简介：ＬＩＴＥＲＡＴＵＲＥＡＮＤＡＲＴ：ＡＢｕｍｐｅｒＨａｒｖｅｓｔ￥／／ＷＥＮＬＩＡＮＫｅｅｐｉｎｇｐａｃｅｗｉｔｈｔｈｅｎａｔｉｏｎａｌｐｒｏｇｒｅｓｓ，Ｔｉｂｅｔｗｉｔｎｅｓｓｅｄｔｈｅｆｌｏｕｒｉｓｈｉｎｇｏｆｌｉｔｅｒａｔｕｒｅａｎｄａｒｔｉｎｔ...

简介：Percutaneousendoscopicgastrostomy（PEG）isawidelyusedmethodofnutritiondeliveryforpatientswithlongterminsufficiencyoforalintake.ThePEGcomplicationratevariesfrom0.4%to22.5%ofcases,withminorcomplicationsbeingthreetimesmorefrequent.Buriedbumpersyndrome（BBS）isaseverecomplicationofthismethod,inwhichtheinternalfixationdevicemigratesalongsidethetractofthestomaoutsidethestomach.ExcessivecompressionoftissuebetweentheexternalandinternalfixationdeviceofthegastrostomytubeisconsideredthemainetiologicalfactorleadingtoBBS.IncidenceofBBSisestimatedataround1%（0.3%-2.4%）.Inabilitytoinsert,lossofpatencyandleakagearoundthePEGtubeareconsideredtobeatypicalsymptomatictriad.GastroscopyisindicatedinallcasesinwhichBBSissuspected.Thedepthofdiscmigrationinrelationtothelaminamuscularispropriaofthestomachiscriticalforfurthertherapyandcanbeestimatedbyendoscopicortransabdominalultrasound.BBScanbecomplicatedbygastrointestinalbleeding,perforation,peritonitis,intra-abdominalandabdominalwallabscesses,orphlegmon,andthesecomplicationscanleadtofataloutcomes.Themostimportantpreventivemeasureisadequatepositioningoftheexternalbolster.Aconservativeapproachshouldbeappliedonlyinpatientswithhighoperativeriskanddismalprognosis.ChoiceofthemethodofreleaseisbasedonthetypeofthePEGsetanddepthofdiscmigration.Adiscretainedinsidethestomachandcompletelycoveredbytheovergrowingtissuecanbereleasedusingsometypeofendoscopicdissectiontechnique（needleknife,argonplasmacoagulation,orpapillotomethroughthecannula）.Properpatientselectionanddissectionoftheovergrowingtissuearethemajordeterminantsforsuccessfulendoscopictherapy.Adisclocalizedoutofthestomach（laminamuscularispropria）shouldbetreatedbyasurgeon.

简介：近日，美国环保局正式宣布MANA公司生产的杀菌剂Bumper乳剂（丙环唑）的登记批准，该产品可广泛用于玉米、大豆、高梁等作物叶片病菌的防治。Bumper乳剂为丙环唑新剂型，同乳油相比药效相当，但用量低、气味小，环保、安全、使用简单，并且对个人防护装备要求低，该产品通过减小对空气质量的影响从而降低环境污染。Bumper乳剂可防治褐斑病、壳针孢叶枯病、颖斑枯病、锈病等。目前该产品已在杏树、浆果类、谷物、柑橘属果树、玉米、花生、美洲山核桃树、水稻、高粱、大豆、核果类、甘蔗和木本坚果上获得登记。