In the industrialized countries the main goal at the national health care policymaking level is to contain costs without compromizing the two goals of health care:access and quality. At the same time medicine is evolv...In the industrialized countries the main goal at the national health care policymaking level is to contain costs without compromizing the two goals of health care:access and quality. At the same time medicine is evolving through inevntions, inno-vations and improvements. Technologies which can be used to prolong life but whichare not curative have also improved and become widely used. With the ageing popu-lations of the industrialized countries containing costs is getting extremely difficult.展开更多
In this manuscript,I comment on the article by Pospisilova et al published in the recent issue of the journal,in which selective embolization was used to treat anorectal hemangioma,a rare disease causing lower gastroi...In this manuscript,I comment on the article by Pospisilova et al published in the recent issue of the journal,in which selective embolization was used to treat anorectal hemangioma,a rare disease causing lower gastrointestinal bleeding.Anorectal hemangioma can easily be mistaken;for example,the patient in this case was previously misdiagnosed with ulcerative colitis.Choosing the appropriate tests and understanding the typical manifestations of anorectal hemangioma under colonoscopy,computerized tomography,magnetic resonance imaging and other tests are beneficial for diagnosis.The patient presented with intermittent rectal bleeding despite treatment with azathioprine and mesalazine and required blood transfusions since the degree of rectal bleeding worsened.Selective embolization successfully alleviated the patient’s bleeding symptoms and avoided the need for repeated blood transfusions.Tranexamic acid may be useful,considering that the patient still has bleeding symptoms and requires parenteral iron supplementation.展开更多
Compared with traditional rain gauges and weather radars,hydrogel flexible electronic sensor capable of responding directly to rainfall events with promptness and authenticity,shows great prospects in real-time rainfa...Compared with traditional rain gauges and weather radars,hydrogel flexible electronic sensor capable of responding directly to rainfall events with promptness and authenticity,shows great prospects in real-time rainfall monitoring.Aluminum coordination hydrogel(Al-HG),one of the most qualified sensors suitable for rainfall monitoring,however,is currently impeded from widespread application by its weak mechanical properties due to the low binding strength between Al^(3+)and functional ligands.Herein,inspired by the antifreeze proteins(AFPs)that protect those Patagonian toothfishes by strongly binding to ice crystals at freezing temperatures,a low temperature-induced strategy is introduced to promote more and stronger ligand carboxyls firm combination with Al^(3+),thus forming a high-coordinated structure to deal with this challenge.Expectedly,the whole mechanical performance of the product Al-HG_(F1/F2) obtained by the low temperature-induced strategy is improved.For example,the tensile fracture toughness and the maximum compressive stress of Al-HG_(F1/F2) are 1.66 MJ·m^(-3) and 12.01 MPa,approximately twice those of the sample Al-HGF3/F0 obtained by traditional soaking method(0.86 MJ·m^(-3) and 7.38 MPa,respectively).Coupled with its good biocompatibility,ionic conductivity,and sensing ability,Al-HG_(F1/F2) demonstrates promising application for real-time rainfall monitoring in discrepant rainfall intensities,different zones,and even under extreme environments.This work aims to offer a stride toward mechanically robust aluminum coordination hydrogel sensors for real-time rainfall monitoring as well as provide insights into flood prevention and disaster mitigation.展开更多
In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for c...In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for clinical practice.However,we believe that the authors should also provide information on the patient's long-term prognosis.展开更多
BACKGROUND Recent advancements in artificial intelligence(AI)have significantly enhanced the capabilities of endoscopic-assisted diagnosis for gastrointestinal diseases.AI has shown great promise in clinical practice,...BACKGROUND Recent advancements in artificial intelligence(AI)have significantly enhanced the capabilities of endoscopic-assisted diagnosis for gastrointestinal diseases.AI has shown great promise in clinical practice,particularly for diagnostic support,offering real-time insights into complex conditions such as esophageal squamous cell carcinoma.CASE SUMMARY In this study,we introduce a multimodal AI system that successfully identified and delineated a small and flat carcinoma during esophagogastroduodenoscopy,highlighting its potential for early detection of malignancies.The lesion was confirmed as high-grade squamous intraepithelial neoplasia,with pathology results supporting the AI system’s accuracy.The multimodal AI system offers an integrated solution that provides real-time,accurate diagnostic information directly within the endoscopic device interface,allowing for single-monitor use without disrupting endoscopist’s workflow.CONCLUSION This work underscores the transformative potential of AI to enhance endoscopic diagnosis by enabling earlier,more accurate interventions.展开更多
