Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco...Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco use^([1]).Adolescents are especially prone to developing persistent smoking habits,with many adult smokers having started before the age of 18.In China,16.7%of secondary school students have tried smoking and 4.7%are current smokers,highlighting the critical need for targeted tobacco control interventions among the youth.展开更多
The scope of management of malignant gastric outlet obstruction is ever-expanding.The therapeutic use of endoscopy is gaining popularity not just owing to its technical advancement and satisfactory patient outcomes.Wi...The scope of management of malignant gastric outlet obstruction is ever-expanding.The therapeutic use of endoscopy is gaining popularity not just owing to its technical advancement and satisfactory patient outcomes.With technical success rates close to 96%,stent placement for palliating gastric obstruction has ensured a median survival of about 2 months post-deployment of gastro-duodenal stents.Understanding the correct concept of palliation is the need of the hour in management.Identifying the right patient for palliation,selecting the appropriate intervention and auditing the outcome are vital in delivering optimal care.Also,newer procedures such as endoscopic gastro-enterostomy offer promising outcomes in palliative care.展开更多
Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojeju...Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.展开更多
BACKGROUND Obesity remains a significant global health concern,and intragastric balloons(IGBs)offer a minimally invasive weight loss option for patients who fail lifestyle and pharmacotherapy interventions.IGBs can ca...BACKGROUND Obesity remains a significant global health concern,and intragastric balloons(IGBs)offer a minimally invasive weight loss option for patients who fail lifestyle and pharmacotherapy interventions.IGBs can cause complications ranging from mild symptoms to severe issues like gastric outlet obstruction(GOO).This report discusses a 39-year-old woman who presented with clinical and radiological features of GOO post Silimed IGB placement.CASE SUMMARY A 39-year-old woman presented to our institution with two-week history of abdominal pain,nausea and vomiting post prandially.This was in the context of a Silimed IGB placement two weeks prior to presentation for weight loss in the context of obesity.A computed tomography of the abdomen demonstrated the IGB device in the body and prepyloric region,with proximal dilatation of the body and fundus of the stomach which contained gastric contents.Due to concerns for GOO,the IGB was removed endoscopically with subsequent symptom alleviation.In addition to this,we performed a literature search of cases of IGB related GOO using the PubMed and Web of Science databases from inception date to the August 26,2024.A total of 27 articles were included in the analysis,identifying 29 cases of IGB-related GOO.These patients commonly presented with nausea,vomiting and abdominal pain,with symptom onset varying from 3 days to 18 months post IGB insertion.Abdominal computed tomography was the primary diagnostic tool and endoscopic removal was the standard treatment modality.CONCLUSION This is the first reported case of GOO caused by Silimed IGB.While effective for weight reduction,IGB-related GOO is a rare but serious complication,usually requiring endoscopic retrieval.Future research should aim to identify patient factors linked to this complication to enhance clinical-decision making and outcomes.展开更多
Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,...Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,shorter hospita-lization,and earlier chemotherapy initiation.However,its long-term efficacy is limited by stent occlusion,which typically occurs 2-4 months post-procedure,due to tumor ingrowth,overgrowth,or food impaction.Covered stents can reduce tumor ingrowth but increase the migration risk,particularly in patients receiving chemotherapy.This review provides a comprehensive comparison of duodenal stenting,surgical gastrojejunostomy,and endoscopic ultrasound-guided gastroen-terostomy,by discussing their clinical outcomes,advantages,and limitations.We further explore stent selection based on stricture characteristics,optimal placement techniques,post-procedural management,and for handling complic-ations including occlusion,migration,bleeding,and perforation.Additionally,we address technical challenges and troubleshooting strategies,including mana-gement of guidewire-induced perforation,incomplete stent expansion,and bile duct obstruction for overlapping biliary and duodenal stricture cases.Despite its widespread clinical use,no prior review has comprehensively covered both the technical and clinical aspects of duodenal stenting so extensively.By providing a clinically oriented,practical guide,this review serves as a valuable resource for endoscopists and gastroenterologists,facilitating optimized decision-making and improved outcomes for patients with GOO in real-world practice.展开更多
