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| 1 | 亚太地区炎症性肠病处理共识意见(一)显示文摘虽然目前亚太地区尚无炎症性肠病(IBD)的大规模流行病学资料,但一系列研究显示其发病率和患病率呈上升趋势,与西方国家相比仍呈滞后现象,溃疡性结肠炎(UC)的发病率仍较克罗恩病(CD)高。除地域差异外,在一些多民族国家中,IBD尚可见种族差异。亚太地区IBD的遗传背景有异于西方国家,如据报道该地区CD患者未检出NOD2/CARD15变异。一般而言,该地区IBD患者的临床过程似不如西方国家严重。亚太地区IBD的诊断存在一些特殊问题。如缺乏IBD诊断金标准,存在多种小肠结肠炎,与IBD临床表现相似,使鉴别诊断特别困难。迄今为止,亚太地区IBD的诊断标准多采用西方国家的诊断标准。诊断必须逐步排除非IBD的小肠结肠炎,确诊应有典型的组织学表现,某些患者需借助随访和诊断性治疗才能确诊。进一步研究IBD发病机制将有助于开发更好的诊断标记物。亚太地区IBD的治疗亦存在特殊问题。由于诊断困难,IBD患者常未能及时接受适当的药物治疗,但该地区仍广泛采用药物治疗方案。结合西方指南和本地经验可制定类似的处理原则,以利诱导缓解和维持缓解。提倡逐级使用基于病变范围、活动性和严重度的阶梯式治疗方案,对不同病例采用综合性、个体化的方法。随着对IBD发病机制和亚太地区IBD独特性的深入理解,合理、实用的药物治疗指南和应用生物制剂治疗将改善该地区IBD的治疗前景。 | 欧阳钦 Rakesh Tandon KL Goh 潘国宗 KM Fock Claudio Fiocchi SK Lam 萧树东 张虎 梁红亮 王玉芳 | 2006 | 胃肠病学2006，11，4： | 123 |
| 2 | 亚太地区炎症性肠病处理共识意见(二)显示文摘 | 欧阳钦 Rakesh Tandon KL Goh 潘国宗 KM Fock Claudio Fiocchi SK Lam 萧树东 张虎(翻译) 梁红亮(翻译) 王玉芳(翻译) 欧阳钦(审校) | 2006 | 胃肠病学2006，11，5： | 47 |
| 3 | Aggressive blood pressure treatment of hypertensive intracerebral hemorrhage may lead to global cerebral hypoperfusion:Case report and imaging perspective显示文摘Hypoperfusion injury related to blood pressure decrease in acute hypertensive intracerebral hemorrhage continues to be a controversial topic. Aggressive treatment is provided with the intent to stop the ongoing bleeding. However, there may be additional factors, including autoregulation and increased intracranial pressure, that may limit this approach. We present here a case of acute hypertensive intracerebral hemorrhage, in which aggressive blood pressure management to levels within the normal range led to global cerebral ischemia within multiple border zones. Global cerebral ischemia may be of concern in the management of hypertensive hemorrhage in the presence of premorbid poorly controlled blood pressure and increased intracranial pressure. | Jose Gavito-Higuera Rakesh Khatri Ihtesham A Qureshi Alberto Maud Gustavo J Rodriguez | 2017 | World Journal of Radiology2017，9，12： | 49 |
| 4 | Endoscopic management of postoperative bile leaks显示文摘BACKGROUND: Significant bile leak as an uncommon complication after biliary tract surgery may constitute a serious and difficult management problem. Surgical management of biliary fistulae is associated with high morbidity and mortality. Biliary endoscopic procedures have become the treatment of choice for management of biliary Gstulae. METHODS: Ninety patients presented with bile leaks after cholecystectomy ( open cholecystectomy in 45 patients, cholecystectomy with common bile duct exploration in 20 and laparoscopic cholecystectomy in 25). The presence of bile leaks was confirmed by ERCP and the appearance of bile in percutaneous drainage of abdominal collections. Of the 90 patients with postoperative bile leaks, 18 patients had complete transaction of the common bile duct by ERCP and were subjected to bilioenteric anastomosis. In the remaining patients after cholangiography and localization of the site of bile leaks. therapeutic procedures like sphinctero-tomy, biliary stenting and nasobiliary drainage ( NBD ) were performed. If residual stones were seen in the common bile duct, sphincterotomy was followed by stone extraction using dormia basket. Nasobiliary drain or stents of 7F size were placed according to the standard techniques. The NBD was removed when bile leak stopped and closure of the fistula confirmed cholangiographically. The stents were removed after an interval of 6-8 weeks. RESULTS: Bile leaks in 72 patients