrifugal pump mainly focuses on reduce the manufacturing cost and improve the pump performance, and how to combine above two aspects together is the most difficult and important topic. In this study, the performances of the deep-well centrifugal pump with four different impeller outlet widths are studied by the numerical, theoretical and experimental methods in this paper. Two stages deep-well centrifugal pump equipped with different impellers are simulated employing the commercial CFD software to solve the Navier-Stokes equations for three-dimensional incompressible steady flow. The sensitivity analyses of the grid size and turbulence model have been performed to improve numerical accuracy. The flow field distributions are acquired and compared under the design operating conditions, including the static pressure, turbulence kinetic energy and velocity. The prototype is manufactured and tested to certify the numerical predicted performance. The numerical results of pump performance are higher than the test results, but their change trends have an acceptable agreement with each other. The performance results indicted that the oversize impeller outlet width leads to poor pump performances and increasing shaft power. Changing the performance of deep-well centrifugal pump by alter impeller outlet width is practicable and convenient, which is worth popularizing in the engineering application. The proposed research enhances the theoretical basis of pump design to improve the performance and reduce the manufacturing cost of deep-well centrifugal pump.展开更多
AIM: To provide an overview of the clinical outcomes of self-expandable metal stent(SEMS) placement for malignant gastric outlet obstruction(MGOO).METHODS: A systematic literature search was performed in Pub Med of th...AIM: To provide an overview of the clinical outcomes of self-expandable metal stent(SEMS) placement for malignant gastric outlet obstruction(MGOO).METHODS: A systematic literature search was performed in Pub Med of the literature published between January 2009 and March 2015. Only prospective studies that reported on the clinical success of stent placement for MGOO were included. The primary endpoint was clinical success,defined according to the definition used in the original article. Data were pooled and analyzed using descriptive statistics. Subgroup analyses were performed for partially covered SEMSs(PCSEMSs) and uncovered SEMSs(UCSEMSs) using Fisher's exact test.RESULTS: A total of 19 studies,including 1281 patients,were included in the final analysis. Gastric(42%) and pancreatic(37%) cancer were the main causes of MGOO. UCSEMSs were used in 76% of patients and PCSEMSs in 24%. The overall pooled technical success rate was 97.3% and the clinical success rate was 85.7%. Stent dysfunction occurred in 19.6% of patients,mainly caused by re-obstruction(12.6%) and stent migration(4.3%),and was comparable between PCSEMSs and UCSEMSs(21.2% vs 19.1%,respectively,P = 0.412). Re-obstruction was more common with UCSEMSs(14.9% vs 5.1%,P < 0.001) and stent migration was more frequent after PCSEMS placement(10.9% vs 2.2%,P < 0.001). The overall perforation rate was 1.2%. Bleeding was reported in 4.1% of patients,including major bleeding in 0.8%. The median stent patency ranged from 68 to 307 d in five studies. The median overall survival ranged from 49 to 183 d in 13 studies.CONCLUSION: The clinical outcomes in this large population showed that enteral stent placement was feasible,effective and safe. Therefore,stent placement is a valid treatment option for the palliation of MGOO.展开更多
A 46-year-old Chinese woman presented with nausea, recurrent vomiting, and abdominal pain. Gastroduodenal endoscopic examination revealed an oval-shaped submucosal tumor at the prepyloric area on the posterior wall of...A 46-year-old Chinese woman presented with nausea, recurrent vomiting, and abdominal pain. Gastroduodenal endoscopic examination revealed an oval-shaped submucosal tumor at the prepyloric area on the posterior wall of the stomach. A degenerated gastrointestinal stromal tumor was suspected. Distal gastrectomy was performed and a histological diagnosis of heterotopic pancreas （HPs） was confirmed. The patient had an uneventful postoperative course and was discharged 7 d a^er operation. The patient remains healthy and symptom-free in the follow-up of 6 mo. This is a report of a case of gastric outlet obstruction resulting from pancreatic heterotopia in the gastric antrum in an adult woman.展开更多
