简介：摘要Endoscopic ultrasound (EUS) has both diagnostic and therapeutic clinical applications. This review article focuses on recent advances in two commonly performed procedures: EUS-guided tissue acquisition and EUS-guided drainage. There is a shift from acquiring aspirates for cytology to obtaining tissue cores for histological diagnoses and molecular analyses. There is growing interest and research about artificial intelligence in EUS. Artificial intelligence may potentially be useful to guide clinical decision making if biopsy results are non-diagnostic. The range of EUS-guided drainage procedures has expanded. EUS-guided drainage of walled-off pancreatic fluid collections is an accepted first line treatment option. EUS-guided palliative drainage of malignant biliary obstruction after unsuccessful endoscopic retrograde cholangiopancreatography (ERCP) is now an accepted alternative to percutaneous transhepatic biliary drainage. EUS-guided gallbladder drainage for management of acute cholecystitis is now a preferred option over percutaneous cholecystostomy for non-surgical candidates. Other EUS-created gastrointestinal anastomoses such as EUS-guided gastroenterostomy in the context of gastric outlet obstruction, and EUS-directed transgastric ERCP for Roux-en-Y gastric bypass are now technically feasible, but further prospective randomized studies are needed to establish the actual clinical impact.

简介：TherevisedAtlantaclassificationofacutepancreatitiswasadoptedbyinternationalconsensus,andisbasedonactuallocalandsystemicdeterminantsofdiseaseseverity.Thelocaldeterminantispancreaticnecrosis(sterileorinfected),andthesystemicdeterminantisorganfailure.Localcomplicationsofpancreatitiscanincludeacuteperi-pancreaticfluidcollection,acutenecroticcollection,pseudocystformation,andwalledoffnecrosis.Interventionalendoscopicultrasound(EUS)hasbeenincreasingutilizedinmanagingtheselocalcomplications.AfterperformingaPubMedsearch,theauthorsmanuallyappliedpre-definedinclusioncriteriaorafiltertoidentifypublicationsrelevanttoEUSandpancreaticcollections(PFCs).Theauthorsthenreviewedtheutility,efficacy,andrisksassociatedwithusingtherapeuticEUSandinvolvedEUSdevicesintreatingPFCs.Duetothedevelopmentandregulatoryapprovalofimprovedandnovelendoscopicdevicesspecificallydesignedfortransmuraldrainageoffluidandnecroticdebris(accessandpatencydevices),theauthorspredictcontinuingevolutioninthemanagementofPFCs.WebelievethatEUSwillbecomeanindispensablepartofproceduresusedtodiagnosePFCsandperformimage-guidedinterventions.AfterdrainingaPFC,theamountoftissuenecrosisisthemostimportantpredictorofasuccessfuloutcome.Hence,itseemslogicaltoclassifythesecollectionsbasedontheirpercentageofnecroticcomponentordebrispresentwhenviewedbyimagingmethodsorEUS.Finally,theauthorsproposeanalgorithmformanagingfluidcollectionsbasedontheirsize,location,associatedsymptoms,internalechogenicpatterns,andcontent.

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简介：Commonpracticedictatestheperformanceofpercutaneouscoronaryinterventionunderconventionalangiographicguidance.Withstudiessuggestingthehighincidenceofintraobservervariability,especiallyinangiographicborderlinelesions,newmodalitiessuchasintravascularultrasound(IVUS)guidanceduringpercutaneouscoronaryinterventionhavesurfaced.MultiplestudieshaveshownimprovedoutcomeswithIVUSguidance,mainlydrivenbyadecreaseinischemia-driventargetlesionrevascularization.Inthepasttwodecades,amultitudeofstudieshaveinvestigatedtheusesandclinicaloutcomesassociatedwiththistechnology.Inthisreview,wehighlighttheutility,advantages,economicimplications,andclinicaloutcomesofIVUSguidanceoverstandardangiographicguidance,withemphasisondataastheypertaintoIVUS-guidedstentimplantation.

简介：ObjectiveToinvestigatetheefficacyandthemechanismofmoxibustioninulcerativecolitis(UC)ratsmodel.MethodsFortygeneralclean-classhealthWistarrats,wererandomlydividedintofourgroups(eachwith10rats),namelythenormalgroup,theblankgroup,moxibustiongroupandthecontrolgroups.