BACKGROUND Sharp foreign body ingestion can cause gastrointestinal tract mucosa injury and requires proper endoscopic removal.Typically,protective devices are used to reduce mucosal damage.This case presents an altern...BACKGROUND Sharp foreign body ingestion can cause gastrointestinal tract mucosa injury and requires proper endoscopic removal.Typically,protective devices are used to reduce mucosal damage.This case presents an alternative approach for the endoscopic removal of a large,irregular,and sharp foreign body(chicken bone)when traditional protective devices are inadequate,thus contributing to the management of such ingestions.CASE SUMMARY A 57-year-old male presented with a history of swallowing an irregular and sharp-pointed chicken bone.Emergent endoscopy showed it was tightly embedded in the esophageal wall,with minor bleeding.The chicken bone was grasped and moved cautiously using a foreign forceps.It was loosened after repeated attempts but could not pass through the pharynx.Considering possible mucosal damage,it was carefully pushed into the stomach cavity and then wrapped in a condom.The chicken bone was retrieved uneventfully by grasping the open edge of the condom with foreign forceps.No additional damage was found,except for primary esophageal injuries caused by the embedded chicken bone.The patient was discharged on the following day.Our experience demonstrated that condoms can be an alternative as a protective device under such conditions.CONCLUSION Condoms can serve as an alternative when traditional protective devices are unsuitable.Because of its smooth and oily nature,it can provide mucosal protection and lubrication during endoscopic removal.展开更多
This paper presents a new technique,termed femtosecond laser shock peening ablation in liquids(fs-LSPAL),which can realize simultaneous crack micro/nanomanufacturing and hierarchical micro/nanolaser ablation,giving ri...This paper presents a new technique,termed femtosecond laser shock peening ablation in liquids(fs-LSPAL),which can realize simultaneous crack micro/nanomanufacturing and hierarchical micro/nanolaser ablation,giving rise to the formation of diverse multiscale hierarchical structures,such as macroporous ratcheted structures and enéchelon microfringes decorated with parabolic nanoripples.Through analysis of surface morphologies,many phenomena have been confirmed to take place during fs-LSPAL,including enéchelon cracks,nanostriation,ripple densification,crack branching,and selective formation of high spatial frequency laser-induced periodic surface structures of 100–200 nm in period.At a high laser power of 700 mW,fs-LSPAL at scanning speeds of 0.2 mm s^-1 and 1 mm s^-1 enables the generation of height-fluctuated and height-homogeneous hierarchical structures,respectively.The height-fluctuated structures can be used to induce‘colony’aggregates of embryonic EB3 stem cells.At 200 mW,fs-LSPAL at 1 mm s^-1 is capable of producing homogeneous tilt macroporous structures with cracked structures interleaved among them,which are the synergistic effects of bubble-induced light refraction/reflection ablation and cracks.As shown in this paper,the conventional laser ablation technique integrated with its self-driven unconventional cracking under extreme conditions expands the horizons of extreme manufacturing and offers more opportunities for complex surface structuring,which can potentially be used for biological applications.展开更多
Crawling-type gastric adenocarcinoma is a rare subtype of gastric cancer with diagnostic and therapeutic challenges due to its flat,ill-defined lesions.Advanced diagnostic techniques,such as narrow-band imaging and li...Crawling-type gastric adenocarcinoma is a rare subtype of gastric cancer with diagnostic and therapeutic challenges due to its flat,ill-defined lesions.Advanced diagnostic techniques,such as narrow-band imaging and linear endoscopic ultrasonography,improve detection,but endoscopic submucosal dissection poses a risk of incomplete resection.Despite negative resection margins,vigilant postoperative monitoring is crucial due to the potential for recurrence.This letter highlights the importance of refined diagnostic criteria,individualized treatment approaches,and continuous follow-up to optimize management of this unique gastric cancer subtype.展开更多
Surface-enhanced Raman scattering(SERS),owing to its high sensitivity based on localized surface plasmon resonance of nanostructured metals,is recently attracting much attention to be used for biotechnology,such as ce...Surface-enhanced Raman scattering(SERS),owing to its high sensitivity based on localized surface plasmon resonance of nanostructured metals,is recently attracting much attention to be used for biotechnology,such as cell imaging and tumor therapy.On the other hand,the trace detection of bio-molecules with large molecular weight is still challenging because the troublesome treatment of SERS substrate using coupling or cross-linking agents is required.In this paper,we apply liquid interface assisted SERS(LI-SERS)method,which provides unique features of collection and self-immobilization of analyte molecules on the SERS substrate,to realize the label-free trace detection of bio-molecules with detection limits of pM~fM.Specifically,deoxyribonucleic acid(DNA)discrimination and quantitative detection ofβ-Amyloid(Aβ)in trace-concentration are demonstrated to illustrate the ultrahigh sensitivity and versatility of the LI-SERS method.The results suggest LI-SERS is promising for the early-stage diagnosis of diseases such as virus infection and Alzheimer's disease.展开更多
