Parallel array signal processing technology for spatial phase distortion correction in heterodyne detection.

The spatial phase distortion caused by a rough target causes a decoherence effect which, in turn, produces system sensitivity degradation. The decoherence phenomenon is the primary problem that restricts the application of active optical heterodyne detection, e.g., synthetic aperture radar and long-range coherent laser detection and ranging. By establishing a one-to-one correspondence between the combination of array signals and the system signal-to-noise ratio (SNR), a scheme for spatial phase distortion correction based on the intelligent optimization algorithm is proposed in this paper. The calculation of phase adjustments for each array signal is transformed into an optimization problem for the combination of array signals, experiments are conducted using rough target heterodyne images, and the parallel genetic algorithm (PGA) is used to calculate the phase adjustment of each array element. The results show that the spatial random phase distortion is corrected effectively without prior knowledge, and the PGA achieves an excellent computational performance which, along the efficiency of the proposed technology, has wide-scale implications for the application of active heterodyne detection and optical coherent communication.

Improvement of the immune efficacy of carbohydrate vaccines by chemical modification on the GM3 antigen.

Tumor cells often display aberrant levels and patterns of cell surface glycosylation, which provides a potential opportunity to develop carbohydrate-based anticancer vaccines for cancer immunotherapy. However, one of the most addressed challenges in this field is the low efficiency of the carbohydrate vaccination due to poor immunogenicity of carbohydrate antigens. In this article, a number of structure-modified GM3 antigen analogues were designed and chemically synthesized. The modified GM3 antigens were conjugated to protein carriers for vaccination. The vaccination results on mice show that the modification on the GM3 antigen could improve the efficiency of the vaccination, and in particular, two glycoconjugates (3-KLH and 8-KLH) elicited higher titers of anti-GM3 antibodies than the unmodified GM3-protein conjugate (2-KLH) did.

The effect of endoscopic ultrasonography in treatment of distal inflammatory biliary stricture: a retrospective analysis of 165 cases.

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) are relatively new alternatives to surgery for the treatment of benign lesions in the biliary duct. This study was to explore the value of EUS in the treatment of distal inflammatory biliary stricture. METHODOLOGY: 165 patients with distal inflammatory biliary stricture underwent EUS, according to EUS, endoscopic retrograde cholangiopancreatography (ERCP), intraductal ultrasonography (IDUS), endoscopic retrograde biliary drainage and endoscopic biliary dilation were performed. The clinical data about therapies and recovery of 22 patients was recorded and analyzed. RESULTS: In 165 patients, 163 cases underwent ERCP and intraductal ultrasonography (IDUS) successfully following EUS. Total 356 ERCPs were performed with 87 biliary duct stents inserted. After EUS the liver function, the thickness and pressure of biliary duct were decreased compared to these before EUS. The complication rate was 5.1% (18/356). After a follow-up of 27.6±10.6 months, strictures had not recurred in 121 patients after stents removed. CONCLUSION: EUS for distal inflammatory biliary stricture can be selected as a safe, effective and minimally invasive therapeutic method.

Visible-light-induced catalyst-free reductive coupling of aldehydes, ketones and imines with cyanopyridines.

This article introduces a reductive coupling driven by visible-light, facilitating the synthesis of pyridine-substituted alcohols and amines through the reaction of aldehydes, ketones and imines with cyanopyridines. Hantzsch esters serve as reductants in this process, eliminating the need for transition-metals or photosensitizers. The method demonstrates extensive compatibility and finds utility in the late-stage functionalization of both natural and pharmaceutical products, offering a sustainable pathway for the diversification of chemical compounds.

Effects of laparoscopic and choledochoscopic gallbladder-preserving cholecystolithotomy on levels of operation indicators, gallbladder function, and cholecystokinin type-A receptor in patients with gallstones.

