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1.
Chemosphere ; 286(Pt 3): 131895, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34435576

RESUMO

Partial denitrification granular sludge (PDGS) and denitrification granular sludge (DGS) play an important role in nitrogen removal from wastewater. However, the inherent cause of aggregation capacity related to the ratio of COD to nitrogen (COD/N) is still unclear. In this study, metabolomics analysis was combined with microbiological analyses, granular performance and extracellular polymeric substances (EPS) structure to explore the granulation mechanism at different influent COD/N ratios. The results showed that the higher COD/N ratio selectively enhanced the gluconeogenesis pathway, purine and pyrimidine metabolism pathway, resulting in more extracellular polysaccharide (PS) excretion and floc sludge. The absence of carbon source weakened tricarboxylic acid cycle (TCA) reaction, resulting in NAD+ and ADP decrease, nitrite accumulation and change of microbial community structure. The amino acids biosynthesis pathway was enhanced under low COD/N ratio, which promoted the hydrophobicity of EPS. PDGS had stronger Acyl-homoserine lactones (AHLs)-based quorum sensing (QS) than DGS during the operational period. CO8-HSL, C8-HSL and C6-HSL, as the main form of AHLs, played a dominating role in DGS and PDGS. Batch tests illustrated that adding AHLs obviously improved the synthesis of the amino acids, threonine (Thr), tryptophan (Trp), methionine (Met) and glycine (Gly). Dosing AHLs regulated PS synthesis only at a high COD/N ratio. The glucose-6P, glycerate-3p and UDP-Glc were up-regulated only in DSG, which increased the hydrophilic groups in EPS. The results not only provided the new insights into the metabolism of denitrifying granular sludge, but also indicated the application potential of the technologies regarding start-up and operation of granule sludge.


Assuntos
Desnitrificação , Percepção de Quorum , Acil-Butirolactonas , Reatores Biológicos , Metabolômica , Esgotos
2.
Soft Matter ; 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34787630

RESUMO

Giant number fluctuations are often considered as a hallmark of the emergent nonequilibrium dynamics of active fluids. However, these anomalous density fluctuations have only been reported experimentally in two-dimensional dry active systems heretofore. Here, we investigate density fluctuations of bulk Escherichia coli suspensions, a paradigm of three-dimensional (3D) wet active fluids. Our experiments demonstrate the existence and quantify the scaling relation of giant number fluctuations in 3D bacterial suspensions. Surprisingly, the anomalous scaling persists at small scales in low-concentration suspensions well before the transition to active turbulence, reflecting the long-range nature of hydrodynamic interactions of 3D wet active fluids. To illustrate the origin of the density fluctuations, we measure the energy spectra of suspension flows and explore the density-energy coupling in both the steady and transient states of active turbulence. A scale-invariant density-independent correlation between density fluctuations and energy spectra is uncovered across a wide range of length scales. In addition, our experiments show that the energy spectra of bacterial turbulence exhibit the scaling of 3D active nematic fluids, challenging the common view of dense bacterial suspensions as active polar fluids.

3.
Ear Nose Throat J ; : 1455613211058114, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34814772

RESUMO

OBJECTIVE: The present study was designed to investigate whether acellular dermal matrix (ADM) grafts could prevent Frey's syndrome (FS) and improve esthetic scores following parotidectomy. METHODS: From January 2015 to December 2019, 175 patients underwent parotidectomy. We divided the patients into two groups: the ADM group and the control group. We included in each group 30 patients according to a propensity score matched analysis. RESULTS: FS was subjective in 1 patient (3%) from the ADM group and 9 patients (30%) from the control group (P=0.015). Patients in the ADM group had a subjective esthetic score of 6.1 + 1.7 compared with 5.2 + 1.7 in the control group. The subjective esthetic score for patients in the ADM group was higher than that for patients in the control group (P =0.040). CONCLUSION: The present clinical study suggests that ADM grafts are effective in preventing FS and improving esthetic scores after parotidectomy.

