Lumen-apposing metal stents versus traditional self-expanding metal stents for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a systematic review and meta-analysis.

BACKGROUND: Endoscopic drainage has become the preferred treatment for pancreatic fluid collections (PFCs). There is still a lack of reliable evidence to prove which metal stent is the best choice for endoscopic ultrasound (EUS)-guided drainage of PFCs. In this study, we aimed to evaluate the efficacy and safety of lumen-apposing metal stents (LAMS) compared to traditional self-expanding metal stents (SEMS) in meta-analysis. METHODS: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library up to July 15, 2023. Relevant publications that compared LAMS with traditional SEMS for drainage of patients' PFCs under EUS-guidance were included. This meta-analysis assessed endpoints using Review Manager 5.3 and Stata 14.0 statistical software. RESULT: Nine citations comprising 707 patients with PFCs were included. The clinical success rate of LAMS tended to be higher than that of SEMS (RR = 1.07, 95%CI [1.00, 1.15], P = 0.05). LAMS had a lower technical success rate (RR = 0.97, 95%CI [0.94, 0.99], P = 0.02) and faster procedure time (minutes) (MD = - 24.29, 95%CI [- 25.59, - 22.99], P < 0.00001) compared to SEMS. In addition, LAMS had fewer overall adverse events (RR = 0.64, 95%CI [0.48, 0.87], P = 0.004). For specific adverse events, LAMS had fewer migration (RR = 0.37, 95%CI [0.19, 0.72], P = 0.003), occlusion (RR = 0.43, 95%CI [0.22, 0.82], P = 0.01) and infection (RR = 0.38, 95%CI [0.20, 0.70], P = 0.002). There was no significant difference in bleeding and perforation between the two stents. For hospital stay (days), LAMS group was similar to SEMS group (MD = - 3.34, 95%CI [- 7.71, - 1.03], P = 0.13). Regarding recurrence, LAMS group was fewer than SEMS group (RR = 0.41, 95%CI [0.21, 0.78], P = 0.007). CONCLUSION: Compared to traditional SEMS, LAMS has a higher clinical success rate, faster procedure time, fewer adverse events, similar hospital stay and lower recurrence rate in EUS-guided drainage of PFCs. LAMS is a good choice with a high technical success rate over 95%, and using a shorter length or "one-step" operation can further improve it. Richer placement experience is required for LAMS placement under EUS-guidance.

Primary pulmonary lymphoepithelioma-like carcinoma misdiagnosed as lung squamous cell carcinoma: A case report.

BACKGROUND: Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is an uncommon subtype of squamous cell carcinoma (SCC) of the lung, closely associated with Epstein-Barr virus (EBV) infection. The pathological features of PPLELC closely resemble those of SCC, which makes it prone to misdiagnosis. Surgical intervention constitutes the primary treatment approach for PPLELC. CASE SUMMARY: This report describes a 44-year-old woman who was hospitalized for 1 mo due to left chest pain. Computed tomography revealed a mass shadow in the anterior basal segment of the left lower lobe, and a subsequent needle biopsy suggested SCC. The patient underwent radical tumor resection in the lower left lobe of the lung, and postoperative pathological examination indicated lymphoepithelial carcinoma, and the test for EBV encoded small RNA was positive. Following surgery, the patient was scheduled to receive four cycles of adjuvant chemotherapy, using the paclitaxel + carboplatin regimen, but the patient refused further treatment. CONCLUSION: PPLELC is an exceptionally rare subtype of lung SCC and is prone to misdiagnosis.

Facile fabrication of hierarchical porous ZIF-8 for enhanced adsorption of antibiotics.

