Placement of Plastic Stents after Direct Endoscopic Necrosectomy through a Novel Lumen-Apposing Metal Stent for Effective Treatment of Laterally Extended Walled-Off Necrosis: A Pilot Study.

Direct endoscopic necrosectomy (DEN) using a lumen-apposing metal stent (LAMS) is a standard therapy for the management of symptomatic walled-off necrosis (WON). Here, we demonstrated the efficacy of the routine placement of long plastic stents after a DEN session to treat laterally extended WON. Patients (n = 6) with symptomatic laterally extended WON who underwent DEN after long plastic stent placement were included. The primary endpoint was clinical efficacy of the procedure. The technical and clinical success rates were 100% without major adverse events. The WON extended to the pelvic cavity or pericolic area, and the WON size was between 18.6 and 35.8 cm in length. The median number of DEN sessions was 10 (range 6-16), and two or three long plastic stents were placed after every DEN session. Only one patient suffered from pneumoperitoneum during DEN, which spontaneously resolved within 20 min. Placement of a long plastic stent after DEN using LAMS is a minimally invasive and effective treatment for symptomatic laterally extended WON. Further studies are needed to define the indications and most suitable patients.

Response of the chemical structure of soil organic carbon to modes of maize straw return.

Elucidating the chemical structure of soil organic matter (SOM) is important for accurately evaluating the stability and function of SOM. Aboveground vegetation directly affects the quantity and quality of exogenous organic matter input into the soil through plant residues and root exudates, which in turn affects soil microbial species, community structure, and activity, and ultimately impacts the chemical structure of SOM. In this study, a 13C nuclear magnetic resonance technique was used to analyze the chemical structure characteristics of soil organic carbon (SOC) under various rates of straw returning combined with rotary tillage and under full straw mulching. The results showed that full straw returning with rotary tillage and full straw mulching more effectively increased the SOC content than reduced rate of straw returning (1/2 and 1/3 of full straw) with rotary tillage. The contents of alkyl C and alkoxy C in the functional groups of SOC under various straw returning treatments were increased compared with those under the treatment of maize stubble remaining in soil (CK). Furthermore, the contents of aromatic C and carboxyl C were decreased, which were consistent with the chemical shift changes of SOC. Compared with CK treatment, straw returning decreased the content of aromatic C in the functional groups of SOC, but increased the content of alkoxy C, which could be associated with the change in integral areas of absorption peaks of alkyl C and alkoxy C moving toward left and right, respectively. The content of total SOC was significantly positively (P < 0.05) correlated with that of alkoxy C and significantly negatively (P < 0.01) correlated with that of aromatic C. The molecular structure of SOC tends to be simplified due to the decreasing in refractory C and the increasing in easily decomposed C after straw returning to the field.

Changes of soil physical and chemical properties of albic soil in the meadow of Sanjiang Plain after rice planting.

The changes and renewal of soil quality are the criteria for judging agricultural development and soil management. The albic soil is the main paddy field soil in Sanjiang Plain. There is limited knowledge about the changes of soil quality after the dry field was changed into the paddy field. Taking albic soils from different years of rice planting as study objects, the changes of soil physical and chemical properties were investigated. The results showed that the total amount of soil organic carbon and reducing substances increased in the ploughing layer (16-23 cm thick) and the bottom ploughing layer (6-8 cm thick). The depth of ploughing layer gradually increased with the increases of rice planting years. There was no significant change after the bottom layer was changed into the paddy field. There was no significant difference in the subsoil layer (20 cm thick) compared with dryland. The Fe2+ and Mn2+ in the soil tended to migrate downward, but only to the plough bottom layer. The ratio of soil solid phase of the ploughing layer and the ploughing bottom layer increased after rice planting, with the ratio of soil solid phase of the ploughing bottom layer increased from 47.8% to 70.0% and the bulk density increased from 1.22 g·cm-3 to 1.77 g·cm-3. Decreases of the total amount of soil porosity, increases of the proportion of micropores, and cohesive leaching deposition in the albic soil were observed after rice planting. The changes of soil physical and chemical properties of albic soil after rice planting were generally consistent with the evolution of paddy soil except for several particularities.

Comparative efficacy of various endoscopic techniques for the treatment of common bile duct stones: a network meta-analysis.

BACKGROUND AND AIMS: Although various endoscopic techniques have been introduced for successful removal of common bile duct (CBD) stones, the optimal method is not yet clear. We aimed to compare the efficacy of different endoscopic techniques for CBD stone removal. METHODS: We searched for all relevant randomized controlled trials published until June 2017, examining the outcomes of endoscopic techniques for CBD stone removal, including endoscopic sphincterotomy (EST), endoscopic papillary balloon dilatation (EPBD), and EST with balloon dilatation (ESBD). A Bayesian network meta-analysis was performed. RESULTS: Twenty-five studies with 3726 patients were included in the meta-analysis. ESBD had a higher successful rate of stone removal in the first endoscopic session than EPBD (odds ratio [OR] [95% credible interval {CrI}], 2.09 [1.07-4.16]). Mechanical lithotripsy was less common in ESBD than in EPBD (OR [95% CrI], .45 [.25-.83]). EPBD revealed a lower risk of bleeding than both EST and ESBD (OR [95% CrI], vs EST, .06 [.008-.23]; vs ESBD, .12 [.01-.64]). The pooled incidences of bleeding were 3.0% (95% confidence interval [CI], 1.8%-5.2%), 1.1% (95% CI, .6%-2.0%), and 2.0% (95% CI, .9%-4.4%) in the EST, EPBD, and ESBD groups, respectively. Pancreatitis tended to be more common in EPBD than in both EST and ESBD (OR [95% CrI]: vs EST, 1.49 [.84-2.59]; vs ESBD, 1.49 [.61-3.57]). CONCLUSION: The efficacy of ESBD in stone removal during the first endoscopic session was superior to that of EPBD. Pancreatitis in ESBD and EST tended to be less common than in EPBD, although this difference was not statistically significant. However, ESBD and EST carried a higher risk of bleeding than EPBD.

