Effect of oral simethicone on the quality of colonoscopy: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: In this systematic review and meta-analysis, we aimed to investigate the effect of oral simethicone (SIM), an antifoaming agent, on the quality of colonoscopy in terms of bowel preparation quality, adenoma or polyp detection rate (ADR/PDR) and cecal intubation rate (CIR). METHODS: All randomized controlled trials (RCTs) on the use of SIM during bowel preparation for colonoscopy published up to 17 March 2021 were identified from the PubMed, EMBASE and Cochrane Library databases. Bowel preparation quality, ADR/PDR/CIR, cecal intubation time (CIT), withdrawal time (WT), patients' tolerability, acceptability and volume of foam and bubbles were compared between the SIM and non-SIM groups. RESULTS: Thirty-eight RCTs with 10 505 patients were included. Oral SIM significantly increased the rate of total Boston bowel preparation scale (BBPS) score ≥6 (risk ratio [RR]  1.13, P < 0.0001), acceptability (RR  1.15, P = 0.01) and the rate of no or minimal foam and bubbles (RR  1.28, P < 0.00001) and decreased abdominal distension (RR  0.64, P < 0.0001). However, it had no significant impact on overall ADR, overall PDR, CIR, CIT or WT. The rate of total BBPS score ≥6 remained significantly higher in the SIM group when a single-dose laxative regimen or a SIM dosage of ≥320 mg was employed; and ADR, PDR and CIR were significantly increased in the SIM group among colonoscopy clinicians who achieved an ADR <31%, PDR <45% and CIR <96%, respectively. CONCLUSIONS: Oral SIM can improve bowel preparation quality, especially in patients receiving a SIM dosage of ≥320 mg or a single-dose laxative regimen. SIM may be preferred by junior colonoscopy physicians/trainees with a lower ADR/PDR or CIR.

Adaptive Action Assessment.

Action assessment, the process of evaluating how well an action is performed, is an important task in human action analysis. Action assessment has experienced considerable development based on visual cues; however, existing methods neglect to adaptively learn different architectures for varied types of actions and are therefore limited in achieving high-performance assessment for each type of action. In fact, every type of action has specific evaluation criteria, and human experts are trained for years to correctly evaluate a single type of action. Therefore, it is difficult for a single assessment architecture to achieve high performance for all types of actions. However, manually designing an assessment architecture for each specific type of action is very difficult and impracticable. This work addresses this problem by adaptively designing different assessment architectures for different types of actions, and the proposed approach is therefore called the adaptive action assessment. In order to facilitate our adaptive action assessment by exploiting the specific joint interactions for each type of action, a set of graph-based joint relations is learned for each type of action by means of trainable joint relation graphs built according to the human skeleton structure, and the learned joint relation graphs can visually interpret the assessment process. In addition, we introduce using a normalized mean squared error loss (N-MSE loss) and a Pearson loss that perform automatic score normalization to operate adaptive assessment training. The experiments on four benchmarks for action assessment demonstrate the effectiveness and feasibility of the proposed method. We also demonstrate the visual interpretability of our model by visualizing the details of the assessment process.

Characteristics of the Distance and Space Required for Knife Slashing Using a Motion Capture System.

OBJECTIVES: To investigate the relationship between the perpetrator's sex, victim's position and slashing location as well as anthropometric parameters on distance and space required for slashing, to provide the theoretical basis for the judgment of whether the crime scene was consistent with the criminal activity space. METHODS: The kinematics data of 12 male and 12 female subjects slashing the neck of standing and supine mannequins as well as the chest of the standing mannequins with a kitchen knife were obtained by using a 3D motion capture system. The relationship between the perpetrator's sex-victim's position, the perpetrator's sex-slashing location, and anthropometric parameters and the distance and space required for the slashing were analyzed by two-factor repeated measures ANOVA and Pearson correlation analysis respectively. RESULTS: Compared with slashing the neck of supine mannequins, the distance (L) and normalized L (l) of slashing the neck of standing mannequins were greater, while vertical distance (LVR) and normalized LVR (lVR) of the knife side were smaller. Compared with slashing the neck of standing mannequins, the L and l slashing the chest of standing mannequins were greater, while LVR and lVR were smaller. Horizontal distance (LHR) and normalized LHR (lHR) of the knife side in males were greater than that in females. Height and arm length were positively correlated with L, LHR, and LVR when striking the standing mannequins. CONCLUSIONS: When slashing the neck of supine or standing victims, the slashing distance is shorter and the slashing height is greater. Furthermore, the distance and space required for slashing are correlate with anthropometric parameters.

