BACKGROUND Chronic pouchitis remains a significant and prevalent complication following ileal pouch-anal anastomosis in patients with ulcerative colitis.AIM To identify potential risk factors for the development of ch...BACKGROUND Chronic pouchitis remains a significant and prevalent complication following ileal pouch-anal anastomosis in patients with ulcerative colitis.AIM To identify potential risk factors for the development of chronic pouchitis.METHODS Predictors of chronic pouchitis were investigated through a systematic review and meta-analysis.A comprehensive search of the Medline,EMBASE,and PubMed databases was undertaken to identify relevant studies published up to October 2023.Meta-analytic procedures employed random-effects models for the combination of estimates,with the I^(2)statistic used to assess between-study heterogeneity.RESULTS Eleven studies with a total of 3722 patients,comprising 513 with chronic pouchitis and 3209 patients without,were included in the final analysis.Extraintestinal manifestation[odds ratio(OR)=2.11,95%confidence intervals(CI):1.53-2.91,P<0.001,I^(2)=0%],specifically primary sclerosing cholangitis(PSC)(OR=3.69,95%CI:1.40-9.21,P=0.01,I2=48%),and extensive colitis(OR=1.96,95%CI:1.23-3.11,P=0.00,I^(2)=31%)were associated with an increased risk of chronic pouchitis.Other factors,including gender,smoking status,family history of inflammatory bowel disease and ileal pouch anal anastomosis surgical indication were not significantly associated with chronic pouchitis.CONCLUSION Extraintestinal manifestations,PSC and extensive colitis are associated with the development of chronic pouchitis.These findings underscore the importance of comprehensive pre-operative assessment and tailored post operative management strategies.展开更多
High-energy-density lithium metal batteries hold great promise for advancing low-altitude economic development.However,the practical application of ultrathin lithium anodes remains challenging due to significant inter...High-energy-density lithium metal batteries hold great promise for advancing low-altitude economic development.However,the practical application of ultrathin lithium anodes remains challenging due to significant interfacial side reactions,dendrite formation,and substantial volume fluctuations.In this study,lithium metal electrodes were fabricated using a spin-coating process,enabling an in situ reaction between lithium and phenyl disulfide(PDS).The resulting robust organic sulfurization interface,composed of lithium thiophenoxide,facilitates rapid lithium-ion transport and effectively suppresses dendrite formation.Symmetric cells with a 50μm Li@PDS anode exhibited an impressive lifespan exceeding3000 h at 1 mA cm^(-2)and 1 mAh cm^(-2).The Li@PDS anode demonstrated excellent structural stability in a practical LiNi_(0.8)Co_(0.1)Mn_(0.1)O_(2)(NCM811)lILi@PDS pouch cell,maintaining 94.8%of its initial capacity(1.45 Ah)over 260 cycles at a 0.4C rate and 87.30%of its initial capacity(1.1 Ah)over 360 cycles at a 2C rate(1C=200 mA g^(-1)).This work provides a promising pathway for developing durable lithium metal anodes suitable for scalable practical applications.展开更多
Electrolyte additives are pivotal for stable cycling of rechargeable sodium-ion batteries(SIBs),which dictate the creation of the protective interface film on electrodes.Cyclic sulfur-containing additives,such as1,3,2...Electrolyte additives are pivotal for stable cycling of rechargeable sodium-ion batteries(SIBs),which dictate the creation of the protective interface film on electrodes.Cyclic sulfur-containing additives,such as1,3,2-dioxathiolane-2,2-dioxide(DTD),with the structure of sulfur surrounded by four oxygen atoms,have been proposed but less knowledge is available on the relationship between their molecular structures and interfacial stability.This work compares two similar molecule structure of cyclic sulfurcontaining additives,DTD and ethylene sulfite(ES),to investigate their effects on the electrochemical performance of NaNi_(1/3)Fe_(1/3)Mn_(1/3)O_(2)(NFM)||hard carbon(HC)pouch cells.Therein,ES with the structure of sulfur surrounded by three oxygen atoms,as electrolyte additive,is investigated in the SIBs for the first time.It is shown that adding 3.0%ES or 2.0%DTD(the optimal proportion)in the Control electrolyte(1 M NaPF_(6)in EC:EMC=3:7 with 5.0%FEC in weight)can improve cyclic stability and rate performance,respectively.Even under the high-temperature conditions,both ES and DTD exhibit good performance,but DTD is superior.Combinations of electrochemical methods,multi-spectroscopy,and theoretical calculations have been employed to evaluate and compare the effects of ES and DTD on sodium-ion battery.They reveal that ES and DTD can generate different content and composition by redox reaction on cathode and anode surface.The more and effective high-valence sulfur-containing components for DTD are the main reason to explain the better effect on DTD.This work shares new insights into the relationship between cyclic sulfur-containing additive molecule structure and electrolyte-electrode interface films effect,which fills the blanks of previous research.展开更多