Introduction: Gallstones are a common digestive system disease. Aim: To assess the effects of laparoscopic and choledochoscopic gallbladder-preserving cholecystolithotomy on the levels of operation indicators, gallbladder function, and cholecystokinin type-A receptor (CCKAR) in patients with gallstones. Material and methods: The medical records of 100 patients with gallstones receiving operation from July 2019 to August 2022 were collected for retrospective analysis. They were divided into a laparoscopic group (n = 48) and a laparoscopic + choledochoscopic group (n = 52). The laparoscopic group received totally laparoscopic cholecystolithotomy, while the laparoscopic + choledochoscopic group underwent laparoscopic and choledochoscopic cholecystolithotomy. Their perioperative indicators, gallbladder function, stress indicators (cortisol (Cor), norepinephrine (NE), and C-reactive protein (CRP)), serum biochemical indicators (liver receptor homologue 1 (LRH-1), CCKAR, and vasoactive intestinal peptide (VIP)), and complications were compared. Results: The fasting gallbladder volume and gallbladder contraction rate increased, and the minimum residual volume and gallbladder wall thickness decreased in the laparoscopic + choledochoscopic group in comparison with those of the laparoscopic group 6 months after operation (p < 0.05). The levels of serum Cor, NE, CRP, and CCKAR were elevated, whereas the levels of serum LRH-1 and VIP were lowered in both groups 3 d after operation compared with those before operation (p < 0.05). The levels of serum Cor, NE, CRP, LRH-1, and VIP were lower, and the level of serum CCKAR was higher in the laparoscopic + choledochoscopic group than those in the laparoscopic group 3 d after operation (p < 0.05). Conclusions: Both laparoscopic gallbladder-preserving cholecystolithotomy and laparoscopic and choledochoscopic cholecystolithotomy are effective for treating gallstones. However, the latter combination method is superior in enhancing postoperative gallbladder function, decreasing the recurrence risk, regulating the expressions of LRH-1, CCKAR, and VIP, and promoting the postoperative recovery of gastrointestinal function.

Systemic stress responses after laparoendoscopic single-site hepatectomy: a perspective controlled study.

BACKGROUND/AIMS: This study aimed to evaluate the technical feasibility of laparoendoscopic single-site hepatectomy (LESH) and compared stress responses with laparoscopic hepatectomy (LH) through a perspective controlled trial. METHODOLOGY: Thirty small female family pigs as animal models were divided into LESH and LH groups randomly. The data about operations including operating time, blood loss and complication rates were recorded. The stress indicators, including adrenaline, serum cortisol, interleukin-1, interleukin-6 and white blood cell count, were measured at baseline and 1, 24 and 48 hours postoperatively. RESULTS: In LESH group, 1 case was converted to LH for uncontrolled blooding. The other 29 cases underwent respective operations successfully. Postoperative recovery was without complications. Mean operative time of LESH group and LH group was 94.7±31.3 vs. 76.9±24.3min (p=0.0929). The blood loss of two groups was 72.5±26.4 vs. 66.3±21.2mL and there was no statistical difference. In both groups stress indicators showed a rising trend after operations and had no significant differences at the same time point. CONCLUSIONS: LESH is a safe, feasible and minimally invasive approach and has no different impact on stress responses compared to LH. It may be a reasonable alternative to apply in clinical practice by experienced laparoscopic physicians.

Combined laparoendoscopic single-site surgery: initial experience of a single center.