The Low-Frequency Fluctuation of Trial-by-Trial Frontal Theta Activity and Its Correlation With Reaction-Time Variability in Sustained Attention.

Reaction-time variability is a critical index of sustained attention. However, researchers still lack effective measures to establish the association between neurophysiological activity and this behavioral variability. Here, the present study recorded reaction time (RT) and cortical electroencephalogram (EEG) in healthy subjects when they continuously performed an alternative responding task. The frontal theta activity and reaction-time variability were examined trial by trial using the measures of standard deviation (SD) in the time domain and amplitude of low-frequency fluctuation (ALFF) in the frequency domain. Our results showed that the SD of reaction-time variability did not have any correlation with the SD of trial-by-trial frontal theta activity, and the ALFF of reaction-time variability has a significant correlation with the ALFF of trial-by-trial frontal theta activity in 0.01-0.027 Hz. These results suggested the methodological significance of ALFF in establishing the association between neurophysiological activity and reaction-time variability. Furthermore, these findings also support the low-frequency fluctuation as a potential feature of sustained attention.

[A preliminary discussion of the necessity of controlled setting of placebo moxibustion].

Compared with acupuncture research, moxibustion research has made slow progress with great obstacles. With randomized controlled trials as the widely accepted gold standard for the evaluation of clinical effect, moxibustion therapy is facing a great challenge: how to establish a reasonable placebo control group. This article reviewed the current application of placebo moxibustion, analyzed the difficulties in setting up placebo moxibustion, and explored corresponding solutions, in order to attract more attention to moxibustion therapy among traditional Chinese medicine practitioners.

Clinical Characteristics and Antibiotic Resistance of Mycoplasma Pneumoniae Pneumonia in Hospitalized Chinese Children.

AIM: To analyze the clinical characteristics and antibiotic resistance of Mycoplasma pneumoniae pneumonia (MP) in Chinese patients, providing valuable information for the management of patients with MP. METHODS: A total of 120 children who were hospitalized in The First Hospital of Huzhou between January and December 2016 for respiratory tract infection due to M. pneumoniae were enrolled in this study. Infection with M. pneumoniae was confirmed by ELISA for M. pneumoniae antibody, PCR, and throat culture. Antibiotic resistance was measured from the minimum inhibitory concentrations (MICs) of antibiotics. The 23S rRNA gene of M. pneumoniae was also examined for mutations using DNA sequencing. Patients with MP were classified into antibiotic resistance (n = 98) and no resistance (n = 20) groups. For the 98 patients showing antibiotic resistance, they were further stratified into subgroups based on the antibiotics initially prescribed: azithromycin or erythromycin (n = 78) and cephalosporin or penicillin (n = 20). Clinical characteristics were compared between the patient groups. RESULTS: Antibiotic resistance group presented significantly longer febrile days compared to the no resistance group (P = 0.007). The number of febrile days after macrolide treatment was also longer in antibiotic resistance group than in no resistance group (P = 0.042). MP patients initially treated with azithromycin or erythromycin showed a longer average duration of respiratory symptoms (P = 0.046) and had a fever for more days after macrolide treatment (P = 0.009) compared to those received cephalosporin or penicillin. The average white blood cell count of patients treated with azithromycin or erythromycin was nearly half of those treated with cephalosporin or penicillin (P < 0.001). Nearly 90% of the resistant M. pneumoniae strains showed A to G substitution at position 2063 of the 23S rRNA gene. CONCLUSION: The clinical characteristics and antibiotic resistance of MP were analyzed in 120 Chinese patients. DNA sequencing revealed a highly prevalent A2063G mutation in the 23S rRNA gene.

[A Target Discrimination Method Based on the Active Polarization Imaging with the Distribution of Polarization Fresnel Ratio].

