This controlled, randomized clinical trial confirmed the effectiveness and feasibility of EORF based on hunger in patients with moderate or severe AP. EORF could shorten the length of hospitalization in patients with moderate or severe AP.
This article aims to elucidate the classification of and optimal treatment for pancreatic pseudocysts.Various approaches, including endoscopic drainage, percutaneous drainage, and open surgery, have been employed for the management of pancreatic pseudocysts. However, no scientific classification of pancreatic pseudocysts has been devised, which could assist in the selection of optimal therapy.We evaluated the treatment modalities used in 893 patients diagnosed with pancreatic pseudocysts according to the revision of the Atlanta classification in our department between 2001 and 2010. All the pancreatic pseudocysts have course of disease >4 weeks and have mature cysts wall detected by computed tomography or transabdominal ultrasonography. Endoscopic drainage, percutaneous drainage, or open surgery was selected on the basis of the pseudocyst characteristics. Clinical data and patient outcomes were reviewed.Among the 893 patients, 13 (1.5%) had percutaneous drainage. Eighty-three (9%) had type I pancreatic pseudocysts and were treated with observation. Ten patients (1%) had type II pseudocysts and underwent the Whipple procedure or resection of the pancreatic body and tail. Forty-six patients (5.2%) had type III pseudocysts: 44 (4.9%) underwent surgical internal drainage and 2 (0.2%) underwent endoscopic drainage. Five hundred six patients (56.7%) had type IV pseudocysts: 297 (33.3%) underwent surgical internal drainage and 209 (23.4%) underwent endoscopic drainage. Finally, 235 patients (26.3%) had type V pseudocysts: 36 (4%) underwent distal pancreatectomy or splenectomy and 199 (22.3%) underwent endoscopic drainage.A new classification system was devised, based on the size, anatomical location, and clinical manifestations of the pancreatic pseudocyst along with the relationship between the pseudocyst and the pancreatic duct. Different therapeutic strategies could be considered based on this classification. When clinically feasible, endoscopic drainage should be considered the optimal management strategy for pancreatic pseudocysts.
Acute pancreatitis (AP) is a formidable disease, which, in severe forms, causes significant mortality. Biliary AP, or gallstone obstruction-associated AP, accounts for 30-50% of all clinical cases of AP. In biliary AP, pancreatic acinar cell (PAC) death (the initiating event in the disease) is believed to occur as acinar cells make contact with bile salts when bile refluxes into the pancreatic duct. Recent advances have unveiled an important receptor responsible for the major function of bile acids on acinar cells, namely, the cell surface G-protein-coupled bile acid receptor-1 (Gpbar1), located in the apical pole of the PAC. High concentrations of bile acids induce cytosolic Ca(2+) overload and inhibit mitochondrial adenosine triphosphate (ATP) production, resulting in cell injury to both PACs and pancreatic ductal epithelial cells. Various bile salts are employed to induce experimental AP, most commonly sodium taurocholate. Recent characterization of taurolithocholic acid 3-sulphate on PACs has led researchers to focus on this bile salt because of its potency in causing acinar cell injury at relatively low, sub-detergent concentrations, which strongly implicates action via the receptor Gpbar1. Improved surgical techniques have enabled the infusion of bile salts into the pancreatic duct to induce experimental biliary AP in mice, which allows the use of these transgenic animals as powerful tools. This review summarizes recent findings using transgenic mice in experimental biliary AP.