BACKGROUND Groove pancreatitis(GP)is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics.However,it is often difficult to differentiate from pancreatic o...BACKGROUND Groove pancreatitis(GP)is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics.However,it is often difficult to differentiate from pancreatic or periampullary cancers.In this study,we report a case of GP with the rare symptom of severe gastric outlet obstruction.CASE SUMMARY A 68-year-old man presented to our institution with severe gastric outlet obstruction accompanied by vomiting persisted for 3 days,severe electrolyte imbalance,and altered mental status with cardiac arrest.Differential diagnosis of cancers of the ampulla of Vater or duodenum was difficult due to discordant findings from preoperative imaging and an endoscopic biopsy of the lesion.In addition,the gastric outlet obstruction did not improve with conservative treatment;therefore,pancreatoduodenectomy was performed.Postoperatively,the histological findings revealed multiple cystic lesions in the duodenal wall that were collectively diagnosed as GP.The patient underwent a follow-up 3 years postoperatively and was found to have no postoperative sequelae.CONCLUSION In this case of GP,pancreatoduodenectomy safely treated severe gastric outlet obstruction when a cancer diagnosis could not be excluded.展开更多
Background:We evaluated surgical outcomes of biventricular repair for atrioventricular septal defect(AVSD)with tetralogy of Fallot(TOF)or double-outlet right ventricle(DORV).Methods:This retrospective pilot study incl...Background:We evaluated surgical outcomes of biventricular repair for atrioventricular septal defect(AVSD)with tetralogy of Fallot(TOF)or double-outlet right ventricle(DORV).Methods:This retrospective pilot study included 12 patients who underwent biventricular repair of AVSD with TOF(n=6)or DORV(n=6)between 2004 and 2023.Right ventricular outflow tract(RVOT)reconstruction was performed using transannular patch(TAP,n=4)or pulmonary valve preservation(PVP,n=8).Clinical outcomes,including longitudinal pulmonary valve growth,RVOT obstruction,and pulmonary regurgitation,were reviewed descriptively,with particular focus on the feasibility of PVP.Results:The median age and body weight at the time of surgery were 11.7(8.3-18.8)months and 8.6(7.3-10.5)kg,respectively.The median follow-up duration was 67.9(58.7-174.3)months.The two-patch technique(n=10)was most commonly used for AVSD repair.There were no early mortalities and one late mortality.At discharge,significant(≥36 mmHg)RVOT obstruction was observed in two patients who underwent PVP.During follow-up,one patient required reoperation for significant(moderate or greater)atrioventricular valve regurgitation,and two patients in the PVP group underwent transcatheter intervention for significant RVOT obstruction.At the last follow-up,significant RVOT obstruction was present in two patients.Significant(moderate or greater)pulmonary regurgitation occurred in three patients in the TAP group.In patients who underwent PVP,the pulmonary valve annulus z-score remained within acceptable ranges,and the RVOT pressure gradient predominantly decreased to acceptable levels during follow-up.Conclusions:Mid-term outcomes of PVP in the biventricular repair of AVSD with TOF or DORV are acceptable.In selected patients,the PVP strategy may be considered a reasonable and feasible option for RVOT reconstruction.展开更多
Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has emerged as an effective and minimally invasive alternative for treating gastric outlet obstruction.Compared to traditional options,including duodenal stenting ...Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has emerged as an effective and minimally invasive alternative for treating gastric outlet obstruction.Compared to traditional options,including duodenal stenting and surgical gastrojejunostomy,EUS-GE offers comparable technical and clinical success while providing longer-lasting patency,fewer adverse events,and lower reintervention rates.The technique has expanded beyond malignant obstruction to include benign etiologies and complex conditions such as afferent loop syndrome.EUSGE enables rapid recovery and early resumption of oral intake,which is crucial for oncologic patients.However,the procedure remains technically demanding,and optimal techniques,device selection,and management of complications are still under investigation.This mini-review summarizes current evidence,compares EUS-GE with alternative therapies,discusses patient selection and procedural aspects,and outlines key areas for future research.展开更多
Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions...Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions of strengthening“Yang Qi”(one of the fundamental concept in TCM,representing the active,warming,and energizing force within the body.It governs physiological functions,maintains body temperature,and promotes vitality.Balanced“Yang Qi”supports immunity and metabolism,while deficiency may lead to fatigue,cold intolerance,or weakened resilience),promoting blood circulation,and removing blood stasis,and nourishing yin based on the TCM theory.Previous studies have found that it significantly improved BPH and regulate urinary function in estrogen and androgen-induced rats.However,it is unclear whether DZQE has an inhibitory effect on BOO rats.Methods:Male Wistar rats underwent retropubic partial bladder neck ligation to induce BOO.DZQE extract(2.7/5.4 g/kg)was administered orally for 35 days.Anesthetized rats underwent cystometry to assess BOO and treatment effects on urinary parameters.Bladder histopathology,fibrosis,and PCNA expression were evaluated via HE,Masson’s,and IHC staining.Western blot quantified bladder tissue levels of choline acetyltransferase(ChAT),rho-associated protein kinase 1(ROCK1),myosin light chain kinase(MLCK),myosin light chain 2(MLC-2),extracellular signal-regulated kinase(ERK),proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax).Primary bladder smooth muscle cells were cultured,exposed to hydrostatic pressure(HP,3 h/24 h)using a custom apparatus to mimic BOO,and treated with DZQE components for Western blot analysis of ROCK1,MLCK,ERK,PCNA,and Bax.Results:The bladder hyperplasia,bladder index(BI)increased,and histopathological alteration were easily observed in BOO group,which were significantly inhibited by DZQE administration.DZQE also significantly inhibited the up-regulation of maximum voiding pressure(MVP)and down-regulation of residual urine volume(RV)observed in BOO rats.The expressions of ChAT and MLCK and the activation of ERK were much increased,while the expressions of ROCK1,MLC-2 and Bax were obviously decreased in BOO rats,all of which were then significantly inhibited by DZQE.In rat bladder smooth muscle cells(RBSMC),3 h or 24 h duration of HP successfully simulated the BOO compensation and decompensation respectively in vitro.DZQE or its active components reduced the abnormal gene expressions in HP stimulated RBSMC.Conclusion:DZQE improves the urinary function in BOO rats mainly through the activation of ERK.Bakuchiol,salvianolic acid A,kaempferol,and tanshinoneⅡA are possibly the important active components of its therapeutic effects.展开更多
Objective:To observe the effect of Xipayimaizibizi oral liquid(XP)in an overactive bladder(OAB)experimental rat model and to explore its pharmacological mechanisms.Methods:Network pharmacology was used to explore the ...Objective:To observe the effect of Xipayimaizibizi oral liquid(XP)in an overactive bladder(OAB)experimental rat model and to explore its pharmacological mechanisms.Methods:Network pharmacology was used to explore the potential mechanisms of action of XP.The rats underwent bladder outlet obstruction surgery and were administered the corresponding drug concentrations by gavage for 4 weeks.The study observed the body weight,water intake,bladder and kidney indices(to evaluate their general status),urination behavior pattern(to observe frequency and urgency),and urodynamics(to measure bladder parameters).Hematoxylin and eosin and Masson's trichome staining were used to observe changes in the bladder structure.Enzyme-linked immunosorbent assay was used to measure the levels of nerve growth factor,brain-derived neurotrophic factor,and acetylcholine in the urine.The key targets involved in these mechanisms were validated using reverse transcription-quantitative polymerase chain reaction,immunohistochemistry,and western blot in vivo/vitro experiments.Result:Network pharmacological analysis predicted that XP may alleviate OAB by affecting the cholinergic synapse and calcium signaling pathways.XP treatment significantly reduced the bladder index,improved urine behavior and urodynamic