This editorial comments on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al,who conducted a retrospective study aiming at clarifying the...This editorial comments on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al,who conducted a retrospective study aiming at clarifying the stage at colorectal cancer(CRC)diagnosis based on different diagnostic routes.We share our opinion about CRC screening programs.The current situation suggests the need for a more specific and targeted population for CRC screening.展开更多
We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade Ⅱ-Ⅲ internal hemorrhoids.The auth...We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade Ⅱ-Ⅲ internal hemorrhoids.The authors conducted a prospective,multicenter,randomized study to evaluate the long-term sympto-matic and endoscopic efficacy of this combined intervention.In this discussion,we focus on the procedural steps of this combined strategy and suggest potential avenues for future research.展开更多
The albumin-bilirubin(ALBI)score is derived from albumin and bilirubin levels.Currently,the ALBI score is widely used in various clinical settings.A recent article in the World Journal of Gastroenterology summarized t...The albumin-bilirubin(ALBI)score is derived from albumin and bilirubin levels.Currently,the ALBI score is widely used in various clinical settings.A recent article in the World Journal of Gastroenterology summarized the application of the ALBI score in various non-malignant liver diseases.The ALBI score has a predictive power that is superior or non-inferior to established numerous measures.This may be related to its contiguity,sensitivity,and inclusion of albumin.While we recognize the good results of the ALBI score in a number of diseases,the ALBI score also has limitations.Variation studies for population characteristics and other factors should be performed to validate the performance of ALBI.Further modifications or optimization of ALBI scores should be taken into account.展开更多
BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working...BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.METHODS This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group(n=30)and an experimental group(n=30).The material of Teflon tubes was the same as that of the endoscope working channel.Endoscopes in the control group were manually cleaned using traditional cleaning brushes,while those in the experimental group were cleaned using the newly developed spray flushing system.ATP levels,cleanliness,and microbiological testing of the working channels were measured.Additionally,Teflon tubes in the control group underwent 500 passes with a cleaning brush,while those in the experimental group were subjected to the spray flushing system,and channel damage was evaluated.RESULTS The ATP levels(RLU)in the two groups were 32.5(13-66)and 26(16-40),respectively(P>0.05).Cleanliness scores were 1.5(1-2)and 1(1-2),respectively(P>0.05).Debris was found in 73.3%of the control group,which was significantly higher than 46.7%in the experimental group(P<0.05).Microbiological tests for both groups yielded negative results.Teflon tube damage in the control group was rated at 4(4-5.25),which was significantly higher than in the experimental group 4(3-4)(P<0.01).CONCLUSION The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.展开更多
This article is a comment on the article by Jia et al,aiming at establishing a predictive model to predict the occurrence of preoperative gastric retention in endoscopic retrograde cholangiopancreatography preparation...This article is a comment on the article by Jia et al,aiming at establishing a predictive model to predict the occurrence of preoperative gastric retention in endoscopic retrograde cholangiopancreatography preparation.We share our perspectives on this predictive model.First,further differentiation in predicting the severity of gastric retention could enhance clinical outcomes.Second,we ponder whether this predictive model can be generalized to predictions of gastric retention before various endoscopic procedures.Third,large datasets and pro-spective clinical validation are needed to improve the prediction model.展开更多
Recently,we read the article“Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of the literature”published in the W...Recently,we read the article“Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of the literature”published in the World Journal of Gastrointestinal Oncology.The prognosis of advanced hepatocellular carcinoma(HCC)is poor,and multidisciplinary comprehensive treatment is currently the main research direction.This case report demonstrated the efficacy of the combination therapy of transcatheter arterial chemoembolization,hepatic arterial infusion chemotherapy,epclusa,lenvatinib and sintilimab for a patient with advanced HCC,and the report can serve as a reference for clinical practice.We would also like to share some of our views.展开更多
