Endoscopic ultrasound-guided gallbladder endoscopic mucosal resection: a pilot porcine study.

INTRODUCTION: Endoscopic ultrasound (EUS)-guided natural orifice transluminal gallbladder polypectomy provides a minimally invasive alternative to cholecystectomy. The study aimed to investigate the feasibility and safety of protocol for gallbladder endoscopic mucosal resection (gEMR) under EUS guidance using a porcine model. MATERIAL AND METHODS: Fifteen Bama mini pigs were randomly divided into the control (CG, n = 3) and experimental (EG, n = 12) groups. EUS-guided fine needle aspiration was performed in the CG and used to establish a gallbladder pathway for polyp resection under EUS guidance in the EG. Procedural safety was evaluated using routine blood and biochemical tests, microbial bile cultures, histopathological tests, and enzyme-linked immunosorbent assays for inflammatory adhesion factors. RESULTS: EUS-guided metal stents were successfully deployed in all 12 pigs. Two cases of stent displacement occurred postoperatively, and one pig died of infectious peritonitis on the first day after stent implantation. In 11 surviving experimental animals, mature gallbladder paths were formed at 7-14 days after gastro-cholecystostomy, through which gEMR of gallbladder polyps was successfully performed. There were no significant changes in levels of inflammatory and adhesion factors during the postoperative process. CONCLUSIONS: EUS-gEMR may be a safe and effective minimally invasive treatment approach for gallbladder polyps.

Combined effects of straw and water management on CH4 emissions from rice fields.

Water and organic amendments are the two most important factors that control methane (CH4) emissions from rice fields, the combined effect of which on CH4 emissions has been rarely studied. Thus, a field experiment in a split-plot design was conducted to investigate the combined effect of straw and water management on CH4 emissions. Main plots had water treatments: continuous flooding (CF), flooding - midseason drying - flooding (FDF), and flooding for transplanting - rainfed (RF); and subplots had straw treatments: straw incorporated into soil (SI), straw mulching (SM), and without straw. Results showed that the presence of water layer led to substantial increase in CH4 emissions which were enhanced by straw application. Cumulative CH4 emissions were influenced by water, straw, and their interactions significantly (P < 0.05). The cumulative CH4 emissions were 505.3, 241.2, and 56.5 kg ha-1 for CF, FDF, and RF, respectively. By contrast, SI under CF, FDF, and RF increased CH4 emissions by 265.4, 271.4, and 175.6 kg ha-1, respectively. And SM under CF, FDF, and RF increased CH4 emissions by 213.3, 112.8, and 14.6 kg ha-1, respectively. The results indicated that SM resulted in less CH4 emissions compared with SI, especially in plots frequently with absence of water layer. Besides, SM had a potential to increase rice yield in rice paddies that had a lack of water. Therefore, in-season straw application should be avoided in lowland rice paddies, and straw mulching is practical in rice paddies lack of water.

Modified method for the extraction of mRNA from paddy soils.

OBJECTIVE: Paddy soils contain relatively greater organic matter and water contents than other soils thereby limiting effective mRNA extraction. A modification of the conventional mRNA soil extraction method specific to paddy soils is described. RESULTS: Two main modifications for co-extraction of DNA and RNA are: (1) addition of 20 % (w/v) sodium dodecyl sulphate to 10 % (w/v) hexadecyltrimethylammonium bromide extraction buffer, and (2) fresh soil, initially frozen at -80 °C, is immediately immersed in extraction buffer. The high-quality total RNA extracted can be directly used in downstream analyses without an additional step to remove humic acid. RNA purification was conducted to remove 5S rRNA, and the mRNA was enriched by selectively digesting rRNA. cDNA synthesised by reverse transcriptase was not contaminated by the reagents or genomic DNA. CONCLUSION: The modified method for mRNA extraction from paddy soil is suitable for analysing the expression of microbial genes from fresh paddy soil.

Comparison of the effects of esketamine, sufentanil, or lidocaine combined with propofol on tussis reflection during upper gastrointestinal endoscopy: study protocol for a randomised, two centre, three-blind, controlled trial.