Transport of organic carbon via rivers to estuary is a significant geochemical proc- ess in the global carbon cycle. This paper presents bulk total organic carbon （TOC） from the Dongjiang catchment to the adjacent H...Transport of organic carbon via rivers to estuary is a significant geochemical proc- ess in the global carbon cycle. This paper presents bulk total organic carbon （TOC） from the Dongjiang catchment to the adjacent Humen outlet, and discusses the applicability of 613C and ratio of carbon to nitrogen （C/N） as indicators for sources of organic matter in the surface sediments. Survey results showed that organic carbon concentration in summer were higher than in the winter. An elevated trend of TOC occurred along the river to the Humen outlet in both surveys, and the highest mean values of dissolved and particular organic carbon （DOC-279 μmol L-1 and POC-163μmol L-1） were observed in the urban deltaic region in summer flood flow. Winter samples had a wide range of b＇13C and C/N （5-3C -24.6%o to -30.0%o, C/N 4-13）, and summer ones varied slightly （8-3C -24.2%o to -27.6%0, C/N 6-18）. As results suggest that POC in the three zones of upstream-delta-outlet dominantly came from riverbank soil, phytoplankton and agricultural C3 plants in winter, whereas main sources were from the riverbank and mangrove soil in summer. Moreover, anthropogenic sewage inputs had 11% and 7% contribution to POC in the deltaic and outlet. Transport accompanied with seasonal freshwater variation, phytoplankton production and degradation, and removal be- havior caused variation of organic carbon concentration. The results also discovered that TOC export bulk in Dongjiang was approximately one quarter of Humen flux in the dry flow, and anthropogenic activity significantly impacted the river export contribution.展开更多
文摘The scope of management of malignant gastric outlet obstruction is ever-expanding.The therapeutic use of endoscopy is gaining popularity not just owing to its technical advancement and satisfactory patient outcomes.With technical success rates close to 96%,stent placement for palliating gastric obstruction has ensured a median survival of about 2 months post-deployment of gastro-duodenal stents.Understanding the correct concept of palliation is the need of the hour in management.Identifying the right patient for palliation,selecting the appropriate intervention and auditing the outcome are vital in delivering optimal care.Also,newer procedures such as endoscopic gastro-enterostomy offer promising outcomes in palliative care.
文摘Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.
文摘BACKGROUND Obesity remains a significant global health concern,and intragastric balloons(IGBs)offer a minimally invasive weight loss option for patients who fail lifestyle and pharmacotherapy interventions.IGBs can cause complications ranging from mild symptoms to severe issues like gastric outlet obstruction(GOO).This report discusses a 39-year-old woman who presented with clinical and radiological features of GOO post Silimed IGB placement.CASE SUMMARY A 39-year-old woman presented to our institution with two-week history of abdominal pain,nausea and vomiting post prandially.This was in the context of a Silimed IGB placement two weeks prior to presentation for weight loss in the context of obesity.A computed tomography of the abdomen demonstrated the IGB device in the body and prepyloric region,with proximal dilatation of the body and fundus of the stomach which contained gastric contents.Due to concerns for GOO,the IGB was removed endoscopically with subsequent symptom alleviation.In addition to this,we performed a literature search of cases of IGB related GOO using the PubMed and Web of Science databases from inception date to the August 26,2024.A total of 27 articles were included in the analysis,identifying 29 cases of IGB-related GOO.These patients commonly presented with nausea,vomiting and abdominal pain,with symptom onset varying from 3 days to 18 months post IGB insertion.Abdominal computed tomography was the primary diagnostic tool and endoscopic removal was the standard treatment modality.CONCLUSION This is the first reported case of GOO caused by Silimed IGB.While effective for weight reduction,IGB-related GOO is a rare but serious complication,usually requiring endoscopic retrieval.Future research should aim to identify patient factors linked to this complication to enhance clinical-decision making and outcomes.