The diagnosis of inflammatory bowel disease(IBD)is complicated by its nonspecific clinical presentation and the limited accuracy of existing biomarker tests,frequently resulting in significant delays from the time of ...The diagnosis of inflammatory bowel disease(IBD)is complicated by its nonspecific clinical presentation and the limited accuracy of existing biomarker tests,frequently resulting in significant delays from the time of symptom onset to the achievement of a definitive diagnosis.Thus,improving the early identification of IBD remains a crucial focus for gastroenterologists.Blüthner et al innovatively utilized medical data from German IBD patients to investigate risk factors contri-buting to these diagnostic delays.However,certain methodological limitations in the study have impacted data extraction and interpretation,underscoring the need for more comprehensive analyses to validate these findings.展开更多
The theoretical approach along with the rationale of harmonic excitation modality (HEM) applied as optimal dual controlled ventilation (DCV) to anaesthetized or severe brain injured patients, whose respiretory mechani...The theoretical approach along with the rationale of harmonic excitation modality (HEM) applied as optimal dual controlled ventilation (DCV) to anaesthetized or severe brain injured patients, whose respiretory mechanics can be properly assumed steady and linear, are presented and discussed. The design criteria of an improved version of the Advanced Lung Ventilation System (ALVS), including HEM in its functional features, are described in details. In particular, the elimination of any undesiderable artificial distortion affecting the respiratory and ventilation pattern waveforms is achieved by maintaining continuous forever the airflow inside the ventilation circuit, ensuring also the highest level of safety for patient in any condition. In such a way, the full-time compatibility of controlled breathings with spontaneous breathing activity of patient during continuous positive airways pressure (CPAP) or bilevel positive airways pressure (BiPAP) ventilation modalities and during assisted/controlled ventilation(A/CV), includeing also synchronized or triggered ventilation modalities, is an intrinsic innovative feature of the system available for clinical application. As expected and according to the clinical requirements, HEM provides for physiological respiratory and ventilation pattern waveforms together with optimal “breath to breath” feedback control of lung volume driven by an improved diagnostic measurement procedure, whose outputs are also vital for adapting all the preset ventilation parameters to the current value of the respiratory parameters of patient. The results produced by software simulations concerning both adult and neonatal patients in different clinical conditions are completely consistent with those obtained by the theoretical treatment, showing that HEM reaches the best performances from both clinical and engineering points of view.展开更多
Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD therapy.Zeng et al established a prediction system to evaluate adh...Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD therapy.Zeng et al established a prediction system to evaluate adherence to lifestyle interventions in patients with NAFLD and choose optimal management.Here,we discuss the application scenarios of the scale and the areas warranting further attention,aiming to provide a possible reference for clinical recommend-ations.展开更多
In recent years,water evaporation-induced electricity has attracted a great deal of attention as an emerging green and renewable energy harvesting technology.Although abundant materials have been developed to fabricat...In recent years,water evaporation-induced electricity has attracted a great deal of attention as an emerging green and renewable energy harvesting technology.Although abundant materials have been developed to fabricate hydrovoltaic devices,the limitations of high costs,inconvenient storage and transport,low environmental benefits,and unadaptable shape have restricted their wide applications.Here,an electricity generator driven by water evaporation has been engineered based on natural biomass leather with inherent properties of good moisture permeability,excellent wettability,physicochemical stability,flexibility,and biocompatibility.Including numerous nano/microchannels together with rich oxygen-bearing functional groups,the natural leather-based water evaporator,Leather_(Emblic-NPs-SA/CB),could continuously produce electricity even staying outside,achieving a maximum output voltage of∼3 V with six-series connection.Furthermore,the leather-based water evaporator has enormous potential for use as a flexible self-powered electronic floor and seawater demineralizer due to its sensitive pressure sensing ability as well as its excellent photothermal conversion efficiency(96.3%)and thus fast water evaporation rate(2.65 kg m^(−2)h^(−1)).This work offers a new and functional material for the construction of hydrovoltaic devices to harvest the sustained green energy from water evaporation in arbitrary ambient environments,which shows great promise in their widespread applications.展开更多
文摘In the industrialized countries the main goal at the national health care policymaking level is to contain costs without compromizing the two goals of health care:access and quality. At the same time medicine is evolving through inevntions, inno-vations and improvements. Technologies which can be used to prolong life but whichare not curative have also improved and become widely used. With the ageing popu-lations of the industrialized countries containing costs is getting extremely difficult.