Aiming for improve mass transfer rate of antibiotics adsorption from water, a strategy of building larger pores (>2 nm) in microporous MOFs has been put forward. However, most of reported approaches are complicated and inefficient. Herein, a facile one-spot approach to fabricate hierarchical porous Zeolitic Imidazolate Framework-8 (HpZIF-8) was developed, where poly(diallyldimethylammonium chloride) (PDDA) was selected as structure-directing agent to modulate the growth of microporous ZIF-8 (mZIF-8). The final products with meso- and macropores exhibit hierarchical porosity. The mechanism was a two-step process: First, crystal nucleus aggregated initiated by electrostatic interaction between cationic PDDA and deprotonated 2-MI anions. Second, Ostwald ripening process and orientated growth occurred with further growth of crystals. For removing Tetracycline Hydrochloride (TH) and Chloramphenicol (CP) from water, hierarchical porous HpZIF-8-10(D) (D = 1.0, 1.5, 2.0) showed larger adsorption capacity than mZIF-8-10 despite of decreased BET surface area, which could be attributed to novel hierarchical porous structures. The adsorption kinetics and isotherms of TH and CP by HpZIF-8-10(1.5) were analyzed. The strategy present here may provide new thoughts for designing more abundant MOF structures and further expand their application range.

Effects of octamethylcyclotetrasiloxane grafting and in situ silica particle generation on the curing and mechanical properties of a styrene butadiene rubber composite.

The reinforcement of octamethylcyclotetrasiloxane (D4) grafted styrene butadiene rubber (SBR-g-D4) with in situ generated silica was performed using the sol-gel reaction of tetraethoxysilane (TEOS) in latex. The characterization of SBR-g-D4 and in situ generated silica reinforced SBR-g-D4 was investigated by Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy. The grafting efficiency of the styrene butadiene rubber (SBR) was determined by a gravimetric method. It was found that the constant silicon content and the grafting efficiency of SBR were 1.72% and 0.13 wt% when the weight ratio of D4 to SBR was 0.20. The effects of the D4 and in situ generated silica content on the curing characteristics, mechanical properties and morphology of SBR latex were investigated. The mechanical properties of in situ generated silica reinforced SBR-g-D4 vulcanizates were improved significantly compared to raw SBR vulcanizate when the in situ generated silica content was 18.05%. Compared with silica reinforced SBR-g-D4, the tensile strength, wet skid resistance and rolling resistance of the in situ generated silica reinforced SBR-g-D4 were better. This is because of the higher crosslinking degree in the SBR-g-D4 matrix and the strong chemical bond between SBR-g-D4 molecular chains and in situ generated silica. Scanning electron microscopy analysis revealed good silica filler dispersion in all the reinforced SBR-g-D4 vulcanizates.

Synthesis and characterization of brush-like multigraft copolymers PnBA-g-PMMA by a combination of emulsion AGET ATRP and emulsion polymerization.

In this paper, poly(n-butyl acrylate)-g-poly(methyl methacrylate) multigraft copolymers were synthesized by macromonomer technique and miniemulsion copolymerization. The PMMA macromonomers were obtained by an activator generated by electron transfer atom transfer radical polymerization (AGET ATRP) in emulsion system and subsequent allylation. Then the copolymerization of different macromonomers with nBA was carried out in miniemulsion system, obtaining multigraft copolymers with high molecular weight. The latex particles and distribution of emulsion AGET ATRP and miniemulsion copolymerization were characterized using laser light scattering. The molecular weight and polydispersity indices of macromonomers and multigraft copolymers were analyzed by gel permeation chromatography, and the number-average molecular weight range is 187,600-554,800 g/mol for PnBA-g-PMMA copolymers. In addition, the structural characteristics of macromonomer and brush-like copolymers were determined by infrared spectra and (1)H nuclear magnetic resonance spectroscopy. The thermal performance of brush-like copolymers were characterized by differential scanning calorimetry and thermogravimetric analysis. Atomic force microscopy results showed that the degree of microphase separation was varying with increasing PMMA content in PnBA-g-PMMA. The dynamic rheometer analysis revealed that multigraft copolymer with PMMA content of 31.4% exhibited good elastomeric properties to function as a TPE. These multigraft copolymers show a promising low cost and environmental friendly thermoplastic elastomer.