Objective To investigate the indications, operation techniques and clinical effects of a modified technique of Indiana pouch. Methods A modified technique of Indiana pouch was performed on 5 patients following radi...Objective To investigate the indications, operation techniques and clinical effects of a modified technique of Indiana pouch. Methods A modified technique of Indiana pouch was performed on 5 patients following radical cystectomy. Results 5 cases showed satisfactory therapeutic effects with of follow-up range of 6 to 30 months. All patients were continent day and night with easy catherization. The number of micturations was 5 to 6 times in the daytime and 1 to 3 times in the nighttime. Cystography of 4 cases showed that pouches were spheroidic and volumes were between 400 to 500 ml. Conclusion The advantages of the modified Indiana pouch are as follows: easy manipulation; low tension and high volume in pouches; no reflux; satisfactory urinary continence and few complications. Therefore, it is worthy of clinical popularization.展开更多
Restorative proctocolectomy is the most common surgical option for patients with familial adenomatous polyposis(FAP). However,adenomas may develop in the ileal pouch mucosa over time,and even carcinoma in the pouch ha...Restorative proctocolectomy is the most common surgical option for patients with familial adenomatous polyposis(FAP). However,adenomas may develop in the ileal pouch mucosa over time,and even carcinoma in the pouch has been reported. We therefore reviewed the prevalence,nature,and treatment of adenomas and carcinoma that develop after proctocolectomy in the ileal pouch mucosa in patients with FAP. In 25 reports that were reviewed,the incidence of adenomas in the ileal pouch varied from 6.7% to 73.9%. Several potential factors that favor the development of pouch polyposis have been investigated,but many remain controversial. Nevertheless,it seems certain that the age of the pouch is important. The risk appears to be 7%to 16% after 5 years,35% to 42% after 10 years,and75% after 15 years. On the other hand,only 21 cases of ileal pouch carcinoma have been recorded in the literature to date. The diagnosis of pouch carcinoma was made between 3 to 20 years(median,10 years) after pouch construction. Although the risk of malignant transformation in ileal pouches is probably low,it is not negligible,and the long-term risk cannot presently be well quantified. Regular endoscopic surveillance,especially using chromoendoscopy,is recommended.展开更多
To meet the requirements of electronic vehicles(EVs) and hybrid electric vehicles(HEVs),the high energy density Li Ni_(0.8) Co_(0.15) Al_(0.05) O_2(NCA) cathode and Si–C anode have attracted more attention.Here we re...To meet the requirements of electronic vehicles(EVs) and hybrid electric vehicles(HEVs),the high energy density Li Ni_(0.8) Co_(0.15) Al_(0.05) O_2(NCA) cathode and Si–C anode have attracted more attention.Here we report the thermal behaviors of NCA/Si–C pouch cell during the charge/discharge processes at different current densities.The total heat generations are derived from the surface temperature change during electrochemical Li+insertion/extraction in adiabatic surrounding.The reversible heat is determined by the entropic coefficients,which are related with open-circuit voltage at different temperatures; while the irreversible heat is determined by the internal resistance,which can be obtained via V–I characteristic,electrochemical impedance spectroscopy and hybrid pulse power characterization(HPPC).During the electrochemical process,the reversible heat contributes less than 10% to total heat generation; and the heat generated in charge process is less than that in discharge process.The results of thermal behaviors analyses are conducive to understanding the safety management and paving the way for building a reliable thermal model of high energy density lithium ion battery.展开更多
Aim To investigate the role of the Chinese herbal medicine Xianhuayin on the reversal of 7,12-dimethylbenz[a]anthracene （DMBA）-induced premalignant mucosal lesions in the oral buccal pouch of golden hamsters. Method...Aim To investigate the role of the Chinese herbal medicine Xianhuayin on the reversal of 7,12-dimethylbenz[a]anthracene （DMBA）-induced premalignant mucosal lesions in the oral buccal pouch of golden hamsters. Methodology The animals were randomly divided into a non-diseased control group （n=5） and an experimental group including 50 animals in which the buccal mucosa had been painted with DMBA （0.5% in acetone） to generate an oral mucosa premalignant lesion. Animals in the experi- mental group were further divided into Xianhuayin-treated group （n=30）, untreated prem＇alignant lesion group （n=10） and normal saline （NS）-treated group （n=10）. The cheek （buccal） pouch mucosa of the golden hamsters in each group was observed with light and electron microscopy eight weeks after intragastric administration with NS or Xianhuayin. Results In the non-diseased control group, the buccal mucosa was keratinized and stratified squamous epithelium under a light microscope. In the untreated premalignant lesion group, variable degrees of epithelial dysplasia was observed. The irregular epithelial mucosa gradually became distinct in the Xianhuayin-treated group. Scanning electronic microscopic （SEM） analysis showed that surface of the cells exhibited honeycomb structures in the hamster of untreated- group. The cells were morphologically irregular, overlapped and loosened in the untreated premalignant lesion group. Most of the cell surface exhibited honeycomb structure in the Xianhuayin-treated group. Transmission electronic micro- scopic （TEM） analysis showed that buccal mucosal epithelial cells were morphologically regular in the non-diseased control group. Desmosomes and tonofibrils were reduced and the nucleus was morphologically irregular in the untreated premalignant lesion group. In the Xianhuayin-treated group, the widening intercellular gap was gradually reduced, desmosomes and the cells becoming morphologically regular. No significant difference was observed between the hamsters in NS-treated group and those in the untreated premalignant lesion group. Significant therapeutic efficacy was observed in the group receiving Xianhuayin. Conclusion Xianhuayin is effective in the reversal of DMBA-induced premalignant lesions in the buccal pouch of golden hamsters.展开更多
