简介：AbstractBackground:Gastroparesis is a debilitating medical condition with limited treatment options. Gastric per-oral pyloromyotomy (G-POEM) has emerged as a promising treatment option with remarkable short-term clinical success shown in multiple studies. While the post-procedure protocol is not standardized across many centers, the majority of the centers observes these patients in the hospital after the procedure for monitoring. In this single-center prospective study, we evaluated the safety and feasibility of same day discharge after the G-POEM procedure.Methods:All the patients with refractory gastroparesis undergoing G-POEM from October 2019 to March 2020 were enrolled. A total of 25 patients were enrolled in the procedure. Based on the pre-defined criteria, patients were either discharged on the same day after the procedure or admitted to the hospital for further observation. The patient and procedure-related data were extracted from the chart review. Univariate analysis was performed (chi-squared test) on categorical variables after organizing categorical variables as numeric counts or percentages. The student t test was performed on continuous variables after reporting as mean and standard deviation. For analysis with a smaller sample size, Fisher exact and Mann–Whitney tests were used.Results:A total of 25 patients were enrolled. The technical success of G-POEM was 100% and clinical success was 80% (20/25) at 1-month follow-up. Of the 25 patients, 9 patients (36%) were discharged on the same day according to the procedure from the recovery unit. Of the remaining 16 patients who were admitted to the hospital post-procedure, 10 (40%) were admitted due to procedure-related causes while other admissions were either pre-planned or due to social reasons. The average Charlson comorbidity index was lower in the same day discharge group (P < 0.05). The number of patients requiring double myotomy was higher in the same day discharge group (P < 0.05). The overall complication rate of G-POEM in the study cohort was 12% (3/25) with all complications being mild without any severe adverse events.Conclusion:G-POEM is a safe and effective method of treatment for refractory GP with higher clinical success in short-term follow-up. The same day discharge after G-POEM is safe and feasible in >50% of patients with close periprocedural monitoring.

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简介：Correctionisprovidedintheorallanguageclass-roomtohelplearnersidentifyproblematicareas,re-formulaterulesintheirminds,sospeakmoreaccu-rately.However,manycorrectiontechniquesseemtofrustrateandintimidateratherthanenlighten.Thisarticlereviewscurrentcorrectiontechniques.Itthendescribeshowcertainfeaturesoftheclozeprocedurecanbeadaptedintoasimplecorrectionprocedureef-fectiveinelicitingself-andpeer-correctionfromstu-dents.

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简介：Ievaluatedmyteachingpracticefromthefollowingperspective,namely:theapplicationofwholelanguageapproach,emphasisonthevarietyofEnglishbeingtaught,errorcorrection,adoptingauthentictaskinbothteachingandexamaswellasstrategyinstruction.TheyplayaroleinenhancingoralEnglish.

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简介：Objective:Oralsquamous-cellcarcinoma(OSCC)accountsfor>90%oforalcancersaffectingadultsmostlybetweenthefourthtoseventhdecadesoflife.ThemostcommonOSCCtreatmentisconcomitantchemoradiotherapy(CCRT)havingbothlocoregionalanddistantcontrol,butCCRThasacuteandchronictoxiceffectsonadjacentnormaltissue.ThisstudyaimedtodeterminethesideeffectsofCCRTontheoralmucosaandtocharacterizetheclinicopathologyoforallesionsinpatientswithOSCC.Methods:Thisdescriptive,cross-sectionalstudywascertifiedbytheEthicalReviewCommittee(UHS/Education/126-12/2728)oftheUniversityofHealthSciences,Lahore,Pakistan.OSSCpatients(n=81)withvarioushistologicalsubtypes,grades,andstageswererecruited,andfindingsontheiroralexaminationwererecorded.Thesepatientsreceived70,90,and119Gyofradiotherapydosagesincombinationwiththechemotherapydrugscisplatinand5-fluorouracil.DatawereanalyzedusingSPSS20.0.Results:ThemostcommonpresentationofOSCCwasanonhealingulcer(63%)involvingtongue(55.6%).Clinicalfindingsincludedmucositis(92.6%)andxerostomiaofmild,moderate,andseveredegreesin11.1%,46.9%,and35.8%cases,respectively.Ulcers(87.7%),palpablelymphnodes(64.2%),limitedmouthopening(64.2%)andfistula(40.7%)werealsoobserved.Infemales,theassociationofradiotherapydosagewithlimitedmouthopening,xerostomia,andhistologicalgradingwasstatisticallysignificant(P<0.05).Theassociationofchemotherapydrugswithxerostomia(P=0.003)wasalsostatisticallysignificant.Conclusions:CCRTinducedmucositis,xerostomia,andtrismusinpatientswithOSCC.