文摘In this manuscript,I comment on the article by Pospisilova et al published in the recent issue of the journal,in which selective embolization was used to treat anorectal hemangioma,a rare disease causing lower gastrointestinal bleeding.Anorectal hemangioma can easily be mistaken;for example,the patient in this case was previously misdiagnosed with ulcerative colitis.Choosing the appropriate tests and understanding the typical manifestations of anorectal hemangioma under colonoscopy,computerized tomography,magnetic resonance imaging and other tests are beneficial for diagnosis.The patient presented with intermittent rectal bleeding despite treatment with azathioprine and mesalazine and required blood transfusions since the degree of rectal bleeding worsened.Selective embolization successfully alleviated the patient’s bleeding symptoms and avoided the need for repeated blood transfusions.Tranexamic acid may be useful,considering that the patient still has bleeding symptoms and requires parenteral iron supplementation.
基金supported by the National Natural Science Foundation of China(22308210)the Young Talent Fund of the Association for Science and Technology in Shaanxi of China(20240412)+1 种基金the RIKEN-MOST Project between the Ministry of Science and Technology of the People’s Republic of China(MOST)and RIKEN,the China Scholarship Council(202108610127)the Natural Science Foundation of Shaanxi University of Science&Technology(2019BT-44).
文摘Compared with traditional rain gauges and weather radars,hydrogel flexible electronic sensor capable of responding directly to rainfall events with promptness and authenticity,shows great prospects in real-time rainfall monitoring.Aluminum coordination hydrogel(Al-HG),one of the most qualified sensors suitable for rainfall monitoring,however,is currently impeded from widespread application by its weak mechanical properties due to the low binding strength between Al^(3+)and functional ligands.Herein,inspired by the antifreeze proteins(AFPs)that protect those Patagonian toothfishes by strongly binding to ice crystals at freezing temperatures,a low temperature-induced strategy is introduced to promote more and stronger ligand carboxyls firm combination with Al^(3+),thus forming a high-coordinated structure to deal with this challenge.Expectedly,the whole mechanical performance of the product Al-HG_(F1/F2) obtained by the low temperature-induced strategy is improved.For example,the tensile fracture toughness and the maximum compressive stress of Al-HG_(F1/F2) are 1.66 MJ·m^(-3) and 12.01 MPa,approximately twice those of the sample Al-HGF3/F0 obtained by traditional soaking method(0.86 MJ·m^(-3) and 7.38 MPa,respectively).Coupled with its good biocompatibility,ionic conductivity,and sensing ability,Al-HG_(F1/F2) demonstrates promising application for real-time rainfall monitoring in discrepant rainfall intensities,different zones,and even under extreme environments.This work aims to offer a stride toward mechanically robust aluminum coordination hydrogel sensors for real-time rainfall monitoring as well as provide insights into flood prevention and disaster mitigation.
基金Supported by National Natural Science Foundation of China,No.821706751·3·5 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC21011.
文摘In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for clinical practice.However,we believe that the authors should also provide information on the patient's long-term prognosis.
基金Supported by the 135 High-end Talent Project of West China Hospital,Sichuan University,No.ZYDG23029.