Feasibility of laser-cooling AlCl molecule is investigated using ab initio quantum chemistry. Potential energy curves, permanent dipole moments, and transition dipole moments for the X(1)Σ(+), a(3)Π, and A(1)Π states are studied based on multi-reference configuration interaction plus Davidson corrections (MRCI+Q) method with ACVQZ basis set, spin-orbit coupling effects are considered at the MRCI+Q level. Highly diagonally distributed Franck-Condon factors (f00 = 0.9988 and f11 = 0.9970) and branching ratios (R00 = 0.9965, R01 = 2.85 × 10(-3), R02 = 6.35 × 10(-4), and R03 = 2.05 × 10(-6)) for the A(1)Π1(ν(')=0)→X(1)Σ0(+) (+)(ν(″)=0) transition are determined. A sufficiently radiative lifetime τ (A(1)Π1) = 4.99 ns is predicted for rapid laser cooling. The proposed cooling wavelength is deep in the ultraviolet region at λ00 = 261.75 nm. Total emission rates for the a(3)Π0(+) →X(1)Σ0(+) (+), a(3)Π1→X(1)Σ0(+) (+), A(1)Π1 → a(3)Π0(+) , and A(1)Π1 → a(3)Π1 transitions are particularly small (∼10 s(-1)-650 s(-1)). The calculated vibrational branching loss ratio to the intermediate a(3)Π0(+) and a(3)Π1 states can be negligible. The results imply the probability of laser cooling AlCl molecule with three-electronic-level.
We report on the experimental realization of dielectric-metal core-shell resonators with a nearly perfect metal shell layer by physically depositing metal onto the self-supporting dielectric colloids. Sharp electric and magnetic-based cavity plasmon resonances are experimentally observed, whereas increasing the metal shell thickness increases their Q-factors while narrowing their linewidths. In particular, a high Q-factor up to ∼100 with a correspondingly narrow linewidth down to ∼12 nm is experimentally obtained at a dipolar magnetic cavity plasmon resonance. Simulations and analytical Mie calculations show excellent agreements with the experimental results and demonstrate strong optical field confinement of such three-dimensional resonators.
Efficient control of optical radiation at subwavelength scales plays important roles for various applications. Dielectric nanoparticles or dielectric shells with a large refractive index of n ~ 3–4, which are only achievable for limited semiconductors, are involved in most designs so far to control the scattering by overlapping the electric and magnetic dipolar modes of the same magnitude. Here we propose a new mechanism based on the interplay between dipolar and quadrupolar resonances of different amplitudes, both magnetic and electric, to suppress the backward scattering or the forward scattering by using metallo-dielectric core-shell nanoparticles with a dielectric shell layer having a refractive index of n = 2.0. We demonstrate that broadband zero-backward or near-zero-forward scattering can be achieved by optimizing the structural parameters. We also demonstrate that the core-shell nanoparticles with identical dielectric shells but metal cores with various sizes are able to suppress the backward or forward scattering at the same wavelength, thus revealing a large tolerance to fabrication errors induced by the size distributions in the metal cores. These features make the proposed core-shell nanoparticles beyond the dipole limit more easily realized in practical experiments.
We theoretically propose a design of a spaser based on spherical hyperbolic metamaterial cavities consisting of a dielectric core wrapped by several stacks of alternating layers of metal and dielectric, which can support the multipolar whispering-gallery modes (WGMs) with resonance wavelengths much larger than the cavity size. Depending on the mode order of the excited WGMs with the same angular momentum, we show that such cavities are capable of strongly confining the electric fields within different dielectric shell layers. By introducing gains into the different dielectric layers, we demonstrate that the hyperbolic cavities can act as multi-wavelength spasers with a lasing threshold as low as 811 cm−1, operating on the WGMs with the corresponding mode order. Furthermore, we also demonstrate that the slight variation on either the number of stacks or the core radius allows for easily tuning the lasing wavelengths over a wide spectral range.
Exosomes are abundantly secreted extracellular vesicles that accumulate in the circulation and are of great interest for disease diagnosis and evaluation since their contents reflects the phenotype of their cell of origin. Tumor‐derived exosomes (TDEs) are of particular interest for cancer diagnosis and therapy, since most tumor demonstrate highly elevated exosome secretion rates and provide specific information about the genotype of a tumor and its response to treatment. TDEs also contain regulatory factors that can alter the phenotypes of local and distant tissue sites and alter immune cell functions to promote tumor progression. The abundance, information content, regulatory potential, in vivo half‐life, and physical durability of exosomes suggest that TDEs may represent a superior source of diagnostic biomarkers and treatment targets than other materials currently under investigation. This review will summarize current information on mechanisms that may differentially regulate TDE biogenesis, TDE effects on the immune system that promote tumor survival, growth, and metastasis, and new approaches understudy to counteract or utilize TDE properties in cancer therapies.
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