BACKGROUND/AIMS: This study reports the initial experience with combined laparoendoscopic single-site surgery (LESS) referring to cholecystectomy, appendectomy, oophorocystectomy and liver cyst and renal cyst fenestration and explore the feasibility and safety of combined LESS. METHODOLOGY: From October 2008 to May 2011 selective 24 patients underwent combined LESS in our center. The single incision in umbilicus was about 2cm. All the operations were performed by the same surgical team and used conventional rigid instruments. RESULTS: In 24 patients, combined laparoendoscopic single-site cholecystectomy and appendectomy were performed in 17 cases, combined cholecystectomy and liver cyst fenestration in 5 cases and combined cholecystectomy and oophorocystectomy in 2 cases. Twenty one patients were successfully operated and the other 3 were converted to conventional laparoscopic surgery because of separating Calot's triangle difficulty. The mean operating time was 87.3 minutes. One urinary retention (4.2%) and one fat liquefaction in abdominal incision (4.2%) occurred and were cured conservatively. There was no mortality in the study. CONCLUSIONS: Combined laparoendoscopic single-site surgery is safe, feasible, minimally invasive and cosmetic technique but is more difficult than conventional laparoscopic surgery. It is a reasonable alternative to be performed in selective patients by experienced laparoscopic surgeons.

Laparoendoscopic single-site cholecystectomy: a randomized controlled study.

This study reports the initial experience with laparoendoscopic single-site (LESS) cholecystectomy and compares it with laparoscopic cholecystectomy (LC) through a randomized controlled trial. Sixty selective patients diagnosed with cholelithiasis or polyp lesion of the gallbladder (PLG) were randomly divided into two groups undergoing either LESS cholecystectomy or LC separately. The clinical data about operations and recovery of the two groups were compared. In the LESS group 28 of 30 patients underwent LESS cholecystectomy successfully and the remaining two (6.7%) were converted to standard laparoscopic surgery. LC was successfully performed in all patients in the control group. Mean operative time of LESS cholecystectomy group and LC group was 55.6 ± 25.7 versus 42.7 ± 18.6 (p < 0.05). Mean postoperative hospital stay was 3.7 ± 1.3 versus 3.8 ± 0.8 days (p < 0.05). Mean pain index was 2.8 ± 0.6 versus 3.7 ± 1.1 (p < 0.05). A questionnaire revealed that the mean scores of satisfaction with the operation were 8.9 ± 0.7 versus 8.1 ± 1.5 (p < 0.05). LESS cholecystectomy is safe, feasible, minimally invasive, and cosmetic. It is a reasonable alternative to selective patients with uncomplicated cholelithiasis and PLG. But larger controlled studies are still needed.

Endoscopic ultrasound guided transgastric stenting for the treatment of traumatic pancreatic pseudocyst.

BACKGROUND/AIMS: Endoscopic treatment for pancreatic pseudocysts (PPs) is a relatively new alternative to surgery. This study is to prospectively assess the value of endoscopic ultrasound (EUS) guided transgastric stenting in treatment of traumatic PPs. METHODOLOGY: Between January 2005 and January 2010, 14 patients admitted to our centre for traumatic PPs underwent EUS guided transgastric stenting. The clinical data about the therapies and recovery of the patients was recorded and analyzed. RESULTS: All patients underwent EUS and a total of 21 EUS guided transgastric stentings were performed with a success rate of 90.5% (19/21); 2 patients required surgery because therapeutic endoscopy was unsuccessful or impossible. The mean operative time was 46min and mean postoperative hospital duration was 3.8 days. There was no procedure-related mortality. The complication rate was 19.0%with 2 infections of PPs and 2 stent obstructions. The median follow-up period was 29 months (range, 10-58 months). No recurrence or other complications were found. CONCLUSIONS: Endoscopic ultrasound guided transgastric stenting can be selected as a safe, effective and minimally invasive therapeutic method for traumatic PPs. More than 6 months of stent retention for traumatic PP may be reasonable, but larger comparative studies are still needed.

Combined laparoscopic and endoscopic treatment for Mirizzi syndrome.