文摘BACKGROUND Recent advancements in artificial intelligence(AI)have significantly enhanced the capabilities of endoscopic-assisted diagnosis for gastrointestinal diseases.AI has shown great promise in clinical practice,particularly for diagnostic support,offering real-time insights into complex conditions such as esophageal squamous cell carcinoma.CASE SUMMARY In this study,we introduce a multimodal AI system that successfully identified and delineated a small and flat carcinoma during esophagogastroduodenoscopy,highlighting its potential for early detection of malignancies.The lesion was confirmed as high-grade squamous intraepithelial neoplasia,with pathology results supporting the AI system’s accuracy.The multimodal AI system offers an integrated solution that provides real-time,accurate diagnostic information directly within the endoscopic device interface,allowing for single-monitor use without disrupting endoscopist’s workflow.CONCLUSION This work underscores the transformative potential of AI to enhance endoscopic diagnosis by enabling earlier,more accurate interventions.
文摘BACKGROUND Sharp foreign body ingestion can cause gastrointestinal tract mucosa injury and requires proper endoscopic removal.Typically,protective devices are used to reduce mucosal damage.This case presents an alternative approach for the endoscopic removal of a large,irregular,and sharp foreign body(chicken bone)when traditional protective devices are inadequate,thus contributing to the management of such ingestions.CASE SUMMARY A 57-year-old male presented with a history of swallowing an irregular and sharp-pointed chicken bone.Emergent endoscopy showed it was tightly embedded in the esophageal wall,with minor bleeding.The chicken bone was grasped and moved cautiously using a foreign forceps.It was loosened after repeated attempts but could not pass through the pharynx.Considering possible mucosal damage,it was carefully pushed into the stomach cavity and then wrapped in a condom.The chicken bone was retrieved uneventfully by grasping the open edge of the condom with foreign forceps.No additional damage was found,except for primary esophageal injuries caused by the embedded chicken bone.The patient was discharged on the following day.Our experience demonstrated that condoms can be an alternative as a protective device under such conditions.CONCLUSION Condoms can serve as an alternative when traditional protective devices are unsuitable.Because of its smooth and oily nature,it can provide mucosal protection and lubrication during endoscopic removal.
基金the financial support by RIKEN FY2019‘Emerging Collaboration Seed’of‘Collaboration Seed Fund’(Grant No.100948-201901010000-340130)。
文摘This paper presents a new technique,termed femtosecond laser shock peening ablation in liquids(fs-LSPAL),which can realize simultaneous crack micro/nanomanufacturing and hierarchical micro/nanolaser ablation,giving rise to the formation of diverse multiscale hierarchical structures,such as macroporous ratcheted structures and enéchelon microfringes decorated with parabolic nanoripples.Through analysis of surface morphologies,many phenomena have been confirmed to take place during fs-LSPAL,including enéchelon cracks,nanostriation,ripple densification,crack branching,and selective formation of high spatial frequency laser-induced periodic surface structures of 100–200 nm in period.At a high laser power of 700 mW,fs-LSPAL at scanning speeds of 0.2 mm s^-1 and 1 mm s^-1 enables the generation of height-fluctuated and height-homogeneous hierarchical structures,respectively.The height-fluctuated structures can be used to induce‘colony’aggregates of embryonic EB3 stem cells.At 200 mW,fs-LSPAL at 1 mm s^-1 is capable of producing homogeneous tilt macroporous structures with cracked structures interleaved among them,which are the synergistic effects of bubble-induced light refraction/reflection ablation and cracks.As shown in this paper,the conventional laser ablation technique integrated with its self-driven unconventional cracking under extreme conditions expands the horizons of extreme manufacturing and offers more opportunities for complex surface structuring,which can potentially be used for biological applications.
文摘Crawling-type gastric adenocarcinoma is a rare subtype of gastric cancer with diagnostic and therapeutic challenges due to its flat,ill-defined lesions.Advanced diagnostic techniques,such as narrow-band imaging and linear endoscopic ultrasonography,improve detection,but endoscopic submucosal dissection poses a risk of incomplete resection.Despite negative resection margins,vigilant postoperative monitoring is crucial due to the potential for recurrence.This letter highlights the importance of refined diagnostic criteria,individualized treatment approaches,and continuous follow-up to optimize management of this unique gastric cancer subtype.
基金the Special Postdoctoral Researcher Program and Incentive Research Project of RIKEN.