parameters,decreased the neurotransmitters in urine,and reduced the thickness of the bladder wall and collagen ratio.These results indicate that XP can alleviate OAB symptoms and improve the bladder structure.In vivo/vitro experiments further demonstrated that XP can inhibit targets,such as muscarinic acetylcholine receptor 2,and participate in cholinergic synapses to further regulate the parasympathetic nervous system.It can also reduce the overexpression of Ca^(2+) caused by agonists,inhibit targets such as transient receptor potential vanilloid type 1,and participate in calcium signaling pathways to maintain Ca^(2+) homeostasis.Conclusion:These results suggest that XP inhibited bladder overactivity by maintaining Ca^(2+) homeostasis and regulating the parasympathetic nervous system.展开更多
To provide advanced diagnostic techniques for diagnosing the outlet temperature distribution and species concentrations of future advanced combustors,this study focuses on a dual-swirl single-dome rectangular combusto...To provide advanced diagnostic techniques for diagnosing the outlet temperature distribution and species concentrations of future advanced combustors,this study focuses on a dual-swirl single-dome rectangular combustor.Through the integration of multiple diagnostics,simultaneous measurement of outlet temperature distribution and species concentrations was achieved.The study validates the engineering applicability of these simultaneous measurements using tungsten-rhenium(W-Re)thermocouples and Coherent Anti-Stokes Raman Scattering(CARS),CARS and Tunable Diode Laser Absorption Spectroscopy(TDLAS),as well as Gas Analysis(GA)and Mass Spectrometry(MS).The results demonstrate that measurements by thermocouples and CARS exhibit good consistency and repeatability,with a relative deviation of less than 4%,fully meeting the requirements of engineering experiments.The spatial distribution reconstruction results of TDLAS can reflect the temperature distribution characteristics at the combustor outlet.Temperature comparison between TDLAS and CARS at single-point positions shows consistent results,with a relative deviation of less than 11%and 7%under both conditions,respectively.Simultaneous measurements by integrating GA and MS show high engineering applicability for the first time,meeting the requirements for measuring both inorganic species and free radicals at the combustor outlet.Under C_(1)condition,the relative deviations of four key species(Unburned Hydrocarbon(UHC),NO,O_(2),and CO_(2))remain within 2%,while that of NO_(2)is slightly higher at approximately 8%.Under C_(2)condition,the overall deviations increase for most species,with only O_(2)and CO_(2)maintaining relatively low deviations.The primary species of UHCs at the combustor outlet under both conditions are small molecular hydrocarbons(C_(3)-C_(8))and RO_(2)radicals,accounting for over 90%of total UHC.Specifically,RO_(2)species(R is C_(1)-C_(2)alkyl groups)are the predominant species,accounting for 74.3%and 82.1%of total RO_(2)under both conditions,respectively.These integrated diagnostic methods for temperature and species concentrations at the combustor outlet serve as a crucial reference for its engineering applications.展开更多
基金supported by the World Health Organization Global Youth Tobacco Survey(WPDHP1206671)the Global Health Capacity Building and Tobacco Control Project:Tobacco Epidemic Monitoring and Comprehensive Tobacco Control Intervention。
文摘Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco use^([1]).Adolescents are especially prone to developing persistent smoking habits,with many adult smokers having started before the age of 18.In China,16.7%of secondary school students have tried smoking and 4.7%are current smokers,highlighting the critical need for targeted tobacco control interventions among the youth.
文摘The scope of management of malignant gastric outlet obstruction is ever-expanding.The therapeutic use of endoscopy is gaining popularity not just owing to its technical advancement and satisfactory patient outcomes.With technical success rates close to 96%,stent placement for palliating gastric obstruction has ensured a median survival of about 2 months post-deployment of gastro-duodenal stents.Understanding the correct concept of palliation is the need of the hour in management.Identifying the right patient for palliation,selecting the appropriate intervention and auditing the outcome are vital in delivering optimal care.Also,newer procedures such as endoscopic gastro-enterostomy offer promising outcomes in palliative care.
文摘Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.
