Abstract Background Laparoscopic common bile duct exploration (LCBDE) has become one of the main options for treating choledocholithiasis associated with cholelithiasis. Our objective was to assess the short‐term outcomes of patients undergoing laparoscopic primary closure of the common bile duct (CBD) compared with laparoscopic choledochotomy plus T‐tube drainage. Methods We retrospectively studied 137 patients undergoing primary closure following LCBDE (group A) compared with 102 cases with laparoscopic choledochotomy plus T‐tube drainage (group B) between January 2007 and January 2010. Intraoperative cholangiography (IOC) and choledochoscopy were performed in all patients. Results Three patients in group A (2.2%) were converted to open surgery and two (2.0%) in group B because of serious adherence. According to routine IOC, unexpected CBD stones were found in 16 cases (6.8%). The duration of the operation in group A was shorter than in group B (92.4 ± 15.2 vs. 125.7± 32.6 min, P < 0.05), as was length of postoperative stay (3.1± 2.4 vs. 5.7± 4.3 days, P < 0.05). Postoperative bile leakage occurred in six patients (4.5%) in group A and four cases (4.0%) in group B; all of the patients recovered after simple drainage without reoperation. Bile peritonitis was seen in one case after T‐tube removal. The median follow‐up was 26 months. There were no recurrences. Conclusions Laparoscopic primary closure of the CBD is safe and successful for the management of CBD stones. Application of IOC and choledochoscopy to ensure clearance of the CBD and careful suturing are essential for primary closure.
is a Gram-positive, spore-forming, rod-shaped, obligate anaerobe that is the leading cause of antibiotic-associated diarrhea. Type IV pili (T4P) are elongated appendages on the surface of
Large Multimodal Models (LMMs) have ushered in a new era in artificial intelligence, merging capabilities in both language and vision to form highly capable Visual Foundation Agents. These agents are postulated to excel across a myriad of tasks, potentially approaching general artificial intelligence. However, existing benchmarks fail to sufficiently challenge or showcase the full potential of LMMs in complex, real-world environments. To address this gap, we introduce VisualAgentBench (VAB), a comprehensive and pioneering benchmark specifically designed to train and evaluate LMMs as visual foundation agents across diverse scenarios, including Embodied, Graphical User Interface, and Visual Design, with tasks formulated to probe the depth of LMMs' understanding and interaction capabilities. Through rigorous testing across nine proprietary LMM APIs and eight open models, we demonstrate the considerable yet still developing agent capabilities of these models. Additionally, VAB constructs a trajectory training set constructed through hybrid methods including Program-based Solvers, LMM Agent Bootstrapping, and Human Demonstrations, promoting substantial performance improvements in LMMs through behavior cloning. Our work not only aims to benchmark existing models but also provides a solid foundation for future development into visual foundation agents. Code, train \& test data, and part of fine-tuned open LMMs are available at \url{https://github.com/THUDM/VisualAgentBench}.
Secondary hyperparathyroidism (SHPT) (i.e., renal hyperparathyroidism) is one of the most serious complications in long-term hemodialysis patients. The purpose of this retrospective study was to explore the feasibility of a new surgical approach--endoscopic total parathyroidectomy with autotransplantation (ETP+AT)--and evaluate its practical application for patients with SHPT.The study included 34 SHPT patients who underwent ETP+AT from among 67 cases at the Department of Minimally Invasive Surgery, the First Affiliated Hospital of Nanjing Medical University over a 3-year period. The other 33 patients underwent traditional total parathyroidectomy with autotransplantation (TP+AT). Two criteria were used as indications to perform ETP+AT in SHPT patients. The first was a high serum parathyroid hormone level (PTH >800 pg/ml) associated with hypercalcemia and/or hyperphosphatemia that which were refractory to medical treatment. The second criterion was the presence of clinical symptoms including pruritus, bone and joint pain, muscle weakness, progression of soft tissue calcification, and spontaneous fractures. Ultrasonography, (99m)Tc sestamibi scans, and computed tomography were used to evaluate the thyroid and parathyroid glands.There was no surgery-related mortality among any of the patients with ETP+AT. One patient underwent conventional neck exploration because of bleeding and injury of a unilateral recurrent laryngeal nerve after the operation. Preoperative symptoms were alleviated, and the serum PTH and alkaline phosphatase levels, hyperphosphatemia, and hypercalcemia were improved or normalized in most patients. Recurrence was observed in one patient with a sixth parathyroid gland behind his thyroid, and the patient required a second operation. Hypoparathyroidism was not found after the operation. The clinical data were compared between ETP+AT and TP+AT.ETP+AT is a safe option for the treatment of SHPT with low morbidity and mortality, shorter hospital stay and low recurrence rate. It is important to avoid intraoperative bleeding, identify all parathyroid glands during the surgery, and choose adequate parathyroid tissues for autografting.
In this work, we present STOPNet, a framework for 6-DoF object suction detection on production lines, with a focus on but not limited to transparent objects, which is an important and challenging problem in robotic systems and modern industry. Current methods requiring depth input fail on transparent objects due to depth cameras' deficiency in sensing their geometry, while we proposed a novel framework to reconstruct the scene on the production line depending only on RGB input, based on multiview stereo. Compared to existing works, our method not only reconstructs the whole 3D scene in order to obtain high-quality 6-DoF suction poses in real time but also generalizes to novel environments, novel arrangements and novel objects, including challenging transparent objects, both in simulation and the real world. Extensive experiments in simulation and the real world show that our method significantly surpasses the baselines and has better generalizability, which caters to practical industrial needs.