4.
BMC Genomics ; 22(1): 836, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34794392

RESUMO

BACKGROUND: Bean pyralid is one of the major leaf-feeding insects that affect soybean crops. DNA methylation can control the networks of gene expressions, and it plays an important role in responses to biotic stress. However, at present the genome-wide DNA methylation profile of the soybean resistance to bean pyralid has not been reported so far. RESULTS: Using whole-genome bisulfite sequencing (WGBS) and RNA-sequencing (RNA-seq), we analyzed the highly resistant material (Gantai-2-2, HRK) and highly susceptible material (Wan82-178, HSK), under bean pyralid larvae feeding 0 h and 48 h, to clarify the molecular mechanism of the soybean resistance and explore its insect-resistant genes. We identified 2194, 6872, 39,704 and 40,018 differentially methylated regions (DMRs), as well as 497, 1594, 9596 and 9554 differentially methylated genes (DMGs) in the HRK0/HRK48, HSK0/HSK48, HSK0/HRK0 and HSK48/HRK48 comparisons, respectively. Through the analysis of global methylation and transcription, 265 differentially expressed genes (DEGs) were negatively correlated with DMGs, there were 34, 49, 141 and 116 negatively correlated genes in the HRK0/HRK48, HSK0/HSK48, HSK0/HRK0 and HSK48/HRK48, respectively. The MapMan cluster analysis showed that 114 negatively correlated genes were clustered in 24 pathways, such as protein biosynthesis and modification; primary metabolism; secondary metabolism; cell cycle, cell structure and component; RNA biosynthesis and processing, and so on. Moreover, CRK40; CRK62; STK; MAPK9; L-type lectin-domain containing receptor kinase VIII.2; CesA; CSI1; fimbrin-1; KIN-14B; KIN-14 N; KIN-4A; cytochrome P450 81E8; BEE1; ERF; bHLH25; bHLH79; GATA26, were likely regulatory genes involved in the soybean responses to bean pyralid larvae. Finally, 5 DMRs were further validated that the genome-wide DNA data were reliable through PS-PCR and 5 DEGs were confirmed the relationship between DNA methylation and gene expression by qRT-PCR. The results showed an excellent agreement with deep sequencing. CONCLUSIONS: Genome-wide DNA methylation profile of soybean response to bean pyralid was obtained for the first time. Several specific DMGs which participated in protein kinase, cell and organelle, flavonoid biosynthesis and transcription factor were further identified to be likely associated with soybean response to bean pyralid. Our data will provide better understanding of DNA methylation alteration and their potential role in soybean insect resistance.


Assuntos
Epigenoma , Soja , Animais , Metilação de DNA , Perfilação da Expressão Gênica , Larva/genética , Soja/genética
5.
Artigo em Inglês | MEDLINE | ID: mdl-34752396

RESUMO

We present a novel two-stage approach for automated floorplan design in residential buildings with a given exterior wall boundary. Our approach has the unique advantage of being human-centric, that is, the generated floorplans can be geometrically plausible, as well as topologically reasonable to enhance resident interaction with the environment. From the input boundary, we first synthesize a human-activity map that reflects both the spatial configuration and human-environment interaction in an architectural space. We propose to produce the human-activity map either automatically by a pre-trained generative adversarial network (GAN) model, or semi-automatically by synthesizing it with user manipulation of the furniture. Second, we feed the human-activity map into our deep framework ActFloor-GAN to guide a pixel-wise prediction of room types. We adopt a re-formulated cycle-consistency constraint in ActFloor-GAN to maximize the overall prediction performance, so that we can produce high-quality room layouts that are readily convertible to vectorized floorplans. Experimental results show several benefits of our approach. First, a quantitative analysis of ablated techniques shows superior performance of leveraging the human-activity map in predicting piecewise room types. Second, a subjective evaluation by architects shows that our results have compelling quality as professionally-designed floorplans and much better than those generated by existing methods in terms of the room layout topology. Last, our approach allows manipulating the furniture placement, considers the human activities in the environment, and enables the incorporation of user-design preferences.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34802868

