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
BACKGROUND Routine assessment of solid gastric emptying is challenging due to the prolonged test duration and complex meal preparation.Replacing solid test meals with easily prepared,commercially available semisolid m...BACKGROUND Routine assessment of solid gastric emptying is challenging due to the prolonged test duration and complex meal preparation.Replacing solid test meals with easily prepared,commercially available semisolid meals and shortening the test duration can significantly enhance the feasibility and practicality of gastric emptying evaluations.AIM To compare the gastric emptying and antral motility of solid vs semi-solid meals of similar volume and nutritional consistency,and to assess the feasibility of meal substitution and reduction in test duration during the solid gastric emptying assessment.METHODS Thirty healthy volunteers(17 males,age:29.4±6.0 years,body mass index:23.4±2.94 and 13 females,age:37.2±11.9 years,body mass index:22.9±4.34)underwent gastric emptying by real-time ultrasonography after a solid meal and a comparable commercially prepared semi-solid meal(each meal,total calorie 350 kcal,carbohydrates 60%,fat 30%and proteins 10%),on separate dates 1 week apart.The gastric antral area was measured at 5 minutes,15 minutes,30 minutes,45 minutes,60 minutes,90 minutes,120 minutes,150 minutes,180 minutes,210 minutes,and 240 minutes post-ingestion using a previously validated technique and compared between meals.RESULTS Mean and median antral areas,gastric emptying rates,gastric residual ratios,and motility index at each time point were almost similar between meals for up to 3 hours.At the end of 4 hours,the mean emptied percentage of the semisolid meal and solid meal was 81.1%and 70.6%,respectively.The emptying rate of the semisolid meal at 90 minutes significantly correlated with that of 240 minutes.There was no correlation between the solid meal emptying rates at 90 minutes and 240 minutes.CONCLUSION Gastric emptying,residual antral cross-sectional area and antral motility of a semisolid meal are almost similar to that of a solid meal of the same nutritional value until three hours post-ingestion.A semisolid test meal can effectively substitute a solid test meal during ultrasound assessment of gastric emptying,without compromising the validity of the results.Additionally,the ease of preparation and administration of semisolid meals enhances the overall feasibility of gastric emptying assessments.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
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
The new view denies the existence of fundamental particles in matter, and instead states that any particle and matter is a dynamic superposition of three natural elements, motion, force, and emptiness. This paper prop...The new view denies the existence of fundamental particles in matter, and instead states that any particle and matter is a dynamic superposition of three natural elements, motion, force, and emptiness. This paper proposes a new theory of the structure of matter and the unification of the four forces. A correct understanding of the logic of material structure will enable atomic energy and nuclear physics to generate new manufacturing ideas. The dissertation expounds the natural distribution of dynamics and forces in space and the new deterministic theory of dynamic relationship. This theory solves problems such as the unity of the four forces and the dynamic laws of the material structure. In practical applications, it can provide new theoretical guidance for industrial manufacturing such as nuclear energy, fusion engineering, new energy, new materials, battery energy storage, new-generation reactors, etc., and then adopt effective means in line with the laws of natural power to make the substances needed by human beings. The supply of resources and energy is perfectly satisfied. Applying this theoretical model of material structure to all aspects of the manufacturing industry will surely open up a new era of material civilization for human beings.展开更多
Moran considered a dam whose inflow in a given interval of time is a continuous random variable. He then developed integral equations for the probabilities of emptiness and overflow. These equations are difficult to s...Moran considered a dam whose inflow in a given interval of time is a continuous random variable. He then developed integral equations for the probabilities of emptiness and overflow. These equations are difficult to solve numerically;thus, approximations have been proposed that discretize the input. In this paper, extensions are considered for storage systems with different assumptions for storage losses. We also develop discrete approximations for the probabilities of emptiness and overflow.展开更多