文摘Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,shorter hospita-lization,and earlier chemotherapy initiation.However,its long-term efficacy is limited by stent occlusion,which typically occurs 2-4 months post-procedure,due to tumor ingrowth,overgrowth,or food impaction.Covered stents can reduce tumor ingrowth but increase the migration risk,particularly in patients receiving chemotherapy.This review provides a comprehensive comparison of duodenal stenting,surgical gastrojejunostomy,and endoscopic ultrasound-guided gastroen-terostomy,by discussing their clinical outcomes,advantages,and limitations.We further explore stent selection based on stricture characteristics,optimal placement techniques,post-procedural management,and for handling complic-ations including occlusion,migration,bleeding,and perforation.Additionally,we address technical challenges and troubleshooting strategies,including mana-gement of guidewire-induced perforation,incomplete stent expansion,and bile duct obstruction for overlapping biliary and duodenal stricture cases.Despite its widespread clinical use,no prior review has comprehensively covered both the technical and clinical aspects of duodenal stenting so extensively.By providing a clinically oriented,practical guide,this review serves as a valuable resource for endoscopists and gastroenterologists,facilitating optimized decision-making and improved outcomes for patients with GOO in real-world practice.
文摘BACKGROUND Groove pancreatitis(GP)is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics.However,it is often difficult to differentiate from pancreatic or periampullary cancers.In this study,we report a case of GP with the rare symptom of severe gastric outlet obstruction.CASE SUMMARY A 68-year-old man presented to our institution with severe gastric outlet obstruction accompanied by vomiting persisted for 3 days,severe electrolyte imbalance,and altered mental status with cardiac arrest.Differential diagnosis of cancers of the ampulla of Vater or duodenum was difficult due to discordant findings from preoperative imaging and an endoscopic biopsy of the lesion.In addition,the gastric outlet obstruction did not improve with conservative treatment;therefore,pancreatoduodenectomy was performed.Postoperatively,the histological findings revealed multiple cystic lesions in the duodenal wall that were collectively diagnosed as GP.The patient underwent a follow-up 3 years postoperatively and was found to have no postoperative sequelae.CONCLUSION In this case of GP,pancreatoduodenectomy safely treated severe gastric outlet obstruction when a cancer diagnosis could not be excluded.
文摘Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has emerged as an effective and minimally invasive alternative for treating gastric outlet obstruction.Compared to traditional options,including duodenal stenting and surgical gastrojejunostomy,EUS-GE offers comparable technical and clinical success while providing longer-lasting patency,fewer adverse events,and lower reintervention rates.The technique has expanded beyond malignant obstruction to include benign etiologies and complex conditions such as afferent loop syndrome.EUSGE enables rapid recovery and early resumption of oral intake,which is crucial for oncologic patients.However,the procedure remains technically demanding,and optimal techniques,device selection,and management of complications are still under investigation.This mini-review summarizes current evidence,compares EUS-GE with alternative therapies,discusses patient selection and procedural aspects,and outlines key areas for future research.
基金supported by the Natural Science Foundation in Xinjiang Uygur Autonomous Region(Urumqi,China,2023D01F38).
文摘Objective:To observe the effect of Xipayimaizibizi oral liquid(XP)in an overactive bladder(OAB)experimental rat model and to explore its pharmacological mechanisms.Methods:Network pharmacology was used to explore the potential mechanisms of action of XP.The rats underwent bladder outlet obstruction surgery and were administered the corresponding drug concentrations by gavage for 4 weeks.The study observed the body weight,water intake,bladder and kidney indices(to evaluate their general status),urination behavior pattern(to observe frequency and urgency),and urodynamics(to measure bladder parameters).Hematoxylin and eosin and Masson's trichome staining were used to observe changes in the bladder structure.Enzyme-linked immunosorbent assay was used to measure the levels of nerve growth factor,brain-derived neurotrophic factor,and acetylcholine in the urine.The key targets involved in these mechanisms were validated using reverse transcription-quantitative polymerase chain reaction,immunohistochemistry,and western blot in vivo/vitro experiments.Result:Network pharmacological analysis predicted that XP may alleviate OAB by affecting the cholinergic synapse and calcium signaling pathways.XP treatment significantly reduced the bladder index,improved urine behavior and urodynamic parameters,decreased the neurotransmitters in urine,and reduced the thickness of the bladder wall and collagen ratio.These results indicate that XP can alleviate OAB symptoms and improve the bladder structure.In vivo/vitro experiments further demonstrated that XP can inhibit targets,such as muscarinic acetylcholine receptor 2,and participate in cholinergic synapses to further regulate the parasympathetic nervous system.It can also reduce the overexpression of Ca^(2+) caused by agonists,inhibit targets such as transient receptor potential vanilloid type 1,and participate in calcium signaling pathways to maintain Ca^(2+) homeostasis.Conclusion:These results suggest that XP inhibited bladder overactivity by maintaining Ca^(2+) homeostasis and regulating the parasympathetic nervous system.