RESUMO

INTRODUCTION: Cephalometry plays an important role in the diagnosis and treatment of orthodontics and orthognathic surgery. This study intends to develop an automatic landmark location system to make cephalometry more convenient. METHODS: In this study, 512 lateral cephalograms were collected, and 37 landmarks were included. The coordinates of all landmarks in the 512 films were obtained to establish a labeled dataset: 312 were used as a training set, 100 as a validation set, and 100 as a testing set. An automatic landmark location system based on the convolutional neural network was developed. This system consisted of a global detection module and a locally modified module. The lateral cephalogram was first fed into the global module to obtain an initial estimate of the landmark's position, which was then adjusted with the locally modified module to improve accuracy. Mean radial error (MRE) and success detection rate (SDR) within the range of 1-4 mm were used to evaluate the method. RESULTS: The MRE of our validation set was 1.127 ± 1.028 mm, and SDR of 1.0, 1.5, 2.0, 2.5, 3.0, and 4.0 mm were respectively 45.95%, 89.19%, 97.30%, 97.30%, and 97.30%. The MRE of our testing set was 1.038 ± 0.893 mm, and SDR of 1.0, 1.5, 2.0, 2.5, 3.0, and 4.0 mm were respectively 54.05%, 91.89%, 97.30%, 100%, 100%, and 100%. CONCLUSIONS: In this study, we proposed a new automatic landmark location system on the basis of the convolutional neural network. The system could detect 37 landmarks with high accuracy. All landmarks are commonly used in clinical practice and could meet the requirements of different cephalometric analysis methods.

8.
BMC Biol ; 19(1): 245, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789250

RESUMO

BACKGROUND: The Mediator complex is an evolutionarily conserved multi-subunit protein complex that plays major roles in transcriptional activation and is essential for cell growth, proliferation, and differentiation. Recent studies revealed that some Mediator subunits formed nuclear condensates that may facilitate enhancer-promoter interactions and gene activation. The assembly, regulation, and functions of these nuclear condensates remain to be further understood. RESULTS: We found that Med15, a subunit in the tail module of the Mediator complex, formed nuclear condensates through a novel mechanism. Nuclear foci of Med15 were detected by both immunostaining of endogenous proteins and live cell imaging. Like Med1 foci and many other biomolecular condensates, Med15 foci were sensitive to 1, 6-Hexanediol and showed rapid recovery during fluorescence recovery after photobleaching. Interestingly, overexpressing DYRK3, a dual-specificity kinase that controls the phase transition of membraneless organelles, appeared to disrupt Med1 foci and Med15 foci. We identified two regions that are required to form Med15 nuclear condensates: the glutamine-rich intrinsically disordered region (IDR) and a short downstream hydrophobic motif. The optodroplet assay revealed that both the IDR and the C-terminal region of Med15 contributed to intracellular phase separation. CONCLUSIONS: We identified that the Mediator complex subunit Med15 formed nuclear condensates and characterized their features in living cells. Our work suggests that Med15 plays a role in the assembly of transcription coactivator condensates in the nucleus and identifies Med15 regions that contribute to phase separation.

9.
Environ Res ; : 112317, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34736924

RESUMO

The evaporation concentrate of gas field wastewater (EC-GFW) is a new type of refractory actual wastewater produced by the three-effect evaporation of gas field wastewater, exhibiting extremely high salinity and complex organic components. This study proposed a set of processes consisting of AOPs, precipitation, distillation, and crystallization for the systematic treatment of EC-GFW. In this paper, the optimal conditions for the processes after pre-treatment were investigated. The optimal operating parameters of UV/Fenton process were determined to be 180 min of reaction time, 4 of initial pH, 0.6 mol/L of H2O2 dosage, 10:1 of n(H2O2): n(Fe2+) value, and 30 W of UV power. Fenton's reagent was added in two steps (0 min and 90 min) for effective utilization. The results showed that the TOC (Total organic carbon) removal efficiency during the two-stage oxidation reached 93% with TOC in the effluent of 132 mg/L. Then, 82.3% of sulfate ions were removed by the desulfurization process using 50 g/L of CaCl2 within 10 min at a pH of 5 before distillation. It was found that the TOC in the influent of distillation played a decisive role in the quality of the effluent and purity of the crystalline salt, which was expected to be controlled lower than 132 mg/L. The final condensate could utilize to reuse, 99% of main pollutants of which have been removed, reducing the pressure of water supply on site. Simultaneously, the industrial-grade NaCl with extensive application prospect can be recovered. The harmless disposal and resource utilization of EC-GFW was achieved on a laboratory scale, providing the data support and theoretical guidance for treating EC-GFW at gas field project site.