The ileal pouch anal anastomosis(IPAA)has revolutionised the surgical management of ulcerative colitis(UC)and familial adenomatous polyposis(FAP).Despite refinement in surgical technique(s)and patient selection,IPAA c...The ileal pouch anal anastomosis(IPAA)has revolutionised the surgical management of ulcerative colitis(UC)and familial adenomatous polyposis(FAP).Despite refinement in surgical technique(s)and patient selection,IPAA can be associated with significant morbidity.As the IPAA celebrated its 40th anniversary in 2018,this review provides a timely outline of its history,indications,and complications.IPAA has undergone significant modification since 1978.For both UC and FAP,IPAA surgery aims to definitively cure disease and prevent malignant degeneration,while providing adequate continence and avoiding a permanent stoma.The majority of patients experience long-term success,but“early”and“late”complications are recognised.Pelvic sepsis is a common early complication with far-reaching consequences of long-term pouch dysfunction,but prompt intervention(either radiological or surgical)reduces the risk of pouch failure.Even in the absence of sepsis,pouch dysfunction is a longterm complication that may have a myriad of causes.Pouchitis is a common cause that remains incompletely understood and difficult to manage at times.10%of patients succumb to the diagnosis of pouch failure,which is traditionally associated with the need for pouch excision.This review provides a timely outline of the history,indications,and complications associated with IPAA.Patient selection remains key,and contraindications exist for this surgery.A structured management plan is vital to the successful management of complications following pouch surgery.展开更多
Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative colitis.However,despite the widespread use of RP-IPAA,many aspects of this treatment still ...Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative colitis.However,despite the widespread use of RP-IPAA,many aspects of this treatment still remain controversial,such as the approach(open or laparoscopic),number of stages in the surgery,type of pouch,and construction type(hand-sewn or stapled ileal pouch-anal anastomosis).The present narrative review aims to discuss current evidence on the short-,mid-,and long-term results of each of these technical alternatives as well as their benefits and disadvantages.A review of the MEDLINE,EMBASE,and Ovid databases was performed to identify studies published through March 2016.Few large,randomized,controlled studies have been conducted,which limits the conclusions that can be drawn regarding controversial issues.The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases.Regarding 2- and 3-stage RP-IPAA,patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables,making any comparisons extremely difficult.The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly,although the J pouch is generally preferred by surgeons.Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages,and there is no clear benefit of one technique over the other.展开更多
Ulcerative colitis (UC) is a relapsing and remitting disease characterised by chronic mucosal and submucosal inflammation of the colon and rectum. Treatment may vary depending upon the extent and severity of inflammat...Ulcerative colitis (UC) is a relapsing and remitting disease characterised by chronic mucosal and submucosal inflammation of the colon and rectum. Treatment may vary depending upon the extent and severity of inflammation. Broadly speaking medical treatments aim to induce and then maintain remission. Surgery is indicated for inflammatory disease that is refractory to medical treatment or in cases of neoplastic transformation. Approximately 25% of patients with UC ultimately require colectomy. Ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis who ultimately require colectomy. This review will examine indications for IPAA, patient selection, technical aspects of surgery, management of complications and long term outcome following this procedure.展开更多
Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)has become the surgical treatment of choice for many patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP)....Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)has become the surgical treatment of choice for many patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP).UC patients with IPAA(UC-IPAA)are,nevertheless,susceptible to inflammatory and noninflammatory sequelae such as pouchitis,which is only rarely noted in FAP patients with IPAA.Pouchitis is the most frequent long-term complication of UC-IPAA patients,with a cumulative prevalence of up to 50%.Although the aetiology of pouchitis remains unclear,accumulating evidence suggests that a dysbiosis of the pouch microbiota and an abnormal mucosal immune response are implicated in its pathogenesis.Studies using culture and molecular techniques have detected a dysbiosis of the pouch microbiota in patients with pouchitis.Risk factors,genetic associations,and serological markers suggest that interactions between the host immune response and the pouch microbiota underlie the aetiology of this idiopathic inflammatory condition.This systematic review focuses on the dysbiosis of the microbiota that inhabit the pouch in UC and FAP patients and its interaction with the mucosal immune system.A metaanalysis was not attempted due to the highly heterogeneous microbiota composition and the different detection methods used by the various studies.Although no specific bacterial species,genus,or family has as yet been identified as pathogenic,there is evidence that a dysbiosis characterized by decreased gut microbiota diversity in UC-IPAA patients may,in genetically predisposed subjects,lead to aberrant mucosal immune regulation triggering an inflammatory process.展开更多
Developing sulfur cathodes with high catalytic activity on accelerating the sluggish redox kinetics of lithium polysulfides(Li PSs) and unveiling their mechanisms are pivotal for advanced lithium–sulfur(Li–S)batteri...Developing sulfur cathodes with high catalytic activity on accelerating the sluggish redox kinetics of lithium polysulfides(Li PSs) and unveiling their mechanisms are pivotal for advanced lithium–sulfur(Li–S)batteries. Herein, MoS2 is verified to reduce the Gibbs free energy for rate-limiting step of sulfur reduction and the dissociation energy of lithium sulfide(Li2 S) for the first time employing theoretical calculations. The Mo S2 nanosheets coated on mesoporous hollow carbon spheres(MHCS) are then reasonably designed as a sulfur host for high-capacity and long-life Li–S battery, in which MHCS can guarantee the high sulfur loading and fast electron/ion transfer. It is revealed that the shuttle effect is efficiently inhibited because of the boosted conversion of Li PSs. As a result, the coin cell based on the MHCS@Mo S2-S cathode exhibits stable cycling performance maintaining 735.7 mAh g^(-1) after 500 cycles at 1.0 C. More importantly, the pouch cell employing the MHCS@Mo S2-S cathodes achieves high specific capacity of1353.2 m Ah g^(-1) and prominent cycle stability that remaining 960.0 m Ah g^(-1) with extraordinary capacity retention of 79.8% at 0.1 C after 170 cycles. Therefore, this work paves a new avenue for developing practical high specific energy and long-life pouch-type Li–S batteries.展开更多
While restorative proctocolectomy with ileal pouch-anal anastomosis has significantly improved the quality of life in patients with underlying ulcerative colitis who require surgery,complications can occur.Pouchitis a...While restorative proctocolectomy with ileal pouch-anal anastomosis has significantly improved the quality of life in patients with underlying ulcerative colitis who require surgery,complications can occur.Pouchitis as the most common long-term complication represents a spectrum of disease processes ranging from acute,antibiotic-responsive type to chronic antibiotic-refractory entity.Accurate diagnosis using a combined assessment of symptoms,endoscopy and histology and the stratification of clinical phenotypes is important for treatment and prognosis the disease.The majority of patients respond favorably to antibiotic therapy.However,management of chronic antibiotic-refractory pouchitis remains a challenge.展开更多
The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this repo...The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this report, we have described a successful treatment of severe refractory pouchitis with a novel agent, rebamipide, known to promote epithelial cell regeneration and angiogenesis. A 27-year-old male with ileo-anal pouch surgery presented with worsening anal pain, diarrhea, and abdominal pain. The patient was diagnosed to have pouchitis and was given metronidazole together with betamethasone enema （3.95 rag/dose）. However, despite this intensive therapy, the patient did not improve. On endoscopy, ulceration and inflammation were seen in the ileal pouch together with contact bleeding and mucous discharge. The patient was treated with rebamipide enema （150 rag/close） twice a clay for 8 wk without additional drug therapy. Two weeks after the rebamipide therapy, stool frequency started to decrease and fecal hemoglobin became negative at the 4^th wk. At the end of the therapy, endoscopy revealed that ulcers in the ileal pouch had healed with no obvious inflammation. The effect of rebamipide enema was dramatic and was maintained throughout the ll-mo follow-up. The patient continued to be in remission. No adverse effects were observed during the treatment or the follow-up period. The sustained response seen in this case with severe and refractory pouchitis indicates that agents, which promote epithelial cell growth, angiogenesis and mucosal tissue regeneration, are potential therapeutic agents for the treatment of refractory colorectal lesions.展开更多
Objective: To study the physiology value of colonic pouch anastomosis after rectal cancer excision. Methods: Forty-six patients with total mesonectal excision for carcinoma were randomized to either a straight (Group ...Objective: To study the physiology value of colonic pouch anastomosis after rectal cancer excision. Methods: Forty-six patients with total mesonectal excision for carcinoma were randomized to either a straight (Group A, n=23) or a colonic pouch anastomosis (Group B, n=23). The neorectal physiologic function of patients in both groups was evaluated, which included laboratory studies. Results: Sphincter pressures in both groups were similar. Preoperative compliance of the rectum was restored after surgery in the Group B, 0.296 (0.224–0.347) L/Kpa, but there was a significant decrease after surgery in the Group A, 0.194 (0.112–0.235) L/Kpa P<0.001. By a multiple regression analysis, neo-rectal complicance was associated with favorable clinical function, and hypermotility of the canal was associated with adverse clinical function. Conclusion: Colonic pouch-anastomosis restores neorectal compliance, which is important for good function after low anterior resection.展开更多