文摘Surface-enhanced Raman scattering(SERS),owing to its high sensitivity based on localized surface plasmon resonance of nanostructured metals,is recently attracting much attention to be used for biotechnology,such as cell imaging and tumor therapy.On the other hand,the trace detection of bio-molecules with large molecular weight is still challenging because the troublesome treatment of SERS substrate using coupling or cross-linking agents is required.In this paper,we apply liquid interface assisted SERS(LI-SERS)method,which provides unique features of collection and self-immobilization of analyte molecules on the SERS substrate,to realize the label-free trace detection of bio-molecules with detection limits of pM~fM.Specifically,deoxyribonucleic acid(DNA)discrimination and quantitative detection ofβ-Amyloid(Aβ)in trace-concentration are demonstrated to illustrate the ultrahigh sensitivity and versatility of the LI-SERS method.The results suggest LI-SERS is promising for the early-stage diagnosis of diseases such as virus infection and Alzheimer's disease.
基金Supported by the National Natural Science Foundation of China,No.82170675135 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC21011.
文摘This editorial comments on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al,who conducted a retrospective study aiming at clarifying the stage at colorectal cancer(CRC)diagnosis based on different diagnostic routes.We share our opinion about CRC screening programs.The current situation suggests the need for a more specific and targeted population for CRC screening.
文摘We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade Ⅱ-Ⅲ internal hemorrhoids.The authors conducted a prospective,multicenter,randomized study to evaluate the long-term sympto-matic and endoscopic efficacy of this combined intervention.In this discussion,we focus on the procedural steps of this combined strategy and suggest potential avenues for future research.
基金Supported by the Natural Science Foundation of Sichuan Province,China,No.2022NSFSC0819.
文摘The albumin-bilirubin(ALBI)score is derived from albumin and bilirubin levels.Currently,the ALBI score is widely used in various clinical settings.A recent article in the World Journal of Gastroenterology summarized the application of the ALBI score in various non-malignant liver diseases.The ALBI score has a predictive power that is superior or non-inferior to established numerous measures.This may be related to its contiguity,sensitivity,and inclusion of albumin.While we recognize the good results of the ALBI score in a number of diseases,the ALBI score also has limitations.Variation studies for population characteristics and other factors should be performed to validate the performance of ALBI.Further modifications or optimization of ALBI scores should be taken into account.
基金West China Nursing Discipline Development Special Fund Project,No.HXHL21029。
文摘BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.METHODS This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group(n=30)and an experimental group(n=30).The material of Teflon tubes was the same as that of the endoscope working channel.Endoscopes in the control group were manually cleaned using traditional cleaning brushes,while those in the experimental group were cleaned using the newly developed spray flushing system.ATP levels,cleanliness,and microbiological testing of the working channels were measured.Additionally,Teflon tubes in the control group underwent 500 passes with a cleaning brush,while those in the experimental group were subjected to the spray flushing system,and channel damage was evaluated.RESULTS The ATP levels(RLU)in the two groups were 32.5(13-66)and 26(16-40),respectively(P>0.05).Cleanliness scores were 1.5(1-2)and 1(1-2),respectively(P>0.05).Debris was found in 73.3%of the control group,which was significantly higher than 46.7%in the experimental group(P<0.05).Microbiological tests for both groups yielded negative results.Teflon tube damage in the control group was rated at 4(4-5.25),which was significantly higher than in the experimental group 4(3-4)(P<0.01).CONCLUSION The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.
基金Supported by National Natural Science Foundation of China,No.82170675.
文摘This article is a comment on the article by Jia et al,aiming at establishing a predictive model to predict the occurrence of preoperative gastric retention in endoscopic retrograde cholangiopancreatography preparation.We share our perspectives on this predictive model.First,further differentiation in predicting the severity of gastric retention could enhance clinical outcomes.Second,we ponder whether this predictive model can be generalized to predictions of gastric retention before various endoscopic procedures.Third,large datasets and pro-spective clinical validation are needed to improve the prediction model.
文摘Recently,we read the article“Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of the literature”published in the World Journal of Gastrointestinal Oncology.The prognosis of advanced hepatocellular carcinoma(HCC)is poor,and multidisciplinary comprehensive treatment is currently the main research direction.This case report demonstrated the efficacy of the combination therapy of transcatheter arterial chemoembolization,hepatic arterial infusion chemotherapy,epclusa,lenvatinib and sintilimab for a patient with advanced HCC,and the report can serve as a reference for clinical practice.We would also like to share some of our views.