Objective To evaluate the effect of Pyonex in treatment of patients with delayed gastric emptying after esophagectomy.Methods Twenty-three patients were treated with Pyonex at Pishu（脾俞 BL 20,bilateral）,Weishu（胃...Objective To evaluate the effect of Pyonex in treatment of patients with delayed gastric emptying after esophagectomy.Methods Twenty-three patients were treated with Pyonex at Pishu（脾俞 BL 20,bilateral）,Weishu（胃俞 BL 21,bilateral）,Neiguan（内关 PC 6）,Zusanli（足三里 ST 36）,Sanyinjiao（三阴交 SP 6） and Shidao（食道 CO 2） on the basis of conventional treatment.The pyonexs were changed every four days,and change for five times was considered as one course of treatment.The efficacy was evaluated after treatment for one course.Results One patient was cured after treatment for one time,with the effective rate of 4.4%;two patients were cured after treatment for two times,with the effective rate of 8.7%;ten patients were cured after treatment for three times,with the effective rate of 44.5%;seven patients were cured after treatment for four times,with the effective rate of30.4%;and three patients were cured after treatment for five times,with the effective rate of 13.0%.23 patients were cured after treatment for five times,with the total effective rate of 100%.Conclusion Pyonex has sound effect in treatment of patients with delayed gastric emptying after esophagectomy.展开更多
AIM: To study the effects of low-dose amitriptyline (AMT) on gastrointestinal function and brain-gut peptides in healthy Chinese volunteers. METHODS: This was a double-blind, randomised, placebo-controlled, two-period...AIM: To study the effects of low-dose amitriptyline (AMT) on gastrointestinal function and brain-gut peptides in healthy Chinese volunteers. METHODS: This was a double-blind, randomised, placebo-controlled, two-period cross-over trial. Twentyeight healthy volunteers were randomised and administered 1-wk treatments of AMT (12.5 mg tid) or placebo. Before and during the final two days of treatment, gastric emptying, proximal gastric accommodation and visceral sensitivity were measured by drinkingultrasonography test; the orocecal transit time (OCTT) was measured by lactulose hydrogen breath test, and fasting blood was collected. Plasma levels of ghrelin, motilin and neuropeptide Y (NPY) were measured by enzyme-linked immunosorbent assay kits.RESULTS: AMT slowed the OCTT (109.2 ± 29.68 min vs 96.61 ± 23.9 min, P = 0.004) but did not affect liquid gastric emptying and had no effect on proximal gastric accommodation. AMT resulted in decreases in the visual analogue scale (VAS) for difficulty in drinking 600 and 800 mL of water (3.57 ± 0.94 vs 2.98 ± 0.85, 5.57 ± 0.82 vs 4.57 ± 0.98, P < 0.01 for both), although it had no significant effect on the VAS for difficulty in drinking 200 mL and 400 mL of water. AMT significantly increased the plasma ghrelin level (442.87 ± 176.79 pg/mL vs 526.87 ± 158.44 pg/mL, P = 0.04) and the neuropeptide-Y level (890.15 ± 131.46 pg/mL vs 965.64 ± 165.63 pg/mL, P = 0.03), whereas it had no effect on the MTL level. CONCLUSION: Low-dose AMT could slow OCTT, make the stomach less sensitive and increase the plasma levels of ghrelin and NPY. Thus, we recommend the use of low-dose AMT for functional gastrointestinal disorders.展开更多
AIM To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people,and evaluate its application in guiding enteral nutrition(EN) in critically ill patient...AIM To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people,and evaluate its application in guiding enteral nutrition(EN) in critically ill patients. METHODS First,30 healthy volunteers were selected. The modified B-ultrasound method and the traditional B-ultrasound method were applied to assess gastric function. The correlation of indices of gastric function between the two groups was analyzed statistically. In addition,64 critically ill patients were selected,and the modified B-ultrasound method and the gastric juice withdrawal method were applied to guide the implementation of EN. Daily caloric value,the time required to achieve complete EN,ICU stay,hospitalization time,and serum prealbumin and albumin levels were recorded and compared between the two groups. Kaplan-Meier survival curve was used to compare the complications of EN between the two groups. RESULTS In healthy subjects,there was a good correlation among gastric emptying time,antral contraction frequency andantral motility index between the two groups(r = 0.57,0.61 and 0.54,respectively). The study on critically ill patients also revealed that a better effect of EN was achieved in the modified B-ultrasound method group,in which patients had shorter ICU stay and hospitalization time and higher levels of serum prealbumin and albumin. The Kaplan-Meier survival analysis revealed that the improved B-ultrasound method was associated with significantly fewer EN complications(P = 0.031).CONCLUSION The modified B-ultrasound method can provide a good real-time assessment of gastric function and has a better effect than the traditional method in guiding EN in critically ill patients.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.