BACKGROUND: Tussis, which increases the incidence of airway spasm, aspiration, nausea, and vomiting, is a common complication faced during upper gastrointestinal (GI) endoscopy. However, sedatives and analgesics exhibit inhibitory actions against airway reflexes to different degrees. Our assumption is a combination of propofol and small doses of sufentanil, esketamine, or lidocaine, especially the combination of propofol and esketamine, might reduce tussis incidence. METHOD: The study will be performed as a randomised controlled three-blind, two-centre trial. Patients undergoing upper GI endoscopy, ≥ 18 years old, with American Society of Anesthesiologists (ASA) classification I-III will be randomised to four groups: P group (single administration of propofol), P + S group (administration of propofol and sufentanil in combination), P + K group (administration of propofol and esketamine in combination), and P + L group (administration of propofol and lidocaine in combination) (N = 100 per group). The primary endpoints include the frequency of tussis, nausea and vomiting, and/or body movements observed at the insertion of the endoscope into the pharyngeal cavity or within 5 min of endoscope insertion. Secondary outcomes are recovery assessment, patients' and endoscopists' satisfaction with the procedure, MMSE scores, MET scores, sleep condition, and the number of sedation-related events. Data on sedation-related events are collected by recording of vital signs. Satisfaction parameters and mental states are collected by means of questionnaires and evaluation scales before and after the procedure and on different following days. DISCUSSION: Esketamine can reduce tussis occurrence with good tolerability and relax the bronchus and also provides high clearance rates and low possibility of adverse reactions. We aim to demonstrate that the combination of esketamine with propofol for sedation in patients subjected to upper GI procedure is nevertheless superior to only administration of propofol or a combination of propofol with other anaesthetics, such as opioids or lidocaine. TRIAL REGISTRATION: ClinicalTrials.gov. NCT05497492 , Registered 09 August 2022.

Application value of real-time 3D speckle tracking imaging in left atrial function evaluation of patients with paroxysmal atrial fibrillation.

OBJECTIVE: To evaluate left atrial volume and function in patients with paroxysmal atrial fibrillation (AF) combined with left atrial appendage thrombosis and patients with paroxysmal AF without left atrial appendage thrombosis by 3-dimensional speckle tracking imaging (3D-STI), and to explore the application value of this set of parameters in the evaluation of left atrial function in patients with paroxysmal AF. MATERIALS AND METHODS: A total of 40 patients with paroxysmal AF admitted from December 2018 to December 2020 were selected as the observation group. All patients with paroxysmal AF in the observation group underwent transesophageal echocardiography. According to the presence of left atrial appendage thrombosis, the patients were divided into the AF without thrombosis group (24 cases) and the AF with thrombosis group (16 cases). Thirty normal people were selected as control group who were chosen as having no heart-related disease. The left atrial volume parameters (Left atrial maximum volume LAVmax, Left atrial minimum volume LAVmin, Left atrial volume before atrial contraction LAVpre-A, Left atrial stroke volume LAEV), left atrial ejection fraction (LAEF) and left atrial strain parameters (Left atrial reservoir longitudinal strain LASr, Left atrial conduit longitudinal strain LAScd, Left atrial contraction longitudinal strain LASct, Left atrial reservoir circumferential strain LASr-c, Left atrial conduit circumferential strain LAScd-c, Left atrial contraction circumferential strain LASct-c) of the 3 groups were measured by 3D-STI. RESULTS: With the progression of paroxysmal AF, the left atrial volume increased, and the reservoir, conduit and contractile function were damaged. The left atrial volume continued to increase, and the reservoir, conduit and contractile function further decreased significantly in patients with AF combined with left atrial appendage thrombosis. LAEF was positively correlated with LASr and LASr_c. CONCLUSION: Real-time 3-dimensional spot tracking imaging (3D-STI) can evaluate the changes in left atrial volume and function in patients with paroxysmal AF, and has a certain reference value for clinical judgment of disease progression and prognosis.

Long-term chemical and organic fertilization induces distinct variations of microbial associations but unanimous elevation of soil multifunctionality.

Intricate microbial associations contribute greatly to the multiple functions (multifunctionality) of natural ecosystems. However, the relationship between microbial associations and soil multifunctionality (SMF) in artificial ecosystems, particularly in agricultural ecosystem with frequent fertilization, remains unclear. In this study, based on a 28-year paddy field experiment, high-throughput sequencing and networks analysis was performed to investigate changes in soil microbial (archaea, bacteria, fungi, and protists) associations and how these changes correlate with SMF under long-term fertilization. Compared to no fertilization (CK), both chemical fertilization with N, P, and K (CF) and chemical fertilization plus rice straw retention (CFR) treatments showed significantly higher soil nutrient content, grain yield, microbial abundance, and SMF. With the exception of archaeal diversity, the CF treatment exhibited the lowest bacterial, fungal, and protist diversity, and the simplest microbial co-occurrence network. In contrast, the CFR treatment had the lowest archaeal diversity, but the highest bacterial, fungal, and protist diversity. Moreover, the CFR treatment exhibited the most complex microbial co-occurrence network with the highest number of nodes, edges, and interkingdom edges. These results highlight that both chemical fertilization with and without straw retention caused high ecosystem multifunctionality while changing microbial association oppositely. Furthermore, these results indicate that rice straw retention contributes to the development of the soil microbiome and ensures the sustainability of high-level ecosystem multifunctionality.

