Search

Background This study aims to evaluate the efficacy and safety of detecting and removing residual common bile duct stones (CBDS) using direct peroralcholangioscopy (DPOC) after performing endoscopic retrograde cholangiopancreatography (ERCP) for stone retrieval. Methods From January 5, 2017 to December 27, 2017, a total of 164 cases of choledocholithiasis were treated by ERCP for stone retrieval. According to the inclusion and exclusion criteria, the remaining 79 cases (39 males; mean age: 63.3 years old, range: 52–79 years old) were enrolled in the present study. The maximum transverse stone diameter was 6–15 mm (12.7 ± 4.2 mm), as determined by ERCP. Furthermore, there were 57 cases of multiple stones (number of stones: two in 41 cases, three in nine cases, and ≥ 4 in seven cases), 13 cases of post-mechanical lithotripsy, and nine cases of broken stones. Results The overall success rate of DPOC was 94.9% (75/79). Furthermore, 18.7%(14/75) of cases were directly inserted, 72%(54/75) of cases required guide wire assistance, and 9.3%(7/75) of cases were successfully inserted with overtube assistance. The average insertion time was 7–17 min (4.9 ± 2.9 min). Residual stones were detected in 19 cases (25.3%), and all of which were

Background For patients with chronic hepatitis B and cirrhosis in less developed western regions in China, due to constraints of local economic conditions, the choice of treatment measures is often limited. However if patients recieved valid management and effective treatment, they were able to maintain their health and benign prognosis. Case presentation This study narrates the long-term treatment and careful follow-up of a patient with chronic hepatitis B and cirrhosis in a less developed western region in China, and analyzes the prognosis of the disease and countermeasures. Conclusions This would partly reflect the development of antiviral therapy for chronic hepatitis B and multidisciplinary comprehensive treatment for cirrhosis-related complications in remote region with limited resources in the past 20 years.

The high-spin structure of $^{109}$In was investigated with the $^{100}$Mo($^{14}$N, 5$n$)$^{109}$In fusion-evaporation reaction at CIAE, Beijing. Eleven new $��$-rays of $^{109}$In were identified, by which the bandheads of the $��I$=2 rotational bands were confirmed. The configurations were assigned with the help of the systematic discussion. Furthermore, the rotational bands are compared with the tilted-axis cranking calculations based on a relativistic mean-field approach. The rotational bands involving the $1p1h$ excitation to the $��$$d_{5/2}$ and $��$$g_{7/2}$ orbitals are suggested as candidates for antimagnetic rotation based on the theoretical results., 10 pages, 9 figures

Supplemental Material for Left ventricular peak early diastolic strain rate detected by two-dimensional speckle tracking echocardiography and disease severity in pre-capillary pulmonary hypertension by Bing-yang Liu, Wei-chun Wu, Qi-xian Zeng, Zhi-hong Liu, Li-li Niu, Yue Tian, Xiao-ling Cheng, Qin Luo, Zhi-hui Zhao, Li Huang, Hao Wang, Jian-guo He and Chang-ming Xiong in Pulmonary Circulation

Introduction: This study aimed to examine the recovery of spiked human cardiac troponin I (cTnI) results measured by four routine assays, and investigate possible interference from microclots. Materials and methods: 457 consecutive samples with cTnI concentration below limit of quantitation (12 ng/L), declared by the Vitros TnI ES assay (reference assay), were measured on Beckman Coulter Accu TnI+3, Siemens TnI-Ultra and Roche TnI STAT assays. These samples were enriched with native full-length cTnI to a concentration of 100 ng/L and retested. A post-spiking result that exceeded the critical difference at a predefined probability of 0.0005 of the target concentration (the median post-spiking result for each individual assay) was considered as outlier. To determine whether microclots were a significant cause of critically discrepant outlier results, a separate 50 samples were centrifuged twice between two post-spiking measurements using the Vitros TnI ES assay. Results: The median recovery of the enriched cTnI was highest with the Roche assay (271 ng/L) and lowest with the Vitros assay (29 ng/L). The Vitros assay had the highest percentage of results that exceeded the critical difference (49%), followed by the Siemens (38%), Roche (18%) and Beckman Coulter (7%) assays. None of the 50 additional samples produced a critically lower cTnI result after re-centrifugation. Conclusions: Our findings underscored the variability of cTnI assays in measuring native cTnI. The lack of cTnI results that became significantly lower after re-centrifugation suggested that microclots are unlikely to be a major cause of the outlier results.

Black-start scheme plays an important role for the rapid restoration of the power system after a large-area blackout. The subjective role of decision makers is easily ignored by traditional calculation method of indicator weight and black-start scheme evaluation model. Therefore, this paper proposes a new calculation method of black-start indicator weight and a novel black-start scheme evaluation model based on risk utility function. This paper uses different risk utility functions to consider the subjective will of decision makers, and employs the combination of Gini coefficient and Pearson coefficient to calculate indicator weight based on the difference of weight values and the conflict among weights. Furthermore, the comprehensive indicator weight is calculated with considering of indicator weights integrity and weight itself based on minimum cross entropy criterion and game theory respectively. At the same time, this paper proposes the weight adjustment coefficient to combine the two different comprehensive weights, and studies the influence of the change of the weight adjustment coefficient on the evaluation result. The traditional VIKOR evaluation method is improved by adopting the prospect theory to solve the problem that the influence of decision-makers' experience and knowledge on evaluation results is easily neglected. The influence of the change of the decision coefficient on the ranking result of the black start scheme is discussed based on the optimal weight adjustment coefficient determined by combining the relative entropy and the gray correlation. Finally, Example results verify the rationality and effectiveness of the proposed calculation method and evaluation model in this paper.