基金Supported by the University of Kelaniya Grant,No.RP/03/04/11/01/2011.
文摘BACKGROUND Routine assessment of solid gastric emptying is challenging due to the prolonged test duration and complex meal preparation.Replacing solid test meals with easily prepared,commercially available semisolid meals and shortening the test duration can significantly enhance the feasibility and practicality of gastric emptying evaluations.AIM To compare the gastric emptying and antral motility of solid vs semi-solid meals of similar volume and nutritional consistency,and to assess the feasibility of meal substitution and reduction in test duration during the solid gastric emptying assessment.METHODS Thirty healthy volunteers(17 males,age:29.4±6.0 years,body mass index:23.4±2.94 and 13 females,age:37.2±11.9 years,body mass index:22.9±4.34)underwent gastric emptying by real-time ultrasonography after a solid meal and a comparable commercially prepared semi-solid meal(each meal,total calorie 350 kcal,carbohydrates 60%,fat 30%and proteins 10%),on separate dates 1 week apart.The gastric antral area was measured at 5 minutes,15 minutes,30 minutes,45 minutes,60 minutes,90 minutes,120 minutes,150 minutes,180 minutes,210 minutes,and 240 minutes post-ingestion using a previously validated technique and compared between meals.RESULTS Mean and median antral areas,gastric emptying rates,gastric residual ratios,and motility index at each time point were almost similar between meals for up to 3 hours.At the end of 4 hours,the mean emptied percentage of the semisolid meal and solid meal was 81.1%and 70.6%,respectively.The emptying rate of the semisolid meal at 90 minutes significantly correlated with that of 240 minutes.There was no correlation between the solid meal emptying rates at 90 minutes and 240 minutes.CONCLUSION Gastric emptying,residual antral cross-sectional area and antral motility of a semisolid meal are almost similar to that of a solid meal of the same nutritional value until three hours post-ingestion.A semisolid test meal can effectively substitute a solid test meal during ultrasound assessment of gastric emptying,without compromising the validity of the results.Additionally,the ease of preparation and administration of semisolid meals enhances the overall feasibility of gastric emptying assessments.
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.
文摘The new view denies the existence of fundamental particles in matter, and instead states that any particle and matter is a dynamic superposition of three natural elements, motion, force, and emptiness. This paper proposes a new theory of the structure of matter and the unification of the four forces. A correct understanding of the logic of material structure will enable atomic energy and nuclear physics to generate new manufacturing ideas. The dissertation expounds the natural distribution of dynamics and forces in space and the new deterministic theory of dynamic relationship. This theory solves problems such as the unity of the four forces and the dynamic laws of the material structure. In practical applications, it can provide new theoretical guidance for industrial manufacturing such as nuclear energy, fusion engineering, new energy, new materials, battery energy storage, new-generation reactors, etc., and then adopt effective means in line with the laws of natural power to make the substances needed by human beings. The supply of resources and energy is perfectly satisfied. Applying this theoretical model of material structure to all aspects of the manufacturing industry will surely open up a new era of material civilization for human beings.
文摘Moran considered a dam whose inflow in a given interval of time is a continuous random variable. He then developed integral equations for the probabilities of emptiness and overflow. These equations are difficult to solve numerically;thus, approximations have been proposed that discretize the input. In this paper, extensions are considered for storage systems with different assumptions for storage losses. We also develop discrete approximations for the probabilities of emptiness and overflow.