As the polarization characteristics are the physical property determined by the material itself, its corresponding polarization image contains abundant target's information. Using polarization information to identify the target is always a hot research topic in the field of the target detection. Active polarization imaging has more advantages compared with passive polarization imaging because of its high signal-to-noise ratio and good controllability. In this paper, based on the detailed analysis of the theory of the distribution of polarization Fresnel reflectance ratio, a kind of active polarization imaging method is proposed with detecting the polarization Fresnel ratio of the surface of the object. The proposed method adopts two kind of polarization light with orthogonal polarization direction at the light emission part to exposure to the target scenario alternately. Then two cameras side-by-side at the detecting part respectively equipped with two orthogonal polarization direction filters to capture the polarization images. Meanwhile, the detectors are placed in different detecting direction to acquire the polarization imaging with active polarization light source illuminating. Finally, with transmitting the data to the calculating center, optical constants can be recovered from the polarization data by the optimization fitting technique. Because the materials of target's surface are different, the corresponding optical constants are different. Then the purpose of discriminating the targets with different materials is achieved. The simulated and actual measured experiments are explored to verify the effectiveness of the proposed method. Simulation experiment shows it is not only scientific but also more convenient and effective in that the proposed method can distinguish the different materials using the calculated optical constants. The actual measured data further shows that the method is able to do better in recover optical constants of targets, especially in the distinction between metal and dielectric materials. Furthermore, the system has great application prospect in the field of target detection and camouflage recognition with its simple structure and practicability.

Antimycobacterial activity of fusaric acid from a mangrove endophyte and its metal complexes.

Due to the increasing prevalence of multidrug-resistant Mycobacterium tuberculosis, there is an urgent need for new antituberculosis drugs that have novel mechanisms of action. As part of our ongoing search for antimycobacterial metabolites from mangrove endophytes, chemical analysis of the active extract of a strain of Fusarium sp. was performed, which led to the isolation of fusaric acid as the predominant constituent. A variety of metal complexes of fusaric acid were prepared. Antimycobacterial assays showed that Cadmium (II) and Copper (II) complexes exhibited potent inhibitory activity against the M. bovis BCG strain [minimum inhibitory concentration (MIC) = 4 µg/mL] and the M. tuberculosis H37Rv strain (MIC = 10 µg/mL), respectively. This is the first report of the antimycobacterial activity of the mangrove Fusarium metabolite and its coordinating metal complexes.

Three bianthraquinone derivatives from the mangrove endophytic fungus Alternaria sp. ZJ9-6B from the South China Sea.

Three new bianthraquinone derivatives, alterporriol K (1), L (2) and M (3), along with six known compounds were obtained from extracts of the endophytic fungus Alternaria sp. ZJ9-6B, isolated from the mangrove Aegiceras corniculatum collected in the South China Sea. Their structures were elucidated by one- and two-dimensional NMR spectroscopy, MS data analysis and circular dichroism measurements. Compounds 1, 2 and 3 were first isolated alterporriols with a C-2-C-2' linkage. The crystallographic data of tetrahydroaltersolanol B (7) was reported for the first time. In the primary bioassays, alterporriol K and L exhibited moderate cytotoxic activity towards MDA-MB-435 and MCF-7 cells with IC50 values ranging from 13.1 to 29.1 µM.

Cu(II): a "signaling molecule" of the mangrove endophyte Fusarium oxysporum ZZF51?

We previously reported the isolation of Cu-fusaric acid (Cu-FA) complex from the mangrove endophyte Fusarium oxysporum ZZF51. In this study, we explored the mechanism of Cu-FA production in the strain ZZF51 by comparing with that of another endophyte Fusarium sp. B2, which produced FA but not Cu-FA in the same culture condition. The results allowed us to hypothesize that Cu(2+) may act as a "signaling molecule" to awaken the silent FA biosynthetic genes in ZZF51, inducing intracellular production of FA followed by chelation with Cu(2+). This signaling network was triggered specifically by Cu(2+) and may be interfered by other metal ions.

Penicinoline, a new pyrrolyl 4-quinolinone alkaloid with an unprecedented ring system from an endophytic fungus Penicillium sp.

A new pyrrolyl 4-quinolinone alkaloid with an unprecedented ring system, named penicinoline (1) was isolated from a mangrove endophytic fungus. The structure of 1 was elucidated by spectroscopic methods and comparison with its derivative, penicinotam (1a), an unexpected lactam that was obtained from 1 by intramolecular dehydration. The structure of 1a was unambiguously confirmed by single-crystal X-ray analysis. Penicinoline (1) showed potent in vitro cytotoxicity toward 95-D and HepG2 cell lines with IC(50) values of 0.57 and 6.5 microg/mL, respectively.

Application of a visible simulation surgery technique in preoperation planning for intrahepatic calculi.