基金supported by The National Key Research and Development Project of China(No.2023YFC3504302)the National Natural Science Foundation of China(General Program No.82074105).
文摘Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions of strengthening“Yang Qi”(one of the fundamental concept in TCM,representing the active,warming,and energizing force within the body.It governs physiological functions,maintains body temperature,and promotes vitality.Balanced“Yang Qi”supports immunity and metabolism,while deficiency may lead to fatigue,cold intolerance,or weakened resilience),promoting blood circulation,and removing blood stasis,and nourishing yin based on the TCM theory.Previous studies have found that it significantly improved BPH and regulate urinary function in estrogen and androgen-induced rats.However,it is unclear whether DZQE has an inhibitory effect on BOO rats.Methods:Male Wistar rats underwent retropubic partial bladder neck ligation to induce BOO.DZQE extract(2.7/5.4 g/kg)was administered orally for 35 days.Anesthetized rats underwent cystometry to assess BOO and treatment effects on urinary parameters.Bladder histopathology,fibrosis,and PCNA expression were evaluated via HE,Masson’s,and IHC staining.Western blot quantified bladder tissue levels of choline acetyltransferase(ChAT),rho-associated protein kinase 1(ROCK1),myosin light chain kinase(MLCK),myosin light chain 2(MLC-2),extracellular signal-regulated kinase(ERK),proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax).Primary bladder smooth muscle cells were cultured,exposed to hydrostatic pressure(HP,3 h/24 h)using a custom apparatus to mimic BOO,and treated with DZQE components for Western blot analysis of ROCK1,MLCK,ERK,PCNA,and Bax.Results:The bladder hyperplasia,bladder index(BI)increased,and histopathological alteration were easily observed in BOO group,which were significantly inhibited by DZQE administration.DZQE also significantly inhibited the up-regulation of maximum voiding pressure(MVP)and down-regulation of residual urine volume(RV)observed in BOO rats.The expressions of ChAT and MLCK and the activation of ERK were much increased,while the expressions of ROCK1,MLC-2 and Bax were obviously decreased in BOO rats,all of which were then significantly inhibited by DZQE.In rat bladder smooth muscle cells(RBSMC),3 h or 24 h duration of HP successfully simulated the BOO compensation and decompensation respectively in vitro.DZQE or its active components reduced the abnormal gene expressions in HP stimulated RBSMC.Conclusion:DZQE improves the urinary function in BOO rats mainly through the activation of ERK.Bakuchiol,salvianolic acid A,kaempferol,and tanshinoneⅡA are possibly the important active components of its therapeutic effects.
基金support of the National Major Science and Technology Projects of China(No.J2019-V-0005-0096)the National Key Research and Development Program of China(No.2020YFA0405700).
文摘To provide advanced diagnostic techniques for diagnosing the outlet temperature distribution and species concentrations of future advanced combustors,this study focuses on a dual-swirl single-dome rectangular combustor.Through the integration of multiple diagnostics,simultaneous measurement of outlet temperature distribution and species concentrations was achieved.The study validates the engineering applicability of these simultaneous measurements using tungsten-rhenium(W-Re)thermocouples and Coherent Anti-Stokes Raman Scattering(CARS),CARS and Tunable Diode Laser Absorption Spectroscopy(TDLAS),as well as Gas Analysis(GA)and Mass Spectrometry(MS).The results demonstrate that measurements by thermocouples and CARS exhibit good consistency and repeatability,with a relative deviation of less than 4%,fully meeting the requirements of engineering experiments.The spatial distribution reconstruction results of TDLAS can reflect the temperature distribution characteristics at the combustor outlet.Temperature comparison between TDLAS and CARS at single-point positions shows consistent results,with a relative deviation of less than 11%and 7%under both conditions,respectively.Simultaneous measurements by integrating GA and MS show high engineering applicability for the first time,meeting the requirements for measuring both inorganic species and free radicals at the combustor outlet.Under C_(1)condition,the relative deviations of four key species(Unburned Hydrocarbon(UHC),NO,O_(2),and CO_(2))remain within 2%,while that of NO_(2)is slightly higher at approximately 8%.Under C_(2)condition,the overall deviations increase for most species,with only O_(2)and CO_(2)maintaining relatively low deviations.The primary species of UHCs at the combustor outlet under both conditions are small molecular hydrocarbons(C_(3)-C_(8))and RO_(2)radicals,accounting for over 90%of total UHC.Specifically,RO_(2)species(R is C_(1)-C_(2)alkyl groups)are the predominant species,accounting for 74.3%and 82.1%of total RO_(2)under both conditions,respectively.These integrated diagnostic methods for temperature and species concentrations at the combustor outlet serve as a crucial reference for its engineering applications.