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简介：有人的脸的图象在成像领域包括必要部分。在面部部分的吸藏或损坏将带显著不快和信息损失。我们建议能修理的一个算法堵塞了或自动地损坏了面部图象，命名‘facial图象inpainting'。Inpainting是处理方法恢复失踪的图象部分的一套图象。我们在由介绍面部领域知识油漆方法扩大图象。与一个脸数据库的支持，我们的途径宣传结构的信息，即，特征点和边地图，从类似的脸到失踪的面部区域。把推断的结构的信息用作指导，在油漆算法的一幅基于模范的图象被采用从来源部分在一样的脸拷贝补丁到失踪的部分。在油漆的面部图象的这个最新建议的概念超过在美容从一个脸数据库塑造，并且由从一样的脸图象推断颜色和质地从不同图象处于成像条件避免变化的问题的由宣传的画方法传统。我们的系统生产是几乎没看见的缺点的无缝的脸。

简介：Thedispersioncharacteristicsandexcitationmechanismsoftheguidedwavesinmultilayeredplatesarestudiedinthispaper.Firstly,thedispersionequationisobtainedbythepropagatormatrixmethod.Then,thebisectiontechniqueisemployedtofindalltherootsofthedispersionequation.Thedispersioncharacteristicsoftheguidedwavesareinvestigatedandanalyzed.ForthemultilayeredplatesinwhichtheS-wavevelocityincreasesordecreasesfromtoptobottom,itisfoundthatthevelocitylimitsinhighfrequencyofthefirstandhighmodesareequaltotheRayleighwaveandS-wavevelocitiesofthelow-velocitylayer,respectively.ItisalsofoundthatthevelocitylimitsinthehighfrequencyofallmodesareequaltotheS-wavevelocityofthelow-velocitylayerfortheplatewithalow-velocitymiddlelayer.Thenormaldisplacementspectrumofallthemodesexcitedbythenormalforcesourcewithadefinitewidthonthesurfaceoftheplateisalsoinvestigated.ItisprovedthatthedominantmodeisthefirstmodewhentheS-wavevelocityincreasesfromtoptobottomlayerandthedominantmodeisdifferentindifferentfrequencyrangefortheplatewithalow-velocitymiddlelayer.

简介：Usingultrasonicguidedwavestoassesslongbonefracturesandfracturehealinghasbecomeapromisingdiagnosticissue.Butthemultimodeoverlapoftheguidedwaveschallengesthequantitativeevaluationandclinicalapplication.Inthepreformedstudy,inordertosimplifythesignalinterpretation,thelow-frequencysinusoidialsignalswereusedtoonlyexciteS0andA0modesinfracturedlongbones.TheamplitudesofS0andA0modeswerenumericallyanalyzedwithvariationincrackwidthandfractureangle.Numericalsimulation,basedonthetwo-dimensionfinite-differencetime-domain(2D-FDTD)revealsthatbothS0andA0amplitudesdecreasewiththefracturewidening.However,theincreaseinfractureanglegraduallyenhancestheA0amplitude,whilewithrespecttotheS0mode,itsamplitudeshowsanon-monotonictrendtothevariationinfractureanglewithaturningpointaround45°.TheamplituderatiobetweenS0andA0canreflectthevariationsincrackwidthandfractureangles.ThesimulationillustratesthatultrasonicguidedS0andA0modesaresensitivetothedegreeofbothverticalandobliquefracturesinthelongcorticalbone.Thesefindingsmaybehelpfulforfracturesdiagnosisandhealingevaluationofthelongbone.

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简介：Asimplifiedmodalmethodtoexplaintheresonancephenomenoninguidedmoderesonance(GMR)gratingswithasymmetriccoatingsispresented.Theresonanceobservedisduetotheinteractionoftwopropagationmodesinsidethegrating.Thereflectivityspectraandelectricfielddistributionscalculatedfromthesimplifiedmodalmethodarecomparedusingrigorouscoupled-waveanalysis(RCWA).Theinfluencesofhigh-orderevanescentmodesontheresonancepeakareanalyzed.AmatrixFabry-Perot(FP)resonanceconditionisdevelopedtoevaluatetheresonancewavelength.AnexplanationfortheresonancephenomenonobservedbasedontheFPresonancephaseconditionisalsoproposedanddemonstrated.ThesimplifiedmethodprovidesclearphysicalinsightsintoGMRgratingsthatareusefulfortheanalysisofavarietyofotherresonancegratings.