BACKGROUND: The aim of this study was to evaluate a visible simulation surgery technique for choosing the best surgical plan in patients with intrahepatic calculi. METHODS: A medical image processing system was used to process computed tomography (CT) scanning data collected from four cases of intrahepatic calculi. Models of liver and bile ducts in standard template library format were processed by a free-form modeling system and reconstructed three-dimensionally. Accurate digital information about the bile duct system, lesions, calculi distribution, and adjacent organs from all directions, multiple angles, and multi-strata were used to choose the best surgical plan. Then, visible simulation surgery was performed with simulation operation software. RESULTS: Three-dimensionally reconstructed models provide clarity with strong relief perception and a user-friendly interface. Visible simulation surgery performed based on three-dimensionally reconstructed models led to optimal operation planning. CONCLUSIONS: Visible simulation surgery is more objective and complete than routine preoperative examinations to choose the best operation plan for intrahepatic calculi.

[Study on the application of value of digital medical technology in the operation on primary liver cancer].

OBJECTIVE: To study the clinical application of digital medical in the operation on primary liver cancer. METHODS: The patients (n=11) with primary hepatic carcinoma treated between February and July 2008, including 9 cases of hepatocellular carcinoma, 2 cases of cholangiocellular carcinoma, were scanned using 64 slices helicon computerized tomography (CT) and the datasets was collected. Segment and three-dimensional (3D) reconstruction of the CT image was carried out by the medical image processing system which was developed. And the 3D moulds were imported to the FreeForm Modeling System for smoothing. Then the hepatectomy in treatment of hepatoma and implanting of catheter were simulated with the force-feedback equipment (PHANToM). Finally, 3D models and results of simulation surgery were used for choosing mode of operation and comparing with the findings during the operation. RESULTS: The reconstructed models were true to life, and their spatial disposition and correlation were shown clearly; Blood supply of primary liver cancer could be seen easily. In the simulation surgery system, the process of virtual partial hepatectomy and implanting of catheter using simulation scalpel and catheter on 3D moulds with PHANToM was consistent with the clinical course of surgery. Life-like could be felt and power feeling can be touched during simulation operation. CONCLUSIONS: Digital medical benefited knowing the relationship between primary liver cancer and the intrahepatic pipe. It gave an advantage to complete primary liver cancer resection with more liver volume remained. It can improve the surgical effect and decrease the surgical risk and reduce the complication through demonstrating visualized operation before surgery.

[Study on visualized virtual surgery of living-related donor liver transplantation].

OBJECTIVE: To investigate the significance of three dimensional visualization and virtual surgery system in living related donor liver transplantation surgery. METHODS: Two patients suffered biliary calculi were scanned by 64 slice helical computer tomography (CT) on livers and the data were imported into medical image proceeding system (MIPS) for sequence. Man-made segmentation and true-up on the image from the data were carried out. Three dimensional (3D) models of the liver and the intrahepatic vessels were reconstructed by VTK software respectively. The models were exported with format STL from it and then were imported into the FreeForm Modeling System for smoothing and modifying. At last, living related donor liver transplantation were simulated with the force-feedback equipment (PHANToM). RESULTS: It had great verisimilar image for the reconstructed 3D liver models with artery, hepatic vein, portal vein and bile duct. By seeing through liver, it had high fidelity and strong 3D effect for the intrahepatic artery, hepatic vein, portal vein and bile duct, and their spatial disposition and course and co-relationship were shown clearly. In the virtual surgery system, the virtual scalpel could be manipulated on 3D liver model with PHANToM. The simulating effect was the same as the clinic operation for living related donor liver transplantation. CONCLUSIONS: The visualized liver model reconstructed is 3D and verisimilar, and it is helpful to design reasonable scheme for liver transplantation. It can improve the surgical effect, decrease the surgical risk, reduce the complication, enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery.

[Study on three dimensional reconstruction and simulation surgery of spleen].

OBJECTIVE: To study the three-dimensional (3D) reconstruction and the visualization simulation surgery of spleen based on the scanning data of 64-slice helical computed tomograph (CT). METHODS: The original data of 64-slice helical CT of spleen was collected, and then the CT image sequences were segmented and automatically extracted using auto-adapted region growth algorithm, and were conducted with the segmented images by adopt self-developed image processing software for 3D reconstruction. Finally, the 3D models were imported into FreeForm Modeling System for modifying and smooth. And the visualization simulation surgery was performed before splenectomy. RESULTS: It was fast and effective to utilize auto-adapted region growth algorithm to conduct spleen image program segmentation; the reconstructed models were seen clearly and could reappear the structure of the spleen and the important surrounding organs. The effect of the splenectomy simulation surgery was similar to the practical surgery. CONCLUSIONS: The research on 3D models of spleen and visualization simulation surgery of splenectomy could lead to clinical benefits. It maybe improve the surgical effect and decrease the surgical risk and reduce the complication demonstrating visualized operation before surgery.