基金Supported by The Special Project of Public Welfare Industry(Meteorology)of Science and Technology Ministry(GYHY200806020)The National Natural Science Fund(40975084)The Science Research Fund of Liaoning Meteorological Bureau(2008008)
文摘By using the meteorological data in the pollution boundary layer which was observed in two ground observation sites:coast and land in the river outlet area of Grand Liao River during January-February in 2007,the daily change characteristics of pollute boundary layer in winter in the area were discussed. The results showed that the pollute boundary layer in the river outlet area of Grand Liao River was affected by the sea and land. In the certain weather condition,maybe the sea-land breeze appeared in the low altitude which was below 200 m in the coastal zone. The stability change in the different height in the coastal zone was more stable than in the land zone,and the wind field change in the area was mainly in 300 m low altitude. At night,the temperature inversion often appears in the area,and the thickness of temperature inversion layer is stably during 200-300 m. The thermal internal boundary layer penetrated deeply into the land about 10 km,and the height could reach 800 m. The atmospheric diffusion ability in the coastal area was weaker and stronger in the land area.
文摘To compare the impact of transurethral resection of prostate （TURP） on symptom scores and maximal flow rates （Qmax） in patients with equivocal bladder outlet obstruction （BOO） and definite BOO and to assess the relationship between the surgical outcomes and degree of preoperative BOO, we prospectively evaluated men with lower urinary tract symptoms and bladder outlet obstruction index （BOO1） greater than 20, who were refractory to conventional medical treatment and underwent TURP. Urodynamic evaluation, International Prostate Symptom Score （IPSS）, uroflowmetry, post-void residual volume （PVR） check and transrectal ultrasound were performed. 20〈B001〈40 was defined as equivocal BOO and BOO1 〉~40 as definite BOO. Changes of IPSS, Qmax, PVR and correlation analysis was performed between the degree of improvement of Qmax, subdomains of I PSS and BOO1. Fifty-four patients showed equivocal BOO and 80 patients showed definite BOO. Preoperatively equivocal BOO group and definite BOO group showed significant differences in maximal bladder capacity and prevalence of detrusor overactivity, whereas no difference was noted in prostate volume. Postoperatively both groups showed improvements in Qmax, obstructive （IPSSO） and irritative （IPSSI） subdomain of IPSS, but the degree of improvement in Qmax and IPSSI subdomain was statistically significantly greater in definite BOO group. The degree of improvement of Qmax and IPSSI showed weak correlation with preoperative BOO1. As a weak correlation was identified between preoperative degree of BOO and outcome of TURP, other factors other than BOO1 such as severity of patients＇ symptoms should be considered in deciding treatment modality.
基金Supported by Part of Research Results of Special Program of Humane Social Science Fund of Guizhou Education Department(09ZX084)~~
文摘As agricultural eco-tourism development played a vital role in promoting rural economic and social development and constructing new harmonious countryside,the paper had analyzed environmental problem produced during its development,pointed out that blind development of agricultural eco-tourism had seriously destroyed resources and ecological environment and that tourist infrastructure construction and urbanization had ruined rural unique natural landscape.In view of current situation of environment,it also studied reasons causing environmental disruption,which lied in insufficient guidance and support of government,deficient scientific development planning and management system,and poor environmental consciousness of tourist operators and tourists.On this basis,it summarized that agricultural eco-tourism development should follow principles of sustainable development,synchronization between development and protection,and coordination between tourism development and environmental protection.It concluded proper ways to develop agricultural eco-tourism,and emphasized that it should draw up scientific and reasonable development planning,enhance government's macro-administration,establish and perfect ecological compensation mechanism,and strive to cultivate people's environmental awareness.