BACKGROUND/AIMS: To summarize our experience and results of combined endoscopic and laparoscopic treatment for Mirizzi syndrome (MS) retrospectively, and to evaluate the effect of the procedures of minimally invasive strategy. METHODOLOGY: Fifty-four patients with Mirizzi syndrome were admitted to our centre. Endoscopic procedures were performed firstly to identify the Csendes Types and alleviate jaundice. Different laparoscopic surgeries were adopted according to Csendes Types. The clinical data about operation and recovery of the two groups was recorded and compared. RESULTS: Total 63 endoscopic procedures were performed successfully in 46 cases and failed in 3 cases. Five patients were found to have MS intraoperatively. Endoscopic complication rate was 31.7% (20/63). Forty-three patients underwent laparoscopic surgeries successfully and 7 cases were converted to open surgeries. The average laparoscopic operation time was 83.2±34.7min and postoperative hospital stay was 9.5±2.4 days. Postoperative complication rate was 16.3%. Median follow-up period was 38.6 (range, 16-83) months and 4 stone recurrence occurred. CONCLUSION: Combined endoscopic and laparoscopic approaches in treating patients with MS are technically feasible and minimally invasive. However, laparoscopic primary suture of the defect on the wall of common bile duct is difficult; hence it is recommended it be performed by experienced hands.

Endoscopic pancreatic duct and biliary duct stenting in treatment of chronic pancreatitis with distal benign biliary stricture: a single-center experience.

BACKGROUND: The development of endoscopic techniques such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and stenting are relatively new alternatives to surgery for the treatment of benign lesions in the biliary duct and pancreas. The objective of this study was to assess the value of stenting in the endoscopic pancreatic duct and biliary duct in the treatment of chronic pancreatitis with distal benign biliary stricture. METHODS: Twenty-two patients diagnosed with chronic pancreatitis with distal benign biliary stricture underwent endoscopic treatment in our center, with ERCP, EST, endoscopic retrograde biliary drainage (ERBD) and endoscopic retrograde pancreatic drainage (ERPD) with stents. A numeric rating scale was used to assess pain intensity. The clinical data on endoscopic therapies and recovery of the patients were recorded and compared. RESULTS: ERCPs were successfully performed in 21 patients and 1 (4.5%) failed because of pancreatic ductal variation. A total of 68 ERCPs were performed with 47 pancreatic duct stents and 39 biliary duct stents. The rate of complications was 13.2% (9/68). The abdominal pain score after endoscopic treatment was significantly reduced. The levels of bilirubin and alanine transaminase in all 21 patients were improved compared to those before endoscopic treatment. CONCLUSION: Endoscopic stent drainage of the pancreatic duct and biliary duct for chronic pancreatitis with distal biliary benign stricture can be selected as a safe, effective and minimally invasive therapeutic method.

Emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla.

AIM: To evaluate the efficacy and safety of emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla. METHODS: Between January 2010 and January 2015, 118 cases of acute severe cholangitis with impacted common bile duct stones at the native papilla underwent emergency endoscopic retrograde cholangiopancreatography (ERCP) and early needle-knife precut papillotomy in a tertiary referral center. Precut techniques were performed according to the different locations of stones in the duodenal papilla. Clinical data about therapy and recovery of the 118 patients were recorded and analyzed. RESULTS: One hundred and eighteen patients underwent emergency ERCP within 24 h after hospitalization, with a total success rate of 100%. The mean operating time was 6.4 ±â€¯4.1 min. Postoperative acute physiology and chronic health evaluation (APACHE) II scores, white blood cell count and liver function improved significantly. The complication rate was 4.2% (5/118); two with hemorrhage and three with acute pancreatitis. There was no procedure-related mortality. CONCLUSION: Emergency endoscopic needle-knife precut papillotomy is effective and safe for acute severe cholangitis resulting from impacted common bile duct stones at the duodenal papilla.

Electrochemical Sulfonylation/Heteroarylation of Alkenes via Distal Heteroaryl ipso-Migration.