文摘BACKGROUND Chronic pouchitis remains a significant and prevalent complication following ileal pouch-anal anastomosis in patients with ulcerative colitis.AIM To identify potential risk factors for the development of chronic pouchitis.METHODS Predictors of chronic pouchitis were investigated through a systematic review and meta-analysis.A comprehensive search of the Medline,EMBASE,and PubMed databases was undertaken to identify relevant studies published up to October 2023.Meta-analytic procedures employed random-effects models for the combination of estimates,with the I^(2)statistic used to assess between-study heterogeneity.RESULTS Eleven studies with a total of 3722 patients,comprising 513 with chronic pouchitis and 3209 patients without,were included in the final analysis.Extraintestinal manifestation[odds ratio(OR)=2.11,95%confidence intervals(CI):1.53-2.91,P<0.001,I^(2)=0%],specifically primary sclerosing cholangitis(PSC)(OR=3.69,95%CI:1.40-9.21,P=0.01,I2=48%),and extensive colitis(OR=1.96,95%CI:1.23-3.11,P=0.00,I^(2)=31%)were associated with an increased risk of chronic pouchitis.Other factors,including gender,smoking status,family history of inflammatory bowel disease and ileal pouch anal anastomosis surgical indication were not significantly associated with chronic pouchitis.CONCLUSION Extraintestinal manifestations,PSC and extensive colitis are associated with the development of chronic pouchitis.These findings underscore the importance of comprehensive pre-operative assessment and tailored post operative management strategies.
基金financially supported by the National Natural Science Foundation of China (No.52471166)the Central South University Graduate-Student Autonomous Exploration Innovative Programme (No.2024ZZTS0373)
文摘High-energy-density lithium metal batteries hold great promise for advancing low-altitude economic development.However,the practical application of ultrathin lithium anodes remains challenging due to significant interfacial side reactions,dendrite formation,and substantial volume fluctuations.In this study,lithium metal electrodes were fabricated using a spin-coating process,enabling an in situ reaction between lithium and phenyl disulfide(PDS).The resulting robust organic sulfurization interface,composed of lithium thiophenoxide,facilitates rapid lithium-ion transport and effectively suppresses dendrite formation.Symmetric cells with a 50μm Li@PDS anode exhibited an impressive lifespan exceeding3000 h at 1 mA cm^(-2)and 1 mAh cm^(-2).The Li@PDS anode demonstrated excellent structural stability in a practical LiNi_(0.8)Co_(0.1)Mn_(0.1)O_(2)(NCM811)lILi@PDS pouch cell,maintaining 94.8%of its initial capacity(1.45 Ah)over 260 cycles at a 0.4C rate and 87.30%of its initial capacity(1.1 Ah)over 360 cycles at a 2C rate(1C=200 mA g^(-1)).This work provides a promising pathway for developing durable lithium metal anodes suitable for scalable practical applications.
基金supported by the National Natural Science Foundation of China(21875076)the Guangdong Provincial International Joint Research Center for Energy Storage Materials(2023A0505090009)the Science and Technology Planning Project of Guangzhou City(2023B03J1278)。
文摘Electrolyte additives are pivotal for stable cycling of rechargeable sodium-ion batteries(SIBs),which dictate the creation of the protective interface film on electrodes.Cyclic sulfur-containing additives,such as1,3,2-dioxathiolane-2,2-dioxide(DTD),with the structure of sulfur surrounded by four oxygen atoms,have been proposed but less knowledge is available on the relationship between their molecular structures and interfacial stability.This work compares two similar molecule structure of cyclic sulfurcontaining additives,DTD and ethylene sulfite(ES),to investigate their effects on the electrochemical performance of NaNi_(1/3)Fe_(1/3)Mn_(1/3)O_(2)(NFM)||hard carbon(HC)pouch cells.Therein,ES with the structure of sulfur surrounded by three oxygen atoms,as electrolyte additive,is investigated in the SIBs for the first time.It is shown that adding 3.0%ES or 2.0%DTD(the optimal proportion)in the Control electrolyte(1 M NaPF_(6)in EC:EMC=3:7 with 5.0%FEC in weight)can improve cyclic stability and rate performance,respectively.Even under the high-temperature conditions,both ES and DTD exhibit good performance,but DTD is superior.Combinations of electrochemical methods,multi-spectroscopy,and theoretical calculations have been employed to evaluate and compare the effects of ES and DTD on sodium-ion battery.They reveal that ES and DTD can generate different content and composition by redox reaction on cathode and anode surface.The more and effective high-valence sulfur-containing components for DTD are the main reason to explain the better effect on DTD.This work shares new insights into the relationship between cyclic sulfur-containing additive molecule structure and electrolyte-electrode interface films effect,which fills the blanks of previous research.