文摘Objective To evaluate the effect of Pyonex in treatment of patients with delayed gastric emptying after esophagectomy.Methods Twenty-three patients were treated with Pyonex at Pishu（脾俞 BL 20,bilateral）,Weishu（胃俞 BL 21,bilateral）,Neiguan（内关 PC 6）,Zusanli（足三里 ST 36）,Sanyinjiao（三阴交 SP 6） and Shidao（食道 CO 2） on the basis of conventional treatment.The pyonexs were changed every four days,and change for five times was considered as one course of treatment.The efficacy was evaluated after treatment for one course.Results One patient was cured after treatment for one time,with the effective rate of 4.4%;two patients were cured after treatment for two times,with the effective rate of 8.7%;ten patients were cured after treatment for three times,with the effective rate of 44.5%;seven patients were cured after treatment for four times,with the effective rate of30.4%;and three patients were cured after treatment for five times,with the effective rate of 13.0%.23 patients were cured after treatment for five times,with the total effective rate of 100%.Conclusion Pyonex has sound effect in treatment of patients with delayed gastric emptying after esophagectomy.
文摘AIM: To study the effects of low-dose amitriptyline (AMT) on gastrointestinal function and brain-gut peptides in healthy Chinese volunteers. METHODS: This was a double-blind, randomised, placebo-controlled, two-period cross-over trial. Twentyeight healthy volunteers were randomised and administered 1-wk treatments of AMT (12.5 mg tid) or placebo. Before and during the final two days of treatment, gastric emptying, proximal gastric accommodation and visceral sensitivity were measured by drinkingultrasonography test; the orocecal transit time (OCTT) was measured by lactulose hydrogen breath test, and fasting blood was collected. Plasma levels of ghrelin, motilin and neuropeptide Y (NPY) were measured by enzyme-linked immunosorbent assay kits.RESULTS: AMT slowed the OCTT (109.2 ± 29.68 min vs 96.61 ± 23.9 min, P = 0.004) but did not affect liquid gastric emptying and had no effect on proximal gastric accommodation. AMT resulted in decreases in the visual analogue scale (VAS) for difficulty in drinking 600 and 800 mL of water (3.57 ± 0.94 vs 2.98 ± 0.85, 5.57 ± 0.82 vs 4.57 ± 0.98, P < 0.01 for both), although it had no significant effect on the VAS for difficulty in drinking 200 mL and 400 mL of water. AMT significantly increased the plasma ghrelin level (442.87 ± 176.79 pg/mL vs 526.87 ± 158.44 pg/mL, P = 0.04) and the neuropeptide-Y level (890.15 ± 131.46 pg/mL vs 965.64 ± 165.63 pg/mL, P = 0.03), whereas it had no effect on the MTL level. CONCLUSION: Low-dose AMT could slow OCTT, make the stomach less sensitive and increase the plasma levels of ghrelin and NPY. Thus, we recommend the use of low-dose AMT for functional gastrointestinal disorders.
基金Supported by Cangzhou Science and Technology Project,No.131302097
文摘AIM To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people,and evaluate its application in guiding enteral nutrition(EN) in critically ill patients. METHODS First,30 healthy volunteers were selected. The modified B-ultrasound method and the traditional B-ultrasound method were applied to assess gastric function. The correlation of indices of gastric function between the two groups was analyzed statistically. In addition,64 critically ill patients were selected,and the modified B-ultrasound method and the gastric juice withdrawal method were applied to guide the implementation of EN. Daily caloric value,the time required to achieve complete EN,ICU stay,hospitalization time,and serum prealbumin and albumin levels were recorded and compared between the two groups. Kaplan-Meier survival curve was used to compare the complications of EN between the two groups. RESULTS In healthy subjects,there was a good correlation among gastric emptying time,antral contraction frequency andantral motility index between the two groups(r = 0.57,0.61 and 0.54,respectively). The study on critically ill patients also revealed that a better effect of EN was achieved in the modified B-ultrasound method group,in which patients had shorter ICU stay and hospitalization time and higher levels of serum prealbumin and albumin. The Kaplan-Meier survival analysis revealed that the improved B-ultrasound method was associated with significantly fewer EN complications(P = 0.031).CONCLUSION The modified B-ultrasound method can provide a good real-time assessment of gastric function and has a better effect than the traditional method in guiding EN in critically ill patients.