Etomidate versus propofol sedation for complex upper endoscopic procedures: a prospective double-blinded randomized controlled trial.

BACKGROUND AND AIMS: Although a growing body of evidence demonstrates that propofol-induced deep sedation can be effective and performed safely, cardiopulmonary adverse events have been observed frequently. Etomidate is a new emerging drug that provides hemodynamic and respiratory stability, even in high-risk patient groups. The objective of this study was to compare safety and efficacy profiles of etomidate and propofol for endoscopic sedation. METHODS: A total of 128 patients undergoing EUS were randomized to receive either etomidate or propofol blinded administered by a registered nurse. The primary outcome was the proportion of patients with any cardiopulmonary adverse events. RESULTS: Overall cardiopulmonary adverse events were identified in 22 patients (34.38%) of the etomidate group and 33 patients (51.56%) of the propofol group, without significant difference (P = .074). However, the incidence of oxygen desaturation (4/64 [6.25%] vs 20/64 [31.25%]; P =.001) and respiratory depression (5/64 [7.81%] vs 21/64 [32.81%]; P =.001) was significantly lower in the etomidate group than in the propofol group. The frequency of myoclonus was significantly higher in the etomidate group (22/64 [34.37%]) compared with the propofol group (8/64 [12.50%]) (P =.012). Repeated measure analysis of variance revealed significant effects of sedation group and time on systolic blood pressure (etomidate group greater than propofol group). Physician satisfaction was greater in the etomidate group than in the propofol group. CONCLUSIONS: Etomidate administration resulted in fewer respiratory depression events and had a better sedative efficacy than propofol; however, it was more frequently associated with myoclonus and increased blood pressure during endoscopic procedures. (Clinical trial registration number: KCT0001701.).

Sn-doped bismuth telluride nanowires with high conductivity.

Bismuth telluride (Bi(2)Te(3)) nanowires with sub-100 nm diameters were synthesized by Au-Sn co-catalyzed chemical vapor deposition. These Bi(2)Te(3) nanowires were single crystals with a hexagonal lattice. The Sn catalyst played a key role in achieving the one-dimensional nanowire structures, while the absence of Sn resulted in other morphologies such as nanoplates, nanooctahedrons and nanospheres. Raman spectra revealed that compared to the Bi(2)Te(3) bulk materials, the Bi(2)Te(3) nanowires displayed an A(1u) spectral peak, implying the breaking of symmetry. The temperature-dependent electrical measurement indicated that these Sn-doped Bi(2)Te(3) nanowires were metallic, with a high conductivity of 1.6 × 10(5) S m(-1) at 300 K.

Prediction of flavin mono-nucleotide binding sites using modified PSSM profile and ensemble support vector machine.

Flavin mono-nucleotide (FMN) closely evolves in many biological processes. In this study, a computational method was proposed to identify FMN binding sites based on amino acid sequences of proteins only. A modified Position Specific Score Matrix was used to characterize the local environmental sequence information, and a visible improvement of performance was obtained. Also, the ensemble SVM was applied to solve the imbalanced data problem. Additionally, an independent dataset was built to evaluate the practical performance of the method, and a satisfactory accuracy of 87.87% was achieved. It demonstrates that the method is effective in predicting FMN-binding sites.

Prediction of nicotinamide adenine dinucleotide interacting sites based on ensemble support vector machine.

Nicotinamide adenine dinucleotide (NAD) plays an important role in cellular metabolism and acts as hydrideaccepting and hydride-donating coenzymes in energy production. Identification of NAD protein interacting sites can significantly aid in understanding the NAD dependent metabolism and pathways, and it could further contribute useful information for drug development. In this study, a computational method is proposed to predict NAD-protein interacting sites using the sequence information and structure-based information. All models developed in this work are evaluated using the 7-fold cross validation technique. Results show that using the position specific scoring matrix (PSSM) as an input feature is quite encouraging for predicting NAD interacting sites. After considering the unbalance dataset, the ensemble support vector machine (SVM), which is an assembly of many individual SVM classifiers, is developed to predict the NAD interacting sites. It was observed that the overall accuracy (Acc) thus obtained was 87.31% with Matthew's correlation coefficient (MCC) equal to 0.56. In contrast, the corresponding rate by the single SVM approach was only 80.86% with MCC of 0.38. These results indicated that the prediction accuracy could be remarkably improved via the ensemble SVM classifier approach.

Using ensemble methods to deal with imbalanced data in predicting protein-protein interactions.

In proteins, the number of interacting pairs is usually much smaller than the number of non-interacting ones. So the imbalanced data problem will arise in the field of protein-protein interactions (PPIs) prediction. In this article, we introduce two ensemble methods to solve the imbalanced data problem. These ensemble methods combine the based-cluster under-sampling technique and the fusion classifiers. And then we evaluate the ensemble methods using a dataset from Database of Interacting Proteins (DIP) with 10-fold cross validation. All the prediction models achieve area under the receiver operating characteristic curve (AUC) value about 95%. Our results show that the ensemble classifiers are quite effective in predicting PPIs; we also gain some valuable conclusions on the performance of ensemble methods for PPIs in imbalanced data. The prediction software and all dataset employed in the work can be obtained for free at http://cic.scu.edu.cn/bioinformatics/Ensemble_PPIs/index.html.