文摘Objective To investigate the indications, operation techniques and clinical effects of a modified technique of Indiana pouch. Methods A modified technique of Indiana pouch was performed on 5 patients following radical cystectomy. Results 5 cases showed satisfactory therapeutic effects with of follow-up range of 6 to 30 months. All patients were continent day and night with easy catherization. The number of micturations was 5 to 6 times in the daytime and 1 to 3 times in the nighttime. Cystography of 4 cases showed that pouches were spheroidic and volumes were between 400 to 500 ml. Conclusion The advantages of the modified Indiana pouch are as follows: easy manipulation; low tension and high volume in pouches; no reflux; satisfactory urinary continence and few complications. Therefore, it is worthy of clinical popularization.
文摘Restorative proctocolectomy is the most common surgical option for patients with familial adenomatous polyposis(FAP). However,adenomas may develop in the ileal pouch mucosa over time,and even carcinoma in the pouch has been reported. We therefore reviewed the prevalence,nature,and treatment of adenomas and carcinoma that develop after proctocolectomy in the ileal pouch mucosa in patients with FAP. In 25 reports that were reviewed,the incidence of adenomas in the ileal pouch varied from 6.7% to 73.9%. Several potential factors that favor the development of pouch polyposis have been investigated,but many remain controversial. Nevertheless,it seems certain that the age of the pouch is important. The risk appears to be 7%to 16% after 5 years,35% to 42% after 10 years,and75% after 15 years. On the other hand,only 21 cases of ileal pouch carcinoma have been recorded in the literature to date. The diagnosis of pouch carcinoma was made between 3 to 20 years(median,10 years) after pouch construction. Although the risk of malignant transformation in ileal pouches is probably low,it is not negligible,and the long-term risk cannot presently be well quantified. Regular endoscopic surveillance,especially using chromoendoscopy,is recommended.
基金supported by the National Key R&D Program of China:Trackling Key Technology for Development and Industrialization of Power Lithium Ion Battery with High Specific Energy (Grant No.2016YFB0100508)
文摘To meet the requirements of electronic vehicles(EVs) and hybrid electric vehicles(HEVs),the high energy density Li Ni_(0.8) Co_(0.15) Al_(0.05) O_2(NCA) cathode and Si–C anode have attracted more attention.Here we report the thermal behaviors of NCA/Si–C pouch cell during the charge/discharge processes at different current densities.The total heat generations are derived from the surface temperature change during electrochemical Li+insertion/extraction in adiabatic surrounding.The reversible heat is determined by the entropic coefficients,which are related with open-circuit voltage at different temperatures; while the irreversible heat is determined by the internal resistance,which can be obtained via V–I characteristic,electrochemical impedance spectroscopy and hybrid pulse power characterization(HPPC).During the electrochemical process,the reversible heat contributes less than 10% to total heat generation; and the heat generated in charge process is less than that in discharge process.The results of thermal behaviors analyses are conducive to understanding the safety management and paving the way for building a reliable thermal model of high energy density lithium ion battery.
基金supported by grants from the highly distinguished Oncology Subject Foundation of Colleges in Hebei Province
文摘Aim To investigate the role of the Chinese herbal medicine Xianhuayin on the reversal of 7,12-dimethylbenz[a]anthracene （DMBA）-induced premalignant mucosal lesions in the oral buccal pouch of golden hamsters. Methodology The animals were randomly divided into a non-diseased control group （n=5） and an experimental group including 50 animals in which the buccal mucosa had been painted with DMBA （0.5% in acetone） to generate an oral mucosa premalignant lesion. Animals in the experi- mental group were further divided into Xianhuayin-treated group （n=30）, untreated prem＇alignant lesion group （n=10） and normal saline （NS）-treated group （n=10）. The cheek （buccal） pouch mucosa of the golden hamsters in each group was observed with light and electron microscopy eight weeks after intragastric administration with NS or Xianhuayin. Results In the non-diseased control group, the buccal mucosa was keratinized and stratified squamous epithelium under a light microscope. In the untreated premalignant lesion group, variable degrees of epithelial dysplasia was observed. The irregular epithelial mucosa gradually became distinct in the Xianhuayin-treated group. Scanning electronic microscopic （SEM） analysis showed that surface of the cells exhibited honeycomb structures in the hamster of untreated- group. The cells were morphologically irregular, overlapped and loosened in the untreated premalignant lesion group. Most of the cell surface exhibited honeycomb structure in the Xianhuayin-treated group. Transmission electronic micro- scopic （TEM） analysis showed that buccal mucosal epithelial cells were morphologically regular in the non-diseased control group. Desmosomes and tonofibrils were reduced and the nucleus was morphologically irregular in the untreated premalignant lesion group. In the Xianhuayin-treated group, the widening intercellular gap was gradually reduced, desmosomes and the cells becoming morphologically regular. No significant difference was observed between the hamsters in NS-treated group and those in the untreated premalignant lesion group. Significant therapeutic efficacy was observed in the group receiving Xianhuayin. Conclusion Xianhuayin is effective in the reversal of DMBA-induced premalignant lesions in the buccal pouch of golden hamsters.