The mechanism of formaldehyde advanced interaction and oxidation on Fe3O4 (1 1 1) catalyst was investigated with and without the hydroxyl formation from H2O2 decomposition through density functional theory. Binding energies, Mulliken charge population, and the partial density of states were calculated on the basis of different adsorption sites for Fetet1 and Feoct2 terminal surfaces. It has been determined that formaldehyde showed weak interaction on Fetet1 terminal surface, and the carbon atom hardly formed a chemical bond both with and without H2O2. On Feoct2 terminal surface, the oxygen and carbon atoms of the formaldehyde were stably adsorbed on Fetet1/Feoct2 site, especially in the presence of H2O2. In formaldehyde oxidation, the formaldehyde was firstly oxidized into formic acid by hydroxylation and dehydrogenation. The energy barrier was 53.1 kJ/mol followed 103.4 kJ/mol, and 117.5 kJ/mol on Fetet1 and Feoct2 terminal surfaces, respectively. In formic acid oxidation, HCOOH preferred hydroxylation firstly and then produced H2O by dehydrogenation reaction on the two surfaces. The calculated binding energies suggested that the processes of formaldehyde oxidation and CO2 generation were generally exothermic on Fe3O4 (1 1 1) surface with H2O2.

The interaction between mercury species and Fe3O4(1 1 1), Mn doped Fe3O4(1 1 1) surfaces, with Feoct2- termination has been calculated by density functional theory (DFT). Different adsorption sites and placement of adsorbates, potential catalytic oxidation of Hg0 by the adsorbed Cl atoms on the Mn-doped Fe3O4 surface have been considered. The result revealed Hg0 physical and weak chemical adsorption on both pure surface and Mn-doped surface. Horizontally placed HgCl and HgCl2 were better chemisorbed on the surface. Although complete dissociation and partial dissociation occurred during the adsorption process of oxidation mercury, configurations of complete dissociation were more stable than that of partial dissociation. HgCl was chemically adsorbed on both Fe3O4 (1 1 1) and Mn doped Fe3O4 (1 1 1) surface through breaking into two atoms, and HgCl2 adsorbed through three ones. Both of the Cl atom and Hg atom tended to bind to the transition metals on the surface. When Mn and Fe atoms coexisted on the surface, Cl atoms preferred to bind to Mn atoms. Besides, all the decomposition reaction was exothermic process according to the negative values of adsorption energy.

Supplemental material for The clinical characteristics and long-term prognosis of pulmonary arterial hypertension associated with hereditary hemorrhagic telangiectasia by Wen Li, Chang-ming Xiong, Qing Gu, Xiao-tong Wang, Xiao-ling Cheng, Li Huang, Tao Yang, Qin Luo, Zhi-hui Zhao, Xin-hai Ni, Zhi-hong Liu and Jian-guo He: ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories in Pulmonary Circulation

Transfemoral and perventricular device occlusions are performed for doubly committed subarterial ventricular septal defect (dcVSD) to reduce the invasiveness of the conventional surgical repair through a median sternotomy. Few comparative studies have been conducted of these three procedures.Inpatients with isolated dcVSD who had undergone transfemoral and perventricular device occlusions or conventional surgical repair from January 2009 to June 2013 were reviewed to compare the three procedures.Procedure success was achieved in 33 transfemoral (66%), in 74 perventricular (94.9%), and in 205 repair (97.6%) procedures. The transfemoral group had the lowest success rate (p0.001), whereas the perventricular and repair groups had similar success rates (p = 0.418). Transfemoral patients were the oldest (p0.001) and had a dcVSD size similar to that of patients in other two groups (p = 0.518). The repair group required the longest hospitalization and longest stays in the intensive care unit (p0.001), required the longest operating room and mechanical ventilation times (p0.001), and had the highest rate of transfusion (p0.001). Major adverse events occurred in one transfemoral (3%), in two perventricular (2.7%), and in three repair (1.4%) procedures. Minor adverse events were absent in transfemoral (0%) and occurred in three perventricular (4%) and 14 repair (6.7%) procedures. No significant difference was noted in the rates of adverse events the three groups (p = 0.569). No grade 3 valvular regurgitation or complete atrioventricular block was observed in the studied patients.Device occlusion may be an alternative to surgical repair in selected patients with dcVSD. Perventricular occlusion was the preferred approach because it showed a higher success rate than transfemoral occlusion.

Mango malformation disease, caused by Fusarium mangiferae , is one of the most important diseases affecting mango production. Thirty-eight isolates from MM-affected mango tissues were collected from two cities and assessed for genetic diversity using vegetative compatibility groups (VCGs) and inter simple sequence repeats (ISSRs). VCGs were determined among all isolates, using nitrate non-using ( nit ) mutants. Out of the 455 nit mutants generated, 78.02% used both nitrite and hypoxanthine ( nit1 ), 13.63% used hypoxanthine but not nitrite ( nit3 ) and 7.91% used nitrite but not hypoxanthine (NitM). Five different VCGs were identified by pairing the mutants on nitrate medium. Seventy-two bands were amplified by 14 ISSR primers, with an average of 5.14 bands per primer. The size of the amplified products ranged from 300 to 2000 bp. At a genetic similarity of 0.76, the unweighted pair-group method with arithmetic mean analysis separated the isolates into five distinct clusters, comprising 33, 2, 1, 1 and 1 isolates. The VCG and ISSR data support the conclusion that the isolates of F. mangiferae are not necessarily related by geographic origin, type of host tissue, or the mango cultivar from which they were isolated.