文摘BACKGROUND Obesity remains a significant global health concern,and intragastric balloons(IGBs)offer a minimally invasive weight loss option for patients who fail lifestyle and pharmacotherapy interventions.IGBs can cause complications ranging from mild symptoms to severe issues like gastric outlet obstruction(GOO).This report discusses a 39-year-old woman who presented with clinical and radiological features of GOO post Silimed IGB placement.CASE SUMMARY A 39-year-old woman presented to our institution with two-week history of abdominal pain,nausea and vomiting post prandially.This was in the context of a Silimed IGB placement two weeks prior to presentation for weight loss in the context of obesity.A computed tomography of the abdomen demonstrated the IGB device in the body and prepyloric region,with proximal dilatation of the body and fundus of the stomach which contained gastric contents.Due to concerns for GOO,the IGB was removed endoscopically with subsequent symptom alleviation.In addition to this,we performed a literature search of cases of IGB related GOO using the PubMed and Web of Science databases from inception date to the August 26,2024.A total of 27 articles were included in the analysis,identifying 29 cases of IGB-related GOO.These patients commonly presented with nausea,vomiting and abdominal pain,with symptom onset varying from 3 days to 18 months post IGB insertion.Abdominal computed tomography was the primary diagnostic tool and endoscopic removal was the standard treatment modality.CONCLUSION This is the first reported case of GOO caused by Silimed IGB.While effective for weight reduction,IGB-related GOO is a rare but serious complication,usually requiring endoscopic retrieval.Future research should aim to identify patient factors linked to this complication to enhance clinical-decision making and outcomes.
文摘Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,shorter hospita-lization,and earlier chemotherapy initiation.However,its long-term efficacy is limited by stent occlusion,which typically occurs 2-4 months post-procedure,due to tumor ingrowth,overgrowth,or food impaction.Covered stents can reduce tumor ingrowth but increase the migration risk,particularly in patients receiving chemotherapy.This review provides a comprehensive comparison of duodenal stenting,surgical gastrojejunostomy,and endoscopic ultrasound-guided gastroen-terostomy,by discussing their clinical outcomes,advantages,and limitations.We further explore stent selection based on stricture characteristics,optimal placement techniques,post-procedural management,and for handling complic-ations including occlusion,migration,bleeding,and perforation.Additionally,we address technical challenges and troubleshooting strategies,including mana-gement of guidewire-induced perforation,incomplete stent expansion,and bile duct obstruction for overlapping biliary and duodenal stricture cases.Despite its widespread clinical use,no prior review has comprehensively covered both the technical and clinical aspects of duodenal stenting so extensively.By providing a clinically oriented,practical guide,this review serves as a valuable resource for endoscopists and gastroenterologists,facilitating optimized decision-making and improved outcomes for patients with GOO in real-world practice.
文摘BACKGROUND Groove pancreatitis(GP)is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics.However,it is often difficult to differentiate from pancreatic or periampullary cancers.In this study,we report a case of GP with the rare symptom of severe gastric outlet obstruction.CASE SUMMARY A 68-year-old man presented to our institution with severe gastric outlet obstruction accompanied by vomiting persisted for 3 days,severe electrolyte imbalance,and altered mental status with cardiac arrest.Differential diagnosis of cancers of the ampulla of Vater or duodenum was difficult due to discordant findings from preoperative imaging and an endoscopic biopsy of the lesion.In addition,the gastric outlet obstruction did not improve with conservative treatment;therefore,pancreatoduodenectomy was performed.Postoperatively,the histological findings revealed multiple cystic lesions in the duodenal wall that were collectively diagnosed as GP.The patient underwent a follow-up 3 years postoperatively and was found to have no postoperative sequelae.CONCLUSION In this case of GP,pancreatoduodenectomy safely treated severe gastric outlet obstruction when a cancer diagnosis could not be excluded.
文摘Background:We evaluated surgical outcomes of biventricular repair for atrioventricular septal defect(AVSD)with tetralogy of Fallot(TOF)or double-outlet right ventricle(DORV).Methods:This retrospective pilot study included 12 patients who underwent biventricular repair of AVSD with TOF(n=6)or DORV(n=6)between 2004 and 2023.Right ventricular outflow tract(RVOT)reconstruction was performed using transannular patch(TAP,n=4)or pulmonary valve preservation(PVP,n=8).Clinical outcomes,including longitudinal pulmonary valve growth,RVOT obstruction,and pulmonary regurgitation,were reviewed descriptively,with particular focus on the feasibility of PVP.Results:The median age and body weight at the time of surgery were 11.7(8.3-18.8)months and 8.6(7.3-10.5)kg,respectively.The median follow-up duration was 67.9(58.7-174.3)months.The two-patch technique(n=10)was most commonly used for AVSD repair.There were no early mortalities and one late mortality.At discharge,significant(≥36 mmHg)RVOT obstruction was observed in two patients who underwent PVP.During follow-up,one patient required reoperation for significant(moderate or greater)atrioventricular valve regurgitation,and two patients in the PVP group underwent transcatheter intervention for significant RVOT obstruction.At the last follow-up,significant RVOT obstruction was present in two patients.Significant(moderate or greater)pulmonary regurgitation occurred in three patients in the TAP group.In patients who underwent PVP,the pulmonary valve annulus z-score remained within acceptable ranges,and the RVOT pressure gradient predominantly decreased to acceptable levels during follow-up.Conclusions:Mid-term outcomes of PVP in the biventricular repair of AVSD with TOF or DORV are acceptable.In selected patients,the PVP strategy may be considered a reasonable and feasible option for RVOT reconstruction.