简介：Inanefforttodevelopbiomaterialstomeetguidedtissueregeneration(GTR)standardsforperiodontaltissuerecovery,ahomogeneousandtransparentchitosan(CS)/hydroxyapatite(HA)membranewithpotentialapplicationsasGTRbarrierinperiodontaltherapyhasbeenpreparedviainsitucompositing.ThemembranehasbeendesignedtohaveasmoothroughasymmetricstructurethatmeetsthedemandforGTR.ComponentandmorphologyofthemembranearecharacterizedbyXRDandSEM.ItcanbeindicatedthatHAwasinsitusynthesizeduniformlyintheCSmembrane.MechanicalexperimentsofthemembraneswithvariousHAcontentsshowthattheirtensilestrengthsareadequateforperiodontaltherapy.Biologicalpropertiesofthemembranehavebeenperformedbycelltoxicityassays,hemolysistestsandanimalexperiments.Resultsindicatethatthemembranehasgoodbiocompatibilityandinductiveeffectforcellgrowth.ThereforethismembranecanbepotentiallyappliedasGTRbarriermembraneforperiodontaltissueregeneration.

简介：Inthispapermodellingofthetranslationalmotionoftransportationrail-guidedcartwithropesuspendedpayloadisconsidered.Thelinearlymovingcart,drivenbyatravelmechanism,ismodelledasadiscretesixdegreesoffreedom(DOF)dynamicsystem.ThehoistingmechanismforloweringandliftingthepayloadisconsideredandisincludedinthedynamicmodelasoneDOFsystem.DifferentialequationsofmotionofthecartelementsarederivedusingLagrangiandynamicsandaresolvedforasetofreal-lifeconstantparametersofthecart.Atwo-sidedinteractionwasobservedbetweentheswingingpayloadandthetravelmechanism.Resultsforkinematicalandforceparametersofthesystemareobtained.Averificationoftheproposedmodelwasconducted.

简介：Thegenerationofhigh-resolutionDEMfrominterferometricSARhasresultedintheneedforaccurateandefficientmethodsof2-dimensionalphaseunwrapping.Inthispaper,wegiveabriefdescriptionofthemathematicalbaseofphaseunwrapping,andadetaileddescriptionoftheunweightedandweightedleastsquarephaseunwrappingalgorithm.Thenouralgorithmcombiningwiththeweightedleastsquarephaseunwrappingguidedbythebranch-cutsderivedfromGoldstein’salgorithmandcoherencecoefficientmapderivedfromtheINSARdataisprovided.InourexperimentwewritesubroutinesoftheGoldstein’sbranch-cutalgorithm,unweightedandweightedleastsquarephaseunwrappingalgorithmaswellasouralgorithm,andconstructasmallexperimentsystemtoresolvethephaseunwrappingproblem.FinallywetestouralgorithmonsomeINSARdata.Theresultshowsthatourapproachcanobtainunwrappedphasecorrectlyandefficiently.

简介：肝炎B病毒(HBV)感染是使世界范围的3.5亿个人担心的一个全球公共健康问题。有长期的肝炎B(CHB)的个人在开发肝肝硬化，肝的补偿不全和hepatocellular癌的增加的风险。为了维持，无法发现的病毒的负担减少长期的感染复杂并发症。没有治疗，根除HBV感染。当前的药是昂贵的，与不利事件被联系，并且具有有限功效。当前的指南试着标准化临床的实践。不过，争吵与CHB关于无征状的病人的管理留下，并且什么是肝炎Be抗原(HBeAg)与正常丙氨酸aminotransferase积极是病毒的负担的截止价值区分HBeAg否定的CHB病人和不活跃的搬运人。我们详细讨论DNA水平为什么独自不是足够的开始CHB的治疗。

简介：瞄准：为了为内视镜的超声(EUS)比较结果，指导了清楚的液体的排水有脓肿的结果的胰腺的pseudocysts排水。方法：所有病人参考了因为一个液体集合的内视镜的排水有希望地被包括。结果被记录。结果：总的来说26pseudocysts或脓肿在25被对待(6女性)病人。一endoscopist执行了过程。非感染的pseudocysts在15个病人是在场的，10个病人感染了液体集合。包囊尺寸在28厘米漠?桴?潢瑴敬之间变化了吗？