文摘AIM: To investigate the outcomes of treatments for complications after ileal pouch-anal anastomosis (IPAA) in Korean patients with ulcerative colitis.
基金the Mitchell J.Notaras Fellowship in Colorectal Surgery
文摘The ileal pouch anal anastomosis(IPAA)has revolutionised the surgical management of ulcerative colitis(UC)and familial adenomatous polyposis(FAP).Despite refinement in surgical technique(s)and patient selection,IPAA can be associated with significant morbidity.As the IPAA celebrated its 40th anniversary in 2018,this review provides a timely outline of its history,indications,and complications.IPAA has undergone significant modification since 1978.For both UC and FAP,IPAA surgery aims to definitively cure disease and prevent malignant degeneration,while providing adequate continence and avoiding a permanent stoma.The majority of patients experience long-term success,but“early”and“late”complications are recognised.Pelvic sepsis is a common early complication with far-reaching consequences of long-term pouch dysfunction,but prompt intervention(either radiological or surgical)reduces the risk of pouch failure.Even in the absence of sepsis,pouch dysfunction is a longterm complication that may have a myriad of causes.Pouchitis is a common cause that remains incompletely understood and difficult to manage at times.10%of patients succumb to the diagnosis of pouch failure,which is traditionally associated with the need for pouch excision.This review provides a timely outline of the history,indications,and complications associated with IPAA.Patient selection remains key,and contraindications exist for this surgery.A structured management plan is vital to the successful management of complications following pouch surgery.
文摘Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative colitis.However,despite the widespread use of RP-IPAA,many aspects of this treatment still remain controversial,such as the approach(open or laparoscopic),number of stages in the surgery,type of pouch,and construction type(hand-sewn or stapled ileal pouch-anal anastomosis).The present narrative review aims to discuss current evidence on the short-,mid-,and long-term results of each of these technical alternatives as well as their benefits and disadvantages.A review of the MEDLINE,EMBASE,and Ovid databases was performed to identify studies published through March 2016.Few large,randomized,controlled studies have been conducted,which limits the conclusions that can be drawn regarding controversial issues.The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases.Regarding 2- and 3-stage RP-IPAA,patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables,making any comparisons extremely difficult.The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly,although the J pouch is generally preferred by surgeons.Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages,and there is no clear benefit of one technique over the other.
文摘Ulcerative colitis (UC) is a relapsing and remitting disease characterised by chronic mucosal and submucosal inflammation of the colon and rectum. Treatment may vary depending upon the extent and severity of inflammation. Broadly speaking medical treatments aim to induce and then maintain remission. Surgery is indicated for inflammatory disease that is refractory to medical treatment or in cases of neoplastic transformation. Approximately 25% of patients with UC ultimately require colectomy. Ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis who ultimately require colectomy. This review will examine indications for IPAA, patient selection, technical aspects of surgery, management of complications and long term outcome following this procedure.
文摘Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)has become the surgical treatment of choice for many patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP).UC patients with IPAA(UC-IPAA)are,nevertheless,susceptible to inflammatory and noninflammatory sequelae such as pouchitis,which is only rarely noted in FAP patients with IPAA.Pouchitis is the most frequent long-term complication of UC-IPAA patients,with a cumulative prevalence of up to 50%.Although the aetiology of pouchitis remains unclear,accumulating evidence suggests that a dysbiosis of the pouch microbiota and an abnormal mucosal immune response are implicated in its pathogenesis.Studies using culture and molecular techniques have detected a dysbiosis of the pouch microbiota in patients with pouchitis.Risk factors,genetic associations,and serological markers suggest that interactions between the host immune response and the pouch microbiota underlie the aetiology of this idiopathic inflammatory condition.This systematic review focuses on the dysbiosis of the microbiota that inhabit the pouch in UC and FAP patients and its interaction with the mucosal immune system.A metaanalysis was not attempted due to the highly heterogeneous microbiota composition and the different detection methods used by the various studies.Although no specific bacterial species,genus,or family has as yet been identified as pathogenic,there is evidence that a dysbiosis characterized by decreased gut microbiota diversity in UC-IPAA patients may,in genetically predisposed subjects,lead to aberrant mucosal immune regulation triggering an inflammatory process.