简介：关于为心脏性的吃惊的处理的levosimendan的使用的编辑的一封信被介绍。

简介：萨拉和布莱恩，已乘飞机从伦敦出发前往澳大利亚的悉尼旅行。萨拉已答应母亲他们一安全抵达就给她去电话。这是她自孩提时便已做的事情。然而布莱恩认为在那么遥远的地方打电话，花那么多钱，说那么几句话实在很愚蠢的做法。

简介：犬瘟热感染机体后，病毒首先在上呼吸道巨噬细胞和淋巴细胞中复制，然后扩散到系统各淋巴结及多种淋巴器官包括脾、胸腺、骨髓和胃肠淋巴组织等，造成淋巴组织退行性病变从而引起免疫抑制。

简介：AccordingtoXinhuaNewsAgency,HaikougovernmentwillreleaseeducationvouchersworthRMB400perpersonperyeartochildrenaged3to6whopossessthehouseholdregistrationofthecityandcomplywithfamilyplanningpolicies.Thevoucherscanbeusedinalltheregisteredpublicandprivatekindergartensinthecity.

简介：Wehavereviewedthegenetherapyingastrointestinaldiseases^[1].GastriccanceriscommoninChina^(2-20),anditsearlydiagnosisandtreatmentarestilldifficultuptonow^(13-36).Theex-pressionofanexogenousgeneintroducedbygenetherapyintopa-tientswithgliomascanbemonitorednon-invasivelybypositron-emissiontornography^[4].

简介：AbstractGastric cancer (GC) is a common malignancy and is the third leading cause of cancer-related death. At present, there is no simple and effective screening method for early-stage GC, and the treatment results and prognosis are poor. With the continuous improvement of molecular biology techniques, research on circular RNA (circRNA) has gradually expanded over time. Much data supports the role of circRNA in tumorigenesis. Moreover, due to its structural specificity and biological stability, circRNA is anticipated to be a potential biomarker for tumor diagnosis. Studies have confirmed that circRNA can participate in the proliferation, invasion, metastasis, and apoptosis of GC. These findings will lead to novel directions for the diagnosis and treatment of GC. This article reviews the structure and function of circRNA, summarizes the current studies on circRNA, and discusses the potential diagnostic value of circRNA in GC.

简介：AbstractBackground:With the wide application of endoscopic submucosal dissection (ESD) for early gastric neoplasms, metachronous gastric neoplasms (MGN) have gradually become a concern. This study aimed to analyze the characteristics of MGN and evaluate the treatment and follow-up outcomes of MGN patients.Methods:A total of 814 patients were retrospectively enrolled. All these patients were treated by ESD for early gastric cancer or gastric dysplasia between November 2006 and September 2019 at The First Medical Center of Chinese People’s Liberation Army General Hospital. The risk factors for MGN were analyzed using Cox hazard proportional model. Moreover, the cumulative incidence, the correlation of initial lesions and MGN lesions, and the treatment and follow-up outcomes of MGN patients were analyzed.Results:A total of 4.5% (37/814) of patients had MGN after curative ESD. The 3-, 5-, and 7-year cumulative incidences of MGN were 3.5%, 5.1%, and 6.9%, respectively, and ultimately reaching a plateau of 11.3% at 99 months after ESD. There was no significant correlation between initial lesions and MGN lesions in terms of gross type (P = 0.178), location (long axis: P = 0.470; short axis: P = 0.125), and histological type (P = 0.832). Cox multivariable analysis found that initial multiplicity was the only independent risk factor of MGN (hazard ratio: 4.3, 95% confidence interval: 2.0-9.4, P < 0.001). Seventy-three percent of patients with MGN were treated by endoscopic resection. During follow-up, two patients with MGN died of gastric cancer with lymph node metastasis. The disease-specific survival rate was significantly lower in patients with MGN than that in patients without MGN (94.6% vs. 99.6%, P = 0.006).Conclusions:The MGN rate gradually increased with follow-up time within 99 months after curative gastric ESD. Thus, regular and long-term surveillance endoscopy may be helpful, especially for patients with initial multiple neoplasms.

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简介：ThevalidityandreliabilityofBECVantagearethekeyfactorstothesuccessandfailureoforaltest.ThispaperevaluatesthespeakingtestofBECVantagebyanalyzingthereliability,authenticity,validityandtheassessmentofthetest.

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