文摘The main goal of the safe power outlet project is to make power outlets smart and integrate it to all old and new electrical wiring of homes and offices to eliminate the costs.Using the designed socket,home and office electrical appliances can be smarten and controlled remotely through wireless technology.The device designed in this project,is a smart power outlet that supports Wi-Fi connection and the user can connect directly to it and control it by the specific mobile application.There is no need for any other interfaces such as a modem or router,and the user can connect directly to the device.This is the innovative part of the project making it different from the conventional power outlets on the market.All home and office appliances running on AC power can be connected to a safe outlet directly and without an interface;they can be controlled via wireless network by mobiles.This device smartens all old and conventional outlets without making any changes in wiring.It also enables the control via Wi-Fi on the outlets.
文摘AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study.The patients with rectal prolapse hemorrhoids with outlet obstructioninduced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids(PPH)(n = 54) or conventional surgery(n = 54; control group).Short-term(operative time,postoperative hospital stay,postoperative urinary retention,postoperative perianal edema,and postoperative pain) and long-term(postoperative anal stenosis,postoperative sensory anal incontinence,postoperative recurrence,and postoperative difficulty in defecation) clinical effects were compared between the two groups.The short- and long-term efficacies of the two procedures were determined.RESULTS: In terms of short-term clinical effects,operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group(24.36 ± 5.16 min vs 44.27 ± 6.57 min,2.1 ± 1.4 d vs 3.6 ± 2.3 d,both P < 0.01).The incidence of postoperative urinary retention was higher in the PPH group than in the control group,but the difference was not statistically significant(48.15% vs 37.04%).Theincidence of perianal edema was significantly lower in the PPH group(11.11% vs 42.60%,P < 0.05).The visual analogue scale scores at 24 h after surgery,first defecation,and one week after surgery were significantly lower in the PPH group(2.9 ± 0.9 vs 8.3 ± 1.1,2.0 ± 0.5 vs 6.5 ± 0.8,and 1.7 ± 0.5 vs 5.0 ± 0.7,respectively,all P < 0.01).With regard to long-term clinical effects,the incidence of anal stenosis was lower in the PPH group than in the control group,but the difference was not significant(1.85% vs 5.56%).The incidence of sensory anal incontinence was significantly lower in the PPH group(3.70% vs 12.96%,P < 0.05).The incidences of recurrent internal rectal prolapse and difficulty in defecation were lower in the PPH group than in the control group,but the differences were not significant(11.11% vs 16.67% and 12.96% vs 24.07%,respectively).CONCLUSION: PPH is superior to the traditional surgery in the management of outlet obstructive constipation caused by internal rectal prolapse with circumferential hemorrhoids.
基金supported by National Natural Science Foundation of China (Grant Nos. 51279069,51109093)Jiangsu Provincial Natural Science Foundation of China (Grant Nos. BK2011503,BK2011505)
文摘The existing research of the deep-well centrifugal pump mainly focuses on reduce the manufacturing cost and improve the pump performance, and how to combine above two aspects together is the most difficult and important topic. In this study, the performances of the deep-well centrifugal pump with four different impeller outlet widths are studied by the numerical, theoretical and experimental methods in this paper. Two stages deep-well centrifugal pump equipped with different impellers are simulated employing the commercial CFD software to solve the Navier-Stokes equations for three-dimensional incompressible steady flow. The sensitivity analyses of the grid size and turbulence model have been performed to improve numerical accuracy. The flow field distributions are acquired and compared under the design operating conditions, including the static pressure, turbulence kinetic energy and velocity. The prototype is manufactured and tested to certify the numerical predicted performance. The numerical results of pump performance are higher than the test results, but their change trends have an acceptable agreement with each other. The performance results indicted that the oversize impeller outlet width leads to poor pump performances and increasing shaft power. Changing the performance of deep-well centrifugal pump by alter impeller outlet width is practicable and convenient, which is worth popularizing in the engineering application. The proposed research enhances the theoretical basis of pump design to improve the performance and reduce the manufacturing cost of deep-well centrifugal pump.
