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Severe acute pancreatitis (SAP) is associated with high mortality. SAP is generally treated by conservative management at the early phase, and removal of the pancreatic and peripancreatic necrotic tissue at the late phase. However, studies have suggested that the surgical treatment of SAP should focus on pressure reduction and drainage. In this case report, 3 SAP patients of 44, 30 and 60 years of age were treated at the General Hospital of Ningxia Medical University. They underwent emergency endoscopic pancreatic stenting at the early phase and nasopancreatic drainage at the late phase when peripancreatic encapsulated effusion was observed. All patients were successfully treated and discharged from the hospital. The disease duration of the patients was 71, 58, and 88 days, respectively. Our cases suggested that the surgical strategy of endoscopic pancreatic stenting at the early phase and nasopancreatic drainage at the late phase is promising for the treatment of SAP. [ABSTRACT FROM AUTHOR]

Copper smelting slag is a useful secondary resource containing high iron and copper, which can be utilized to prepare crude Fe-Cu alloy by a direct reduction-magnetic separation process for making weathering-resistant steel. However, it is difficult to recover iron and copper from the slag by direct reduction since the iron mainly occurs in fayalite and the copper is held in copper sulfide. Therefore, enhancement reduction of copper slag is conducted to improve the recovery of copper and iron. Additives such as NaCO has been proven to be capable of reinforcing the reduction of refractory iron ore. In this research, the effect of NaCO on the carbothermic reduction of copper slag was investigated, and phase transformations during reduction and the distributing characteristics of iron and copper in the alloy and non-metallic phases of the reduced pellets were also studied. The results show that the metallization rate of iron and copper was increased with the addition of NaCO, leading to higher iron and copper recovery in Fe-Cu alloy powder. X-ray diffraction (XRD) and scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) results confirm that NaCO is capable of enhancing the reduction of fayaltie, copper silicate and copper sulfide, which agrees well with thermodynamic analysis. Furthermore, the reduction mechanism of copper slag was demonstrated based on systematic experimental observations. [ABSTRACT FROM AUTHOR]

Background: This study aimed to construct an enteral nutrition evaluation system for critically ill patients using the Delphi method to direct the formulation of enteral nutrition support strategies and reduce interruption to enteral feeding., Methods: We used domestic and foreign databases to obtain and analyze the literature and form "The Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients." The Delphi method was used to conduct two rounds of expert opinion consultation, combined with the suggestions from the research group to finalize the nutrition evaluation content of the system., Results: After two rounds of expert consultation, a nutrition evaluation system was formed around three dimensions: before the start, during, and after the end of nutritional support. The effective recovery rates of the two rounds of expert consultation were 90.0% (18/20) and 100.0% (18/18), respectively. Authority coefficients were 0.865 and 0.908, while Kendall coordination coefficients were 0.108 ( P < 0.05) and 0.115 ( P < 0.001), respectively. Finally, the full enteral nutrition evaluation system for critically ill patients was constructed based on the Delphi method, including three primary items and seven secondary and 28 tertiary indicators., Conclusion: The established "Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients" has high consistency from expert opinions and reliability, which can provide a practical evaluation tool for the process of enteral nutrition for severe patients., (Copyright © 2023 Copyright: © 2023 Saudi Journal of Gastroenterology.)

Cross-boundary transport of air pollution is a difficult issue in pollution control for the North China Plain. In this study, an industrial district (Shahe City) with a large glass manufacturing sector was investigated to clarify the relative contribution of fine particulate matter (PM 2.5 ) to the city's high levels of pollution. The Nest Air Quality Prediction Model System (NAQPMS), paired with Weather Research and Forecasting (WRF), was adopted and applied with a spatial resolution of 5 km. During the study period, the mean mass concentrations of PM 2.5 , SO 2 , and NO 2 were observed to be 132.0, 76.1, and 55.5 μg/m 3 , respectively. The model reproduced the variations in pollutant concentrations in Shahe at an acceptable level. The simulation of online source-tagging revealed that pollutants emitted within a 50-km radius of downtown Shahe contributed 63.4% of the city's total PM 2.5 concentration. This contribution increased to 73.9±21.2% when unfavorable meteorological conditions (high relative humidity, weak wind, and low planetary boundary layer height) were present; such conditions are more frequently associated with severe pollution (PM 2.5 ≥ 250 μg/m 3 ). The contribution from Shahe was 52.3±21.6%. The source apportionment results showed that industry (47%), transportation (10%), power (17%), and residential (26%) sectors were the most important sources of PM 2.5 in Shahe. The glass factories (where chimney stack heights were normally < 70 m) in Shahe contributed 32.1% of the total PM 2.5 concentration in Shahe. With an increase in PM 2.5 concentration, the emissions from glass factories accumulated vertically and narrowed horizontally. At times when pollution levels were severe, the horizontally influenced area mainly covered Shahe. Furthermore, sensitivity tests indicated that reducing emissions by 20%, 40%, and 60% could lead to a decrease in the mass concentration of PM 2.5 of of 12.0%, 23.8%, and 35.5%, respectively., (Copyright © 2021. Published by Elsevier B.V.)