基金supported by the funding from the Strategy Priority Research Program of Chinese Academy of Science (Grant No. XDA17020404)DICP&QIBEBT (DICP&QIBEBT UN201702)+8 种基金R&D Projects in Key Areas of Guangdong Province (2019B090908001)Science and Technology Innovation Foundation of Dalian (2018J11CY020)Defense Industrial Technology Development Program (JCKY2018130C107)National Natural Science Foundation of China (Grants 51872283)Liao Ning Revitalization Talents Program (Grant XLYC1807153)Natural Science Foundation of Liaoning Province (Grant 20180510038)DICP (DICP ZZBS201708, DICP ZZBS201802)DNL Cooperation FundCAS (DNL180310, DNL180308, DNL201912, and DNL201915)。
文摘Developing sulfur cathodes with high catalytic activity on accelerating the sluggish redox kinetics of lithium polysulfides(Li PSs) and unveiling their mechanisms are pivotal for advanced lithium–sulfur(Li–S)batteries. Herein, MoS2 is verified to reduce the Gibbs free energy for rate-limiting step of sulfur reduction and the dissociation energy of lithium sulfide(Li2 S) for the first time employing theoretical calculations. The Mo S2 nanosheets coated on mesoporous hollow carbon spheres(MHCS) are then reasonably designed as a sulfur host for high-capacity and long-life Li–S battery, in which MHCS can guarantee the high sulfur loading and fast electron/ion transfer. It is revealed that the shuttle effect is efficiently inhibited because of the boosted conversion of Li PSs. As a result, the coin cell based on the MHCS@Mo S2-S cathode exhibits stable cycling performance maintaining 735.7 mAh g^(-1) after 500 cycles at 1.0 C. More importantly, the pouch cell employing the MHCS@Mo S2-S cathodes achieves high specific capacity of1353.2 m Ah g^(-1) and prominent cycle stability that remaining 960.0 m Ah g^(-1) with extraordinary capacity retention of 79.8% at 0.1 C after 170 cycles. Therefore, this work paves a new avenue for developing practical high specific energy and long-life pouch-type Li–S batteries.
基金a grant from National Institutes of Health,No.R03DK 067275 a grant from Broad Medical Research Program ofBroad Foundation
文摘While restorative proctocolectomy with ileal pouch-anal anastomosis has significantly improved the quality of life in patients with underlying ulcerative colitis who require surgery,complications can occur.Pouchitis as the most common long-term complication represents a spectrum of disease processes ranging from acute,antibiotic-responsive type to chronic antibiotic-refractory entity.Accurate diagnosis using a combined assessment of symptoms,endoscopy and histology and the stratification of clinical phenotypes is important for treatment and prognosis the disease.The majority of patients respond favorably to antibiotic therapy.However,management of chronic antibiotic-refractory pouchitis remains a challenge.
文摘The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this report, we have described a successful treatment of severe refractory pouchitis with a novel agent, rebamipide, known to promote epithelial cell regeneration and angiogenesis. A 27-year-old male with ileo-anal pouch surgery presented with worsening anal pain, diarrhea, and abdominal pain. The patient was diagnosed to have pouchitis and was given metronidazole together with betamethasone enema （3.95 rag/dose）. However, despite this intensive therapy, the patient did not improve. On endoscopy, ulceration and inflammation were seen in the ileal pouch together with contact bleeding and mucous discharge. The patient was treated with rebamipide enema （150 rag/close） twice a clay for 8 wk without additional drug therapy. Two weeks after the rebamipide therapy, stool frequency started to decrease and fecal hemoglobin became negative at the 4^th wk. At the end of the therapy, endoscopy revealed that ulcers in the ileal pouch had healed with no obvious inflammation. The effect of rebamipide enema was dramatic and was maintained throughout the ll-mo follow-up. The patient continued to be in remission. No adverse effects were observed during the treatment or the follow-up period. The sustained response seen in this case with severe and refractory pouchitis indicates that agents, which promote epithelial cell growth, angiogenesis and mucosal tissue regeneration, are potential therapeutic agents for the treatment of refractory colorectal lesions.
文摘Objective: To study the physiology value of colonic pouch anastomosis after rectal cancer excision. Methods: Forty-six patients with total mesonectal excision for carcinoma were randomized to either a straight (Group A, n=23) or a colonic pouch anastomosis (Group B, n=23). The neorectal physiologic function of patients in both groups was evaluated, which included laboratory studies. Results: Sphincter pressures in both groups were similar. Preoperative compliance of the rectum was restored after surgery in the Group B, 0.296 (0.224–0.347) L/Kpa, but there was a significant decrease after surgery in the Group A, 0.194 (0.112–0.235) L/Kpa P<0.001. By a multiple regression analysis, neo-rectal complicance was associated with favorable clinical function, and hypermotility of the canal was associated with adverse clinical function. Conclusion: Colonic pouch-anastomosis restores neorectal compliance, which is important for good function after low anterior resection.