文摘The diagnosis of inflammatory bowel disease(IBD)is complicated by its nonspecific clinical presentation and the limited accuracy of existing biomarker tests,frequently resulting in significant delays from the time of symptom onset to the achievement of a definitive diagnosis.Thus,improving the early identification of IBD remains a crucial focus for gastroenterologists.Blüthner et al innovatively utilized medical data from German IBD patients to investigate risk factors contri-buting to these diagnostic delays.However,certain methodological limitations in the study have impacted data extraction and interpretation,underscoring the need for more comprehensive analyses to validate these findings.
文摘The theoretical approach along with the rationale of harmonic excitation modality (HEM) applied as optimal dual controlled ventilation (DCV) to anaesthetized or severe brain injured patients, whose respiretory mechanics can be properly assumed steady and linear, are presented and discussed. The design criteria of an improved version of the Advanced Lung Ventilation System (ALVS), including HEM in its functional features, are described in details. In particular, the elimination of any undesiderable artificial distortion affecting the respiratory and ventilation pattern waveforms is achieved by maintaining continuous forever the airflow inside the ventilation circuit, ensuring also the highest level of safety for patient in any condition. In such a way, the full-time compatibility of controlled breathings with spontaneous breathing activity of patient during continuous positive airways pressure (CPAP) or bilevel positive airways pressure (BiPAP) ventilation modalities and during assisted/controlled ventilation(A/CV), includeing also synchronized or triggered ventilation modalities, is an intrinsic innovative feature of the system available for clinical application. As expected and according to the clinical requirements, HEM provides for physiological respiratory and ventilation pattern waveforms together with optimal “breath to breath” feedback control of lung volume driven by an improved diagnostic measurement procedure, whose outputs are also vital for adapting all the preset ventilation parameters to the current value of the respiratory parameters of patient. The results produced by software simulations concerning both adult and neonatal patients in different clinical conditions are completely consistent with those obtained by the theoretical treatment, showing that HEM reaches the best performances from both clinical and engineering points of view.
文摘Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD therapy.Zeng et al established a prediction system to evaluate adherence to lifestyle interventions in patients with NAFLD and choose optimal management.Here,we discuss the application scenarios of the scale and the areas warranting further attention,aiming to provide a possible reference for clinical recommend-ations.
基金supported by the National Natural Science Foundation of China(22308210)the Scientific Research Program Funded by Shaanxi Provincial Education Department(23JK0350)+3 种基金the Open Foundation of Key Laboratory of Auxiliary Chemistry and Technology for Chemical Industry,Ministry of Education,and Shaanxi Collaborative Innovation Center of Industrial Auxiliary Chemistry and Technology,Shaanxi University of Science and Technology(KFKT2021-12)the Opening Project of Key Laboratory of Leather Chemistry and Engineering(Sichuan University),Ministry of Education(2022)the RIKEN-MOST Project between the Ministry of Science and Technology of the People's Republic of China(MOST)and RIKEN,the China Scholarship Council(202108610127)the Natural Science Foundation of Shaanxi University of Science&Technology(2019BT-44).
文摘In recent years,water evaporation-induced electricity has attracted a great deal of attention as an emerging green and renewable energy harvesting technology.Although abundant materials have been developed to fabricate hydrovoltaic devices,the limitations of high costs,inconvenient storage and transport,low environmental benefits,and unadaptable shape have restricted their wide applications.Here,an electricity generator driven by water evaporation has been engineered based on natural biomass leather with inherent properties of good moisture permeability,excellent wettability,physicochemical stability,flexibility,and biocompatibility.Including numerous nano/microchannels together with rich oxygen-bearing functional groups,the natural leather-based water evaporator,Leather_(Emblic-NPs-SA/CB),could continuously produce electricity even staying outside,achieving a maximum output voltage of∼3 V with six-series connection.Furthermore,the leather-based water evaporator has enormous potential for use as a flexible self-powered electronic floor and seawater demineralizer due to its sensitive pressure sensing ability as well as its excellent photothermal conversion efficiency(96.3%)and thus fast water evaporation rate(2.65 kg m^(−2)h^(−1)).This work offers a new and functional material for the construction of hydrovoltaic devices to harvest the sustained green energy from water evaporation in arbitrary ambient environments,which shows great promise in their widespread applications.