A direct electrooxidative sulfonylation/heteroarylation reaction of alkenes with sulfinic acids, which proceeds through distal heteroaryl ipso-migration and C-S and C-C bond formations, is reported. This electro-synthetic method offers an efficient and environmentally friendly entry to prepare various sulfonated functionalized heteroarenes under an undivided cell at room temperature, avoiding the use of any metal catalysts, additives, and oxidants. Preliminary mechanistic studies indicated a radical pathway.

A Minimally Invasive Strategy for Mirizzi Syndrome Type II: Combined Endoscopic With Laparoscopic Approach.

BACKGROUND: Mirizzi syndrome (MS) is a rare complication of the gallstone disease. Despite the fact that successful laparoscopic treatments have been reported for MS type I, open surgery remains the gold standard approach for MS type II because of the technical difficulties involved. OBJECTIVE: The aim of this study is to determine the best technique for patients with MS type II by comparing the duration of surgery, loss of blood, rates of complication, duration of hospitalization, and outcomes of long-term follow-up. MATERIALS AND METHODS: From January 2009 to September 2014, combined endoscopic retrograde cholangiopancreatography with laparoscopic surgery for MS type II was implemented. Patients' demographics and treatment outcomes were collected prospectively and during the follow-up. RESULTS: Forty-nine patients with MS type II were managed with this strategy. Laparoscopic subtotal cholecystectomy was successfully performed in all the patients without conversion or morbidity. When compared with a historical cohort of 57 patients who underwent a surgery for MS, this group of patients had significantly shorter duration of hospitalization (7.21±1.61 vs. 15.31±3.82 d, P<0.01). It also showed less blood loss (162.81±40.83 vs. 207.55±37.01 mL, P=0.425) and less postoperative complications (10.20% vs. 14.04%, P=0.594), although the duration of surgery (165.73±54.33 vs. 156.04±48.61 min, P=0.334) was longer, but these were not statistically significant. However, no significant difference in the rate of recurrence (4.55% vs. 9.52%, P=0.522) of choledocholithiasis was found. CONCLUSIONS: The MS type II can be effectively managed with a laparoscopic surgery combined with preoperative endoscopic retrograde cholangiopancreatography, which is feasible and minimally invasive.

Associations between near work, outdoor activity, and myopia among adolescent students in rural China: the Xichang Pediatric Refractive Error Study report no. 2.

OBJECTIVE: To study the associations between near work, outdoor activity, and myopia among children attending secondary school in rural China. METHODS: Among a random cluster sample of 1892 children in Xichang, China, subjects with an uncorrected acuity of 6/12 or less in either eye (n = 984) and a 25% sample of children with normal vision (n = 248) underwent measurement of refractive error. Subjects were administered a questionnaire on parental education, time spent outdoors, and weekly time spent engaged in and preferred working distance for a variety of near-work activities. RESULTS: Among 1232 children with refraction data, 998 (81.0%) completed the near-work survey. Their mean age was 14.6 years (SD, 0.8 years), 55.6% were girls, and 83.1% had myopia of -0.5 diopters or less (more myopia) in both eyes. Time and diopter-hours spent on near activities did not differ between children with and without myopia. In regression models, time spent on near activities and time outdoors were unassociated with myopia, adjusting for age, sex, and parental education. CONCLUSIONS: These and other recent results raise some doubts about the association between near work and myopia. Additional efforts to identify other environmental factors associated with myopia risk and that may be amenable to intervention are warranted.

Prevalence and determinants of spectacle nonwear among rural Chinese secondary schoolchildren: the Xichang Pediatric Refractive Error Study Report 3.