10.
Zhongguo Zhen Jiu ; 41(10): 1171-4, 2021 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-34628753

RESUMO

Through analyzing the indication distribution of the different acupoints located at the upper limbs recorded in Science of Acupoints and Science of Meridians and Acupoints, the industry planning teaching materials of traditional Chinese medicine, it is discovered that the acupoints located at the upper arms are commonly selected for the treatment of scrofula and goiter, while the acupoints below the elbow at the hand meridians and those at the lower limbs of the foot meridians which running through the neck, do not have the similar indications. Based on a further analysis on the literature at ancient and modern times, it is believed that the acupoints located on the lateral side of the upper arms, especially those at the large intestine meridian of hand-yangming perhaps have the specific effect in treatment of scrofula and goiter.


Assuntos
Bócio , Meridianos , Tuberculose dos Linfonodos , Pontos de Acupuntura , Braço , Humanos
11.
Int J Ophthalmol ; 14(10): 1463-1472, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34667721

RESUMO

AIM: To investigate the effect of Staphylococcus aureus (S. aures) lysates (SALs) on herpes simplex virus type-I (HSV1) infection in human corneal epithelial (HCE) cells and in a mouse model of HSV1 keratitis. METHODS: HCE, Vero, HeLa, and BV2 cells were infected with HSV1 [HSV1 f strain, HSV1f; HSV-1-H129 with green fluorescent protein (GFP) knock-in, HSV1g]. Pre- or post-infection, SAL at various concentrations was added to the culture medium for 24h. GFP fluorescence in HSV1g or plaque formation by HSV1f were examined. The effects of heat-treated SAL, precooled acetone-precipitated SAL, and SAL subjected to ultrafiltration (100 kDa) were evaluated. The effects of other bacterial components and lysates on HSV1 infection were also tested, including lipoteichoic acid (LTA), peptidoglycan (PGN), staphylococcal protein A (SPA), and α-hemolysin from S. aureus (α-toxin) as well as lysates from a wild-type S. aureus strain, S. epidermidis, and Escherichia coli (W-SAL, SEL, and ECL, respectively). In addition, SAL eye drops were applied topically to BALB/c mice with HSV1 keratitis, followed by in vivo observations. RESULTS: The cytopathic effect, plaque formation (HSV1f), and GFP expression (HSV1g) in infected cells were inhibited by SAL in a dose-dependent manner. The active component of SAL (≥100 kDa) was heat-sensitive and retained activity after acetone precipitation. In HSV1g-infected cells, treatment with LTA-sa, α-toxin, PGN-sa, or SPA did not inhibit GFP expression. SAL, W-SAL, and SEL (but not ECL) decreased GFP expression. In mice with HSV1 keratitis, SAL reduced corneal lesions by 71%. CONCLUSION: The results of this study demonstrate that SAL can be used to inhibit HSV1 infection, particularly keratitis. Further studies are needed to determine the active components and mechanism underlying the effects of SAL.

12.
Foods ; 10(10)2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34681348

RESUMO

The microwave-assisted induction heating (MAIH) method-an emerging thermal technique-was studied to heat the prepackaged raw hard clam (Meretrix lusoria). The cooking effects on microbial and physiochemical qualities of clam were investigated. After the heating of the clam meat samples, the aerobic plate count (APC), psychrotrophic bacteria count (PBC), and total volatile basic nitrogen (TVBN) levels decreased with increasing heating time, but the shucking ratio, area shrinkage, and texture (hardness, cohesiveness, and chewiness) increased. In addition, the L* (lightness) and W (whiteness) of the clam meat samples increased significantly at the beginning of the heating period, whereas they decreased significantly with extended heating time. However, a* (redness) had the opposite trend. This study found that when clams were heated for more than 120 s at 130 °C or 150 s at 90 °C, they displayed obvious shrinking and a yellow-brown appearance, indicating that they are overcooked. After heating by MAIH for at least 110 s at 130 °C or 130 s at 90 °C, the samples were cooked well and gains a completely shucking, along with no microbial count detected. Therefore, the results indicated that the optimum heating conditions for prepackaged hard clams subjected to an MAIH machine were 130 °C for 110 s or 90 °C for 130 s.