文摘AIM: To provide an overview of the clinical outcomes of self-expandable metal stent(SEMS) placement for malignant gastric outlet obstruction(MGOO).METHODS: A systematic literature search was performed in Pub Med of the literature published between January 2009 and March 2015. Only prospective studies that reported on the clinical success of stent placement for MGOO were included. The primary endpoint was clinical success,defined according to the definition used in the original article. Data were pooled and analyzed using descriptive statistics. Subgroup analyses were performed for partially covered SEMSs(PCSEMSs) and uncovered SEMSs(UCSEMSs) using Fisher's exact test.RESULTS: A total of 19 studies,including 1281 patients,were included in the final analysis. Gastric(42%) and pancreatic(37%) cancer were the main causes of MGOO. UCSEMSs were used in 76% of patients and PCSEMSs in 24%. The overall pooled technical success rate was 97.3% and the clinical success rate was 85.7%. Stent dysfunction occurred in 19.6% of patients,mainly caused by re-obstruction(12.6%) and stent migration(4.3%),and was comparable between PCSEMSs and UCSEMSs(21.2% vs 19.1%,respectively,P = 0.412). Re-obstruction was more common with UCSEMSs(14.9% vs 5.1%,P < 0.001) and stent migration was more frequent after PCSEMS placement(10.9% vs 2.2%,P < 0.001). The overall perforation rate was 1.2%. Bleeding was reported in 4.1% of patients,including major bleeding in 0.8%. The median stent patency ranged from 68 to 307 d in five studies. The median overall survival ranged from 49 to 183 d in 13 studies.CONCLUSION: The clinical outcomes in this large population showed that enteral stent placement was feasible,effective and safe. Therefore,stent placement is a valid treatment option for the palliation of MGOO.
文摘A 46-year-old Chinese woman presented with nausea, recurrent vomiting, and abdominal pain. Gastroduodenal endoscopic examination revealed an oval-shaped submucosal tumor at the prepyloric area on the posterior wall of the stomach. A degenerated gastrointestinal stromal tumor was suspected. Distal gastrectomy was performed and a histological diagnosis of heterotopic pancreas （HPs） was confirmed. The patient had an uneventful postoperative course and was discharged 7 d a^er operation. The patient remains healthy and symptom-free in the follow-up of 6 mo. This is a report of a case of gastric outlet obstruction resulting from pancreatic heterotopia in the gastric antrum in an adult woman.
基金National Natural Science Foundation of China, No.41101152 No.40901090+5 种基金 No.41172315 The Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry The talents in- troduced into Universities Foundation of Guangdong Province of China The China Scholarship Council （CSC） funding in 2013 The Universities Disciplinary and Special Construction Funds of Guangdong Prov- ince Foundation, No.C 10092 The Scientific Research Foundation of Graduate School of South China Nor- mal University
文摘Transport of organic carbon via rivers to estuary is a significant geochemical proc- ess in the global carbon cycle. This paper presents bulk total organic carbon （TOC） from the Dongjiang catchment to the adjacent Humen outlet, and discusses the applicability of 613C and ratio of carbon to nitrogen （C/N） as indicators for sources of organic matter in the surface sediments. Survey results showed that organic carbon concentration in summer were higher than in the winter. An elevated trend of TOC occurred along the river to the Humen outlet in both surveys, and the highest mean values of dissolved and particular organic carbon （DOC-279 μmol L-1 and POC-163μmol L-1） were observed in the urban deltaic region in summer flood flow. Winter samples had a wide range of b＇13C and C/N （5-3C -24.6%o to -30.0%o, C/N 4-13）, and summer ones varied slightly （8-3C -24.2%o to -27.6%0, C/N 6-18）. As results suggest that POC in the three zones of upstream-delta-outlet dominantly came from riverbank soil, phytoplankton and agricultural C3 plants in winter, whereas main sources were from the riverbank and mangrove soil in summer. Moreover, anthropogenic sewage inputs had 11% and 7% contribution to POC in the deltaic and outlet. Transport accompanied with seasonal freshwater variation, phytoplankton production and degradation, and removal be- havior caused variation of organic carbon concentration. The results also discovered that TOC export bulk in Dongjiang was approximately one quarter of Humen flux in the dry flow, and anthropogenic activity significantly impacted the river export contribution.