Differential contribution of microbial and plant-derived organic matter to soil organic carbon sequestration over two decades of natural revegetation and cropping.

Both natural revegetation and cropping have great impact on long-term soil carbon (C) sequestration, yet the differences in their underlying mechanisms remain unclear. In this study, we investigated trends in soil organic C (SOC) accumulation during natural revegetation (VR) and cropping processes over 24 years, and explored the contributions of microbial necromass and plant-derived C to SOC formation and their primary controls. Over the course of 24 years of land use/cover change (LUCC) from 1995, SOC content exhibited a more substantial increase in VR (0.31 g kg-1 a-1) than in cropland (0.14 g kg-1 a-1) during Stage II (>10 y after LUCC), and recalcitrant organic carbon explained more of the SOC variation than easily oxidizable carbon. The higher SOC content in VR was attributed to a greater contribution of plant-derived C (14-28 %) than that in cropland (3-11 %) to SOC and a consistently lower ratio of cinnamyl (C)- to vanillyl (V)-type phenols in VR across all the assessed years. Although there were higher proportion of microbial necromass of SOC (41-84 %) in cropland than in VR, the differences were not significant. The dominant bacterial phylum of Chloroflexi and soil nitrogen content were the primary biotic and abiotic factors regulating microbial-derived and plant-derived C in both cropland and VR. However, soil phosphorus content was the main factor in cropland, while climatic factors such as mean annual precipitation were more important in VR. These results provided evidence that long-term natural revegetation enhanced SOC sequestration by greater contribution of plant-derived C to SOC formation compared to cropping. These findings underscore the synergistic contribution of vegetation and microorganisms to long-term SOC sequestration, offering insights into the different mechanisms of carbon formation during VR and cropping processes, and providing support for optimizing land management to achieve global carbon neutrality goals.

[Necessity of prophylactic contralateral nephroureterectomy in the renal transplantation patients with transitional cell carcinoma of unilateral upper urinary tract].

OBJECTIVE: To discuss the necessity of prophylactic contralateral nephroureterectomy in renal transplantation patients with upper urinary tract transitional cell carcinoma (TCC). METHODS: In our study 15 renal transplantation patients with upper urinary tract TCC were involved from Dec.2006 to May 2013. All the patients received prophylactic contralateral nephroureterectomy 3 months after their last nephroureterectomy. A retrospective analysis was performed. RESULTS: TCC of upper urinary tract was confirmed by postoperative pathology in all the 15 cases .Similarly, TCC of contralateral upper urinary tract was detected in 7 of these cases (46.7%), and 13 survived after 36 months' follow-up (86.7%). CONCLUSION: In the renal transplantation patient with unilateral upper urinary tract TCC, the possibility of contralateral upper urinary tract TCC is high, thus the necessity of prophylactic contratateral nephroureterectomy is certain.

Influence of fertilisation regimes on a nosZ-containing denitrifying community in a rice paddy soil.

BACKGROUND: Denitrification is a microbial process that has received considerable attention during the past decade since it can result in losses of added nitrogen fertilisers from agricultural soils. Paddy soil has been known to have strong denitrifying activity, but the denitrifying microorganisms responsible for fertilisers in paddy soil are not well known. The objective of this study was to explore the impacts of 17-year application of inorganic and organic fertiliser (rice straw) on the abundance and composition of a nosZ-denitrifier community in paddy soil. Soil samples were collected from CK plots (no fertiliser), N (nitrogen fertiliser), NPK (nitrogen, phosphorus and potassium fertilisers) and NPK + OM (NPK plus organic matter). The nitrous oxide reductase gene (nosZ) community composition was analysed using terminal restriction fragment length polymorphism, and the abundance was determined by quantitative PCR. RESULTS: Both the largest abundance of nosZ-denitrifier and the highest potential denitrifying activity (PDA) occurred in the NPK + OM treatment with about four times higher than that in the CK and two times higher than that in the N and NPK treatments (no significant difference). Denitrifying community composition differed significantly among fertilisation treatments except for the comparison between CK and N treatments. Of the measured abiotic factors, total organic carbon was significantly correlated with the observed differences in community composition and abundance (P < 0.01 by Monte Carlo permutation). CONCLUSION: This study shows that the addition of different fertilisers affects the size and composition of the nosZ-denitrifier community in paddy soil.