13.
Macromol Rapid Commun ; : e2100577, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34626510

RESUMO

Photocatalysis is an efficient and green technology in the environmental protection. Due to the high charge separation and transfer, donor-acceptor (D-A) conjugated polymers attract much attention for their photocatalytic degradations towards organic pollutants. Herein, the authors reported three novel D-A conjugated polymers, named as HPBP, HPTP, and HPF, with heptazine moieties as electron acceptors, while biphenyl, terphenyl, or fluorene moieties as electron donors, respectively, which indeed exhibit a highly efficient photocatalytic degradation towards tetracyclines upon the visible-light irradiation. Among them, the photocatalytic performance of HPF is especially noticeable with the degradation rate up to 87% within 30 min, almost 11 times in comparison to those of pristine g-C3 N4 , which is mainly attributed to its high crystallinity and conjugation. For their photocatalytic mechanism, the •O2 - radical anions are regarded as the active species.

14.
ChemSusChem ; 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34664405

RESUMO

The chemisorption and catalysis of lithium polysulfides (LiPSs) are effective strategies to suppress the shuttle effect in lithium-sulfur (Li-S) batteries. Herein, multisize CoS 2 particles intercalated/coated-montmorillonite (MMT) as an efficient sulfur host is synthesized. As expected, the obtained S/CoS 2 @MMT cathode achieves an absorption-catalysis synergistic effect through the polar MMT aluminosilicate sheets and the well-dispersed nano-micron CoS 2 particles. Furthermore, efficient interlamellar ion pathways and interconnected conductive network are constructed within the composite host due to the intercalation/coating of CoS 2 in/on MMT. Therefore, the S/CoS 2 @MMT cathode achieves an outstanding rate performance up to 5 C (~548 mAh·g -1 ) and a high cycling stability with low capacity decay of 0.063 and 0.067% per cycle for 500 cycles at 1 and 2 C, respectively. With a higher sulfur loading of 4.0 mg·cm -2 , the cathode still delivers satisfactory rate and cycling performance. It shows that the CoS 2 @MMT host has great application prospects in Li-S batteries.

15.
J Arthroplasty ; 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34653576

RESUMO

BACKGROUND: This study aimed to explore the analgesic effect among adductor canal block (ACB) combined with infiltration between the popliteal artery and the capsule of the posterior knee (IPACK) block, ACB, and IPACK block following total knee arthroplasty (TKA). METHODS: One hundred twenty patients were randomly allocated into 3 groups including group A (ACB + IPACK block), group B (ACB), and group C (IPACK block). The primary outcome was postoperative pain score. The secondary outcome was opioid consumption. Other outcomes included functional evaluation and postoperative complications. RESULTS: Group A showed the lowest pain scores within 8 hours at rest and with knee maximum flexion (P < .001). From 12 to 24 hours, group C showed the highest pain scores, while no significant difference was found between group A and group B. No significant difference was found among the 3 groups 24 hours postoperatively. Group C showed the most opioid consumption within the first 24 hours and during the hospitalization, while no significant difference was found between group A and group B. No significant difference was found among the 3 groups including function evaluation and postoperative complications. CONCLUSION: ACB + IPACK block can improve early analgesia when compared with ACB. However, the small statistical benefit to the addition of IPACK block to ACB may be unlikely to be clinically significant. Further studies may focus on patient selection and how to prolong the effect of IPACK block.

16.
Chemosphere ; : 132648, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34695482

RESUMO

In this study, inorganic magnesium hydroxide (MH) was modified by three phosphoric acids respectively to obtain three different novel functionalized monomers. The chemical structure and morphology of (Pn-MH) were analyzed by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and scanning electron microscopy (SEM). Further, functional monomers were introduced into the PET main chain structure. A new type of high-performance co-polyesters was successfully prepared. The specific structure of P1-MH-PET was characterized by 1H NMR spectroscopy. Thermal stability of Pn-MH-PETs was analyzed by thermogravimetric analysis (TG) and differential scanning calorimetry (DSC). The flame retardant properties were evaluated by limiting oxygen index (LOI), vertical combustion test (UL-94) and cone calorimeter. The results show that the thermal stability and flame retardant properties of 5%Pn-MH-PETs are greatly improved. Among them, the best performance is 5%P1-MH-PET, LOI is 32.5%, UL-94 test reached V-0 grade. Compared with neat PET, the peak heat release rate (PHRR), peak smoke release rate (PSPR), carbon dioxide release rate (CO2PR) and carbon monoxide release rate (COPR) decreased by 57.0%, 38.1%, 54.6% and 57.3%, respectively. Fortunately, the mechanical properties of 5%P3-MH-PET were also improved.