Background: Acute pancreatitis (AP) is a potentially life-threatening inflammatory disease with multiple etiologies. The prevalence of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) has been increasing in recent years. It is reported that early triglyceride (TG) levels were associated with the severity of the disease, and TG- lowering therapies, including medical treatment and blood purification, may impact the clinical outcomes. However, there is no consensus regarding the optimal TG-lowering therapy, and clinical practice varies greatly among different centers. Our objective is to evaluate the TG-lowering effects of different therapies and their impact on clinical outcomes in HTG-AP patients with worrisome features. Methods: This is a multicenter, observational, prospective cohort study. A total of approximately 300 patients with HTG-AP with worrisome features are planned to be enrolled. The primary objective of the study is to evaluate the relationship between TG decline and the evolution of organ failure, and patients will be dichotomized depending on the rate of TG decline. The primary outcome is organ failure (OF) free days to 14 days after enrollment. Secondary outcomes include new-onset organ failure, new-onset multiple-organ failure (MOF), new-onset persistent organ failure (POF), new receipt of organ support, requirement of ICU admission, ICU free days to day 14, hospital free days to day 14, 60-day mortality, AP severity grade (Based on the Revised Atlanta Classification), and incidence of systemic and local complications. Generalized linear model (GLM), Fine and Gray competing risk regression, and propensity score matching will be used for statistical analysis. Discussion: Results of this study will reveal the current practice of TG-lowering therapy in HTG-AP and provide necessary data for future trials., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Cao, Zhou, Chen, Chen, Liu, Mao, Lin, Hong, Yao, Sun, Qin, Guo, Zhou, Jiao, Chen, Li, Ye, Ke, Tong, Liu, Li and Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG).)

Objective: To optimize the protocols for isolation and culture of mesenchymal stem cells from rat bone marrow (BMSCs)., Methods: BMSCs were isolated by adherence to plastic with frequent medium change and reduced trypsinization time. The cell growth curves were drawn and the surface markers of BMSCs were detected by flow cytometry. The cells were induced to differentiate into osteogenic, adipogenic, hepatic and cholic lineages., Results: The cells isolated using this method were positive for CD29, CD44, and CD90 and negative for the hematopoietic surface markers CD45. The osteogenic and adipogenic differentiation of the BMSCs was verified by alkaline phosphatase staining, Alizarin red staining and Oil red staining. The cell subcultures up to passage 10 maintained capacities of differentiation into osteogenic and adipogenic lineages. The BMSCs induced with sequential addition of growth factors, cytokines and hormones differentiated into cells expressing hepatocyte- and cholangiocyte-specific markers., Conclusion: The optimized method allows efficient isolation of homogenous populations of MSCs from rat bone marrow, which can be induced into multiple cell lineages.

Objective: To investigate the advantages of magnetic compressive anastomosis (MCA) for non-suture femoral artery anastomosis., Methods: Twelve adult health mongrel dogs, weighing (16.5 ± 3.6) kg, were selected for in situ end-to-end anastomosis of the femoral artery. One side of the femoral artery was anastomosised with MCA (group A) and the other side of the femoral artery was anastomosised by hand-suturing (group B). The anastomosis time, complications, and vascular bursting pressure were recorded. Gross observation, histological staining (HE and Masson), and scanning electron microscopy observation were performed at 2, 4, 12, and 24 weeks postoperatively., Results: The anastomosis time in group A [(3.89 ± 1.16) minutes] was significantly shorter than that in group B [(14.16 ± 3.72) minutes] (t = 14.226, P = 0.000). The complication rate of group A (0) was significantly lower than that of group B (75%) (P = 0.000). At immediate, 4 and 12 weeks after operation, the vascular bursting pressure of anastomosis site in group A was more than 280 mm Hg (1 mm Hg = 0.133 kPa), and was (140.11 ± 15.23), (180.31 ± 24.55), and more than 280 mm Hg in group B, showing significant differences at immediate and 4 weeks (P < 0.05), but no significant difference at 12 weeks (P > 0.05). In group A at 4 weeks, good intima contact, smooth endothelium, and regular arrangement of endothelial cells were observed; at 12 weeks, chronic inflammation was present, with a few lymphocytes infiltration; and at 24 weeks, inflammation significantly decreased. But in group B, obvious suture foreign body and scar formation were observed, which led to uneven surface with lumen incomplete intima, and irregular endothelial cells in arrangement disorder., Conclusion: Compared with traditional hand-suturing, the MCA has the advantages of shorter operation time, higher patency rate, less complication, and better healing at the anastomotic site. Non-suture anastomosis of the femoral artery by MCA can achieve reliable results.