Under the background of “carbon neutrality”, green and low-carbon have gradually become a broad consensus of the whole society. As an important part of social and economic development, the logistics industry consumes a large amount of energy and urgently needs low-carbon transformation.This paper analyzes the problems encountered in the low-carbon transformation development of our country's logistics industry and puts forward the necessary solutions, which will not only promote the development of the low-carbontransformation of our country's logistics industry, but also promote the realization of the goal of "carbon neutrality" as soon as possible. Based on the economic and social development of our country under the "double carbon" policy, facing the dilemma of low-carbon transformation of logistics industry in China, this paper puts forward the general and concrete ideas of low-carbon transformation of logistics industry in our country, and puts forward the specific path and method under the guidance of the thought of low-carbontransformation, hoping to provide some references for the low-carbon transformation of logistics industry in China.
BACKGROUND: At present, there is no effective method in treating cholangiocarcinoma. Anti-oncogene replacement therapy has gradually become an important new anticancer measure. As an important anti-oncogene, p15 can inhibit the growth of the hepatocarcinoma cell. But as to its role in the cholangiocarcinoma, more research is needed. This study provides a theory for preventing occurrence of human cholangiocarcinoma.
OBJECTIVE: To study the inhibitory effect of anti-oncogene p15 on human cholangiocarcinoma cell line by establishing the cell model of the human cholangiocarcinoma that overexpresses p15 gene.
DESIGN: Completely randomized controlled and open trials.
SETTING AND PARTICIPANTS: Institute of Biochemistry and Molecular Biology, Nanjing Medical University. Hunman cholangiocarcinoma establisdhed cell line.
INTERVENTIONS: The cell model of the human cholangiocarcinoma that overexpresses p15 gene was used as the trial group and the cell model that steadily expresses vector pcDNA3 was used as the control group. The cDNA of anti-oncogene p15 was constructed to the EcoR Ⅰ/ Xba Ⅰ site of pcDNA3-neo, a plasmid carrier that showed a high effective eukaryon expression so as to construct pcDNA3p15, the plasmid that expresses eukaryon of p15. The pcDNA3p15 was transferred into the human cholangiocarcinoma cell line QBC939 using lipofectine. After screening by G-418, we got the cell model of the human cholangiocarcinoma that steadily overexpresses p15 and we also got the corresponding control cell model that expresses no carrier, and this was confirmed by using Western molecular hybridization analysis.
MAIN INDEXES OF OBSERVATION: The differences in cell proliferation velocity, the forming ability of cell clones, cell cycle and the expression of c-Fos protein were observed.
RESULTS: Compared with the control group, the proliferation of QBC939 that overexpressed p15 was obviously inhibited. Cloning experimental results showed that the clones of the cholangiocarcinoma cells that overexpressed p15 were significantly fewer than those in control group (P＜0.01). The flow cytospectrophotometry showed that p15 repressed the conversion of both G1 to S and G2 to M. Western blot analysis showed that the expression level of c-Fos protein in cells that overexpressed p15 dropped to about 40% of that of the control group.
CONCLUSION: The overexpressed p15 gene can significantly inhibit the growth of the cholangiocarcinoma cells, and the descenting of oncogene c-myc protein level may be one of the mechanisms that inhibit the proliferation of cancerous cells.
Objective To observe the impact of growth hormone (GH) on expression of phosphoJAK2 (pJAK2) in pancreatic carcinoma cells and to discuss significance of pJAK2 in signaling.Methods (1)Pancreatic carcinoma cells (SW-1990,Cap-1,ASPC) during exponential growth stage were harvested and cultured in medium containing growth hormone(50 μg/L,100μg/L);After 24,48,72 hours,cells were counted using a Coulter Counter.(2)Athymic nude BALB/C mice were inoculated with SW-1990 cells,When tumors became palpable after inoculation.animals were randomized to receive GH(4 mg/kg.s.c.once daily for 2 weeks,n=21)versus saline control cytotoxic lymphocyte(CTL,n=7).(3)Human pancreatic carcinoma cell lines(SW-1990,Cap-1,Colo,Mia,Aspc,P3,Panc-1) were collected to detect the basal expression of pJAK2 with immol/lunoblots;After GH administration on special times(in vitro:5,10,15,30,45 min,1,2 h;in vivo:1,2,24 h),Cells were collected and Tumor tissues of the mice were rapidly incised respectively.All the specimen were frozen immol/lediately for subsequent Western blotting analysis,to ohserve the impact of GH on expression of pJAK2 in SW-1990 and inoculation tumor cells.Results The results revealed GH stimulated cell growth in vitro;On immol/lunoblots,positive expression of pJAK2 was observed on human pancreatic carcinoma cell lines(SW-1990、Cap-1、Colo、Mia、Aspc、P3、Panc-1).GH augmented rapidly tyrosine phosphorylation of this special proteins to the highest value on the 5th minute after GH administration in vitro and the values fluctuated later;No similar phenomena,however,were observed in vivo.Conclusion Positive expression of pJAK2 is observed on human pancreatic cancer ceils;Furthermore,GH augments rapidly tyrosine phosphorylation of these special proteins not in vivo but in vitro;and this discrepancy helps to explain why GH doesn't accelerate tumor growth in vivo.
Key words:
Growth hormone; Pancreatic carcinoma; pJAK2
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