OBJECTIVE: To study spectacle wear among rural Chinese children. METHODS: Visual acuity, refraction, spectacle wear, and visual function were measured. RESULTS: Among 1892 subjects (84.7% of the sample), the mean (SD) age was 14.7 (0.8) years. Among 948 children (50.1%) potentially benefiting from spectacle wear, 368 (38.8%) did not own them. Among 580 children owning spectacles, 17.9% did not wear them at school. Among 476 children wearing spectacles, 25.0% had prescriptions that could not improve their visual acuity to better than 6/12. Therefore, 62.3% (591 of 948) of children needing spectacles did not benefit from appropriate correction. Children not owning and not wearing spectacles had better self-reported visual function but worse visual acuity at initial examination than children wearing spectacles and had a mean (SD) refractive error of -2.06 (1.15) diopter (D) and -2.78 (1.32) D, respectively. Girls (P < .001) and older children (P = .03) were more likely to be wearing their spectacles. A common reason for nonwear (17.0%) was the belief that spectacles weaken the eyes. Among children without spectacles, 79.3% said their families would pay for them (mean, US $15). CONCLUSIONS: Although half of the children could benefit from spectacle wear, 62.3% were not wearing appropriate correction. These children have significant uncorrected refractive errors. There is potential to support programs through spectacle sales.

Strategies to improve the accuracy of vision measurement by teachers in rural Chinese secondary schoolchildren: Xichang Pediatric Refractive Error Study (X-PRES) report no. 6.

OBJECTIVE: To assess and improve the accuracy of lay screeners compared with vision professionals in detecting visual impairment in secondary schoolchildren in rural China. METHODS: After brief training, 32 teachers and a team of vision professionals independently measured vision in 1892 children in Xichang. The children also underwent vision measurement by health technicians in a concurrent government screening program. RESULTS: Of 32 teachers, 28 (87.5%) believed that teacher screening was worthwhile. Sensitivity (93.5%) and specificity (91.2%) of teachers detecting uncorrected presenting visual acuity of 20/40 or less were better than for presenting visual acuity (sensitivity, 85.2%; specificity, 84.8%). Failure of teachers to identify children owning but not wearing glasses and teacher bias toward better vision in children wearing glasses explain the worse results for initial vision. Wearing glasses was the student factor most strongly predictive of inaccurate teacher screening (P < .001). The sensitivity and specificity of the government screening program detecting low presenting visual acuity were 86.7% and 28.7%, respectively. CONCLUSIONS: Teacher vision screening after brief training can achieve accurate results in this setting, and there is support among teachers for screening. Screening of uncorrected rather than presenting visual acuity is recommended in settings with a high prevalence of corrected and uncorrected refractive error. Low specificity in the government program renders it ineffective.

Spectacle acceptance among secondary school students in rural China: the Xichang Pediatric Refractive Error Study (X-PRES)--report 5.

PURPOSE: To assess determinants of spectacle acceptance and use among rural Chinese children. METHODS: Children with uncorrected acuity < or = 6/12 in either eye and whose presenting vision could be improved > or = 2 lines with refraction were identified from a school-based sample of 1892 students. Information on obtaining glasses and the benefits of spectacles was provided to children, families, and teachers. Purchase of new spectacles and reasons for nonpurchase were assessed by direct inspection and interview 3 months later. RESULTS: Among 674 (35.6%) children requiring spectacles (mean age, 14.7 +/- 0.8 years), 597 (88.6%) were followed up. Among 339 children with no glasses at baseline, 30.7% purchased spectacles, whereas 43.2% of 258 children with inaccurate glasses replaced them. Most (70%) subjects paid US$13 to $26. Among children with bilateral vision < or = 6/18, 45.6% bought glasses. In multivariate models, presenting vision < 6/12 (P < 0.009), refractive error < -2.0 D (P < 0.001), and amount willing to pay for glasses (P = 0.01) were predictors of purchase. Reasons for nonpurchase included satisfaction with current vision (78% of those with glasses at baseline, 49% of those without), concerns over price or parental refusal (18%), and fear glasses would weaken the eyes (13%). Only 26% of children stated that they usually wore their new glasses. CONCLUSIONS: Many families in rural China will pay for glasses, though spectacle acceptance was < 50%, even among children with poor vision. Acceptance could be improved by price reduction, education showing that glasses will not harm the eyes, and parent-focused interventions.