A new hTopo I isomerase inhibitor produced by a mangrove endophytic fungus no. 2240.

A new hTopo I isomerase inhibitor, (+)-3,3',7,7',8,8'-hexahydroxy-5,5'-dimethylbianthraquinone (2240A), was isolated from the mangrove endophytic fungus no. 2240 collected from an estuarine mangrove at the South China Sea coast. Its structure was elucidated by spectral analyses including two-dimensional NMR, HR-EI-MS, IR, and UV. The hTopo I isomerase inhibition experiment showed that 2240A (1) possessed strong inhibiting activity. When its inhibition concentration was 4.65 micromol/l, its percent inhibition rate was 59.1%, while the lowest inhibition concentration of the positive control camptothecin was 1.00 x 10(3) micromol/l.

[Establishment of a three-dimensional pancreas model for simulating surgical resection of pancreatic tail carcinoma using virtual-reality technique].

OBJECTIVE: To assess the feasibility of visual-reality technique for simulating surgical resection of pancreatic tail carcinoma using a 3-dimensional pancreas model reconstructed on the basis of the CT data. METHODS: The original image data of 64-slice spiral CT was obtained from a patient with pancreatic tail carcinoma. Using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted for 3-dimensional reconstruction of the pancreas and the anatomically related structures with a self-designed program. The model was then processed with Freeform Modeling System for image modification and smoothing. With the assistance of GHST SDK and PHANTOM software systems, preoperative simulation of surgical resection of the carcinoma was performed on the basis of the established pancreatic model. RESULTS: The reconstructed 3-dimensional pancreatic model with the related structures clearly visualized the 3-dimensional structures of the pancreas, the pancreatic tail compromised by the carcinoma, and the adjacent organs, displaying also the distribution, courses and the anatomical relations of the ductal systems including the main pancreatic duct, abdominal aorta, portal vein system, and the biliary tract. During simulated surgery for pancreatic tail carcinoma resection, the GHOST SDK system allowed effective application of the virtual surgical instruments, and the use of PHANTOM software produced a surgical experience with high resemblance of that from an actual operation. CONCLUSION: The serial CT data-based reconstruction of 3-dimensional pancreas model and simulated operation on this model using virtual-reality technique has great potentials for application in individualized surgical planning and surgical risk assessment in cases of pancreatic tail carcinoma, and also facilitates clinical training of the surgeons.

[Clinical value of three-dimensional reconstruction of the biliary calculi based on 64-slice spiral CT scanning data].

OBJECTIVE: To study the clinical value of 3-dimensional (3D) reconstruction of the liver and its ductal structures using 64-slice spiral CT data in hepatobiliary surgery. METHODS: The image data of 64-slice spiral CT scanning was obtained from patients with biliary calculi. Image segmentation was performed both using computer programs and manually, and 3D reconstruction of the liver was carried out using Mimics software. The reconstructed model of the liver and the ductal system was exported in STL format, and then into the FreeForm Modeling System for modification and smoothing, followed by image registration of the liver with the ductal system and the calculi. RESULTS: The reconstructed liver model accurately represented the actual size of the liver and its anatomic landmarks, and by adjusting the transparency of the liver, the hepatic and intrahepatic arteries, veins, the portal vein, some abdominal vessels and the biliary system with the calculi were clearly visualized. The calculi in the intrahepatic and extrahepatic bile ducts were distinct in terms of the location and number, and dilation and stenosis of the intrahepatic and extrahepatic bile ducts were also clearly observed. The model presented with realistic profile of the liver that allowed vivid 3D observation. The model also allowed zooming and rotation for observation in full views. CONCLUSIONS: The reconstructed model of the liver and its ductal system can be useful for preoperative planning and intraoperative complete removal of the calculi from the bile duct, and for the bile duct dilation and stenosis detected in the model, appropriate measures should be taken to reduce the residual calculi and prevent reoccurrence.