文摘Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has emerged as an effective and minimally invasive alternative for treating gastric outlet obstruction.Compared to traditional options,including duodenal stenting and surgical gastrojejunostomy,EUS-GE offers comparable technical and clinical success while providing longer-lasting patency,fewer adverse events,and lower reintervention rates.The technique has expanded beyond malignant obstruction to include benign etiologies and complex conditions such as afferent loop syndrome.EUSGE enables rapid recovery and early resumption of oral intake,which is crucial for oncologic patients.However,the procedure remains technically demanding,and optimal techniques,device selection,and management of complications are still under investigation.This mini-review summarizes current evidence,compares EUS-GE with alternative therapies,discusses patient selection and procedural aspects,and outlines key areas for future research.
基金supported by The National Key Research and Development Project of China(No.2023YFC3504302)the National Natural Science Foundation of China(General Program No.82074105).
文摘Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions of strengthening“Yang Qi”(one of the fundamental concept in TCM,representing the active,warming,and energizing force within the body.It governs physiological functions,maintains body temperature,and promotes vitality.Balanced“Yang Qi”supports immunity and metabolism,while deficiency may lead to fatigue,cold intolerance,or weakened resilience),promoting blood circulation,and removing blood stasis,and nourishing yin based on the TCM theory.Previous studies have found that it significantly improved BPH and regulate urinary function in estrogen and androgen-induced rats.However,it is unclear whether DZQE has an inhibitory effect on BOO rats.Methods:Male Wistar rats underwent retropubic partial bladder neck ligation to induce BOO.DZQE extract(2.7/5.4 g/kg)was administered orally for 35 days.Anesthetized rats underwent cystometry to assess BOO and treatment effects on urinary parameters.Bladder histopathology,fibrosis,and PCNA expression were evaluated via HE,Masson’s,and IHC staining.Western blot quantified bladder tissue levels of choline acetyltransferase(ChAT),rho-associated protein kinase 1(ROCK1),myosin light chain kinase(MLCK),myosin light chain 2(MLC-2),extracellular signal-regulated kinase(ERK),proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax).Primary bladder smooth muscle cells were cultured,exposed to hydrostatic pressure(HP,3 h/24 h)using a custom apparatus to mimic BOO,and treated with DZQE components for Western blot analysis of ROCK1,MLCK,ERK,PCNA,and Bax.Results:The bladder hyperplasia,bladder index(BI)increased,and histopathological alteration were easily observed in BOO group,which were significantly inhibited by DZQE administration.DZQE also significantly inhibited the up-regulation of maximum voiding pressure(MVP)and down-regulation of residual urine volume(RV)observed in BOO rats.The expressions of ChAT and MLCK and the activation of ERK were much increased,while the expressions of ROCK1,MLC-2 and Bax were obviously decreased in BOO rats,all of which were then significantly inhibited by DZQE.In rat bladder smooth muscle cells(RBSMC),3 h or 24 h duration of HP successfully simulated the BOO compensation and decompensation respectively in vitro.DZQE or its active components reduced the abnormal gene expressions in HP stimulated RBSMC.Conclusion:DZQE improves the urinary function in BOO rats mainly through the activation of ERK.Bakuchiol,salvianolic acid A,kaempferol,and tanshinoneⅡA are possibly the important active components of its therapeutic effects.