简介：AbstractPurpose:Treatment of irreducible femoral intertrochanteric fractures often requires open reduction. However, the technique unavoidably causes patients to suffer greater trauma. As such, minimally invasive techniques should be employed to reduce the surgical-related trauma on these patients and maintain a stable reduction of the fractures. Herein, a minimally invasive wire introducer was designed and used for the treatment of femoral intertrochanteric fractures. The effectiveness of using a wire-guided device to treat irreducible femoral intertrochanteric fractures was evaluated.Methods:Between 2013 and 2018, patients with femoral intertrochanteric fractures who were initially treated by intramedullary nail fixation but had difficult reduction using the traction beds were retrospectively reviewed. Decision for an additional surgery was based on the displacement of the fracture. The patients were then divided into two groups: those in the control group received an open reduction surgery while those in the observation group received a closed reduction surgery using a minimally invasive wire introducer to guide the wire that could assist in fracture reduction. The operation time, blood loss, visual analogue scale scores, angulation, reduction, neck-shaft angle, re-displacement, limb length discrepancy, and union time were then recorded and analyzed to determine the efficiency of the wire introducer technique. Categorical variables were analyzed by using Chi-square test, while continuous variables by independent t-test and the Mann-Whitney test accordingly.Results:There were 92 patients included in this study: 61 in the control group and 31 in the observation group. There were no significant differences in baseline demographic factors between the two groups. All surgeries were successful with no deaths within the perioperative period. The average follow-up time for the patients was 23.8 months. However, the observation group had a significantly shorter operation time, lower visual analogue scale score, less intraoperative bleeding, and shorter fracture healing time. There were no significant differences in the angulation, reduction, neck-shaft angle, and limb length discrepancy between the two groups.Conclusion:The minimally invasive wire guide achieved a similar effect to that of open reduction in the treatment of intertrochanteric fractures with difficult reduction. Moreover, the minimally invasive wire introducer is a good technology that accurately guides the wire during reduction. Indeed, it is an effective technique and achieves good clinical outcomes in restoration of irreducible femoral intertrochanteric fractures.

简介：Thispaperinvestigatesthedamagedetectionbasedonthepropagationofguidedwaveinbimetalcompositepipes,whichcanidentifydamagelocationsinbothaxialandcircumferentialdirections.ThefeasibilityofthemethodisshowedbynumericalsimulationsusingFEMcodeANSYS.Modeanalysisisusedtoevaluatetheguidedwavemodeanditsstructure,whichcanprovidethebasisofthemodeselectioninmeasurementsscheme.Theguidedwavepropagationinadamagedpipeiscomputedbytransientanalysis.16...

简介：AbstractObjective:Immunotherapy is an effective tumor treatment strategy. However, its long treatment cycle limits its wide application across all cancer types. In this study, we optimized upconversion nanoparticles and manganese composite particles with a porous structure as a nanoplatform for synergistic photodynamic therapy (PDT) and photothermal therapy (PTT), and subsequent longer-term immunotherapy.Methods:The morphology, phase, and stability were first characterized to evaluate the biocompatibility of this material. The upconversion and near infrared II luminescence properties of the material and its stimuli-response effect were assessed from the absorbance and photoluminescence spectra. Phototherapy including PDT and PTT was demonstrated in vitro and in vivo, and immunotherapy was used to enhance the phototherapy. This study was approved by the Xi’an Jiaotong University, China (approval No. XJTULAC2020-585) on April 2, 2020.Results:The nanoplatform showed good PDT and PTT effects with high upconversion luminescence, and exhibited a more sensitive glutathione response (detection limit: 55 μg/mL) using fluorescence recovery than that based on absorbance recovery, with the detection range extending up to 1.2 mg/mL. When the surface of the composite particles was modified with an anti-PD-L1 immune checkpoint inhibitor, it targeted A549 lung cancer cells. The resulting immune response enhanced the long-term anti-tumor effect of the therapy, especially in lung cancer patients with high PD-L1 expression.Conclusion:The designed composite can be simultaneously used to detect the glutathione concentration based on luminescence recovery in the tumor cells and as a theranostic nanoplatform for synergistic immuno-phototherapy when combined with an antibody.