17.
J Org Chem ; 86(21): 14572-14585, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34623805

RESUMO

A novel visible-light-induced coupling-cyclization of ortho-alkynylaryl vinylethers with arylsulfonyl azides has been described. This transformation provided a concise approach to access C3-exocyclic C═C bond/C2-alkylsulfone-tethered benzofurans via a solvent-leveraged carbosulfonylation and [2 + 2 + 3] cyclization. Primary mechanistic studies demonstrated that THF belongs to a crucial H atom source.

18.
Chem Commun (Camb) ; 57(88): 11661-11664, 2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34671802

RESUMO

Herein, the first example of a palladium-catalyzed Fujiwara-Moritani reaction for olefination of tryptophan (Trp) residues, free from directing groups, was presented. The developed reaction proceeds efficiently for peptide modification, ligation and peptide stapling.

19.
J Dig Dis ; 22(11): 622-629, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34633753

RESUMO

OBJECTIVES: Functional constipation is a gastrointestinal disorder prevalent around the world. Lubiprostone is the first locally acting type-2 chloride channel activator to be used for treating constipation. This study aimed to evaluate the efficacy and safety of lubiprostone in Chinese adults with functional constipation. METHODS: This was a multicenter, randomized, double-blind, placebo-controlled study. Patients with functional constipation were randomized to receive either lubiprostone (24 mcg twice daily) or placebo for 4 weeks. The primary end-point was the frequency of spontaneous bowel movements (SBMs) during the first week of treatment. The secondary end-points included the median time of the first SBM, SBM frequency at weeks 2, 3 and 4, weekly response rate of SBMs, the stool consistency score and average number of complete spontaneous bowel movements (CSBMs) per week. RESULTS: In total, 259 patients were randomized, with 130 in the lubiprostone group and 129 in the placebo group. SBM frequency was higher in the lubiprostone group (4.88 ± 4.09/wk) than that in the placebo group (3.22 ± 2.01/wk) at week 1 (P < 0.0001). SBM frequency was also higher in the lubiprostone group at weeks 2, 3 and 4. The average number of CSBMs and the stool consistency score in the lubiprostone group were significantly higher than that in the placebo group at each week. No drug-related serious adverse events (AEs) occurred. The most commonly reported AE was nausea. CONCLUSION: Lubiprostone was superior to placebo in treating Chinese patients with functional constipation, together with good safety profile.

20.
Surg Endosc ; 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34698935

RESUMO

BACKGROUND: Radiation exposure is inherently involved in endoscopic retrograde cholangiopancreatography (ERCP), which could cause radiation-induced injury to endoscopists with long-term exposure. Nonradiation ERCP has been applied to pregnant patients. Conceivably, the same techniques could be used to benefit endoscopists. This study was designed to evaluate the effectiveness and safety of nonradiation-to-endoscopist (NRE) ERCP, compared with standard ERCP. METHODS: A retrospective, single-center study was conducted from August 2010 to December 2015. Patients aged 18-90 years and with choledocholithiasis (< 15 mm) or distal biliary stricture were eligible. Pre-ERCP evaluation with magnetic resonance cholangiopancreatography was mandatory. To overcome selection bias, we performed 1:2 match using propensity score matching (PSM) between NRE and standard groups. The primary endpoint was overall ERCP success rate. Secondary endpoints were cannulation success rate, stone clearance rate, complication rate, and duration of hospitalization. RESULTS: A total of 329 patients met inclusion criteria. After PSM, 73 patients were included in the NRE group and 146 in the standard group. The ERCP overall success rate for NRE and standard groups was equivalent (94.5% vs. 93.2%, P = 0.70). There was no difference in cannulation success rates between the two groups (95.6% vs. 97.8%, P = 0.39). A total of 88.3% of patients in the NRE group and 93.9% of patients in the standard group had stones cleared at initial ERCP (P = 0.57). No difference in overall stone clearance rate between the two groups (95.0% vs. 93.9%, P = 0.77) was found after second ERCP. The complication rate (1.4% vs. 1.4%, P = 1.00) and hospital duration (8.3 ± 5.1 vs. 10.2 ± 8.8 days, P = 0.07) were not different between the two groups. CONCLUSION: Although technically demanding, NRE-ERCP is both safe and feasible in selected patients compared with standard ERCP.

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