基金supported by the Natural Science Foundation in Xinjiang Uygur Autonomous Region(Urumqi,China,2023D01F38).
文摘Objective:To observe the effect of Xipayimaizibizi oral liquid(XP)in an overactive bladder(OAB)experimental rat model and to explore its pharmacological mechanisms.Methods:Network pharmacology was used to explore the potential mechanisms of action of XP.The rats underwent bladder outlet obstruction surgery and were administered the corresponding drug concentrations by gavage for 4 weeks.The study observed the body weight,water intake,bladder and kidney indices(to evaluate their general status),urination behavior pattern(to observe frequency and urgency),and urodynamics(to measure bladder parameters).Hematoxylin and eosin and Masson's trichome staining were used to observe changes in the bladder structure.Enzyme-linked immunosorbent assay was used to measure the levels of nerve growth factor,brain-derived neurotrophic factor,and acetylcholine in the urine.The key targets involved in these mechanisms were validated using reverse transcription-quantitative polymerase chain reaction,immunohistochemistry,and western blot in vivo/vitro experiments.Result:Network pharmacological analysis predicted that XP may alleviate OAB by affecting the cholinergic synapse and calcium signaling pathways.XP treatment significantly reduced the bladder index,improved urine behavior and urodynamic parameters,decreased the neurotransmitters in urine,and reduced the thickness of the bladder wall and collagen ratio.These results indicate that XP can alleviate OAB symptoms and improve the bladder structure.In vivo/vitro experiments further demonstrated that XP can inhibit targets,such as muscarinic acetylcholine receptor 2,and participate in cholinergic synapses to further regulate the parasympathetic nervous system.It can also reduce the overexpression of Ca^(2+) caused by agonists,inhibit targets such as transient receptor potential vanilloid type 1,and participate in calcium signaling pathways to maintain Ca^(2+) homeostasis.Conclusion:These results suggest that XP inhibited bladder overactivity by maintaining Ca^(2+) homeostasis and regulating the parasympathetic nervous system.
基金support of the National Major Science and Technology Projects of China(No.J2019-V-0005-0096)the National Key Research and Development Program of China(No.2020YFA0405700).
文摘To provide advanced diagnostic techniques for diagnosing the outlet temperature distribution and species concentrations of future advanced combustors,this study focuses on a dual-swirl single-dome rectangular combustor.Through the integration of multiple diagnostics,simultaneous measurement of outlet temperature distribution and species concentrations was achieved.The study validates the engineering applicability of these simultaneous measurements using tungsten-rhenium(W-Re)thermocouples and Coherent Anti-Stokes Raman Scattering(CARS),CARS and Tunable Diode Laser Absorption Spectroscopy(TDLAS),as well as Gas Analysis(GA)and Mass Spectrometry(MS).The results demonstrate that measurements by thermocouples and CARS exhibit good consistency and repeatability,with a relative deviation of less than 4%,fully meeting the requirements of engineering experiments.The spatial distribution reconstruction results of TDLAS can reflect the temperature distribution characteristics at the combustor outlet.Temperature comparison between TDLAS and CARS at single-point positions shows consistent results,with a relative deviation of less than 11%and 7%under both conditions,respectively.Simultaneous measurements by integrating GA and MS show high engineering applicability for the first time,meeting the requirements for measuring both inorganic species and free radicals at the combustor outlet.Under C_(1)condition,the relative deviations of four key species(Unburned Hydrocarbon(UHC),NO,O_(2),and CO_(2))remain within 2%,while that of NO_(2)is slightly higher at approximately 8%.Under C_(2)condition,the overall deviations increase for most species,with only O_(2)and CO_(2)maintaining relatively low deviations.The primary species of UHCs at the combustor outlet under both conditions are small molecular hydrocarbons(C_(3)-C_(8))and RO_(2)radicals,accounting for over 90%of total UHC.Specifically,RO_(2)species(R is C_(1)-C_(2)alkyl groups)are the predominant species,accounting for 74.3%and 82.1%of total RO_(2)under both conditions,respectively.These integrated diagnostic methods for temperature and species concentrations at the combustor outlet serve as a crucial reference for its engineering applications.