occurred in the cystic duct (38 patients), the common bile duct (30 ), and the right hepatic duct (4). Of the 72 patients with post-operative bile leak, 24 had associated retained common bile duct stones and 1 had ascaris in common bile duct. All the 72 patients were subjected to therapeutic procedures including sphincterotomy with stone extraction followed by biliary stenting (24 patients), removal of ascaris and biliary stenting (1), sphincterotomy with biliary stenting (18), sphincterotomy with NBD (12), biliary stenting alone (12), and NBD alone (5). Bile leaks stopped in all patients at a median interval of 3 days (range 3-16 days) after endoscopic in- terventions. No difference was observed in efficacy and in time for the treatment of bile leak by sphincterotomy with endoprosthesis or endoprosthesis alone in patients with bile leak after surgery. CONCLUSIONS: Post-cholecystectomy bile leaks occur most commonly in the cystic duct and associated common bile duct stones are found in one-third of cases. Endoscopic therapy is safe and effective in the management of bile leaks and fistulae after surgery. Sphincterotomy with endoprosthesis or endoprosthesis alone is equally effective in the management of postoperative bile leak. | Naresh Agarwal Barjesh Chander Sharma Sanjay Garg Rakesh Kumar Shiv K Sarin | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，2： | 33 |
| 5 | A Comprehensive Survey of TDD-Based Mobile Communications Systems from TD-SCDMA 3G to TDLTE-Advanced 4G and 5G directions显示文摘TDD(Time Division Duplex) is one of the two duplex modes.TD-SCDMA(Time division Synchronous CDMA) is the first TDD-based cellular mobile system which is commercialized in wide area and large scale and TD-SCDMA is also the first cellular mobile system which adopted smart antenna technology,also called as beamforming.As the long term evolution of TD-SCDMA,TDLTE(A)(Time Division-Lone Term Evolution,and TD-LTE Advanced) introduced OFDM(Orthogonal Frequency Division Multiplexing)and enhanced smart antenna technology together with MIMO(Multiple Input Multiple Output),which are adopted by LTE FDD(Frequency Division Duplex) either.It is indicated that TD-SCDMA and TD-LTE(A)have opened a sustainable utilization era of TDD and smart antenna Technologies in the wireless mobile communication.This paper aims to present a systematic introduction to TDD-based mobile communications from TD-SCDMA to TD-LTE and beyond and its comparisons to FDD,with particular focuses on TDD key technologies,principles of TDD cellular mobile systems,TDD evolution path,and future TDD 5G directions.We hope that this paper will provide a comprehensive overview of TDD technology upgrade and its standard evolution,and serve as a valuable reference for research on 5G mobile communication systems.It is believed that TDD will play more important role in 5G. | CHEN Shanzhi SUN Shaohui WANG Yingmin XIAO Guojun Rakesh Tamrakar | 2015 | China Communications2015，12，2： | 17 |
| 6 | Controversies in diagnosis and management of Kawasaki disease显示文摘Kawasaki disease(KD) is a common medium vessel systemic vasculitis that usually occurs in small children. It has a predilection for the coronary arteries, but other medium sized arteries can also be involved. The etiology of this disorder remains a mystery. Though typical presentation of KD is quite characteristic, it may also present as incomplete or atypical disease in which case the diagnosis can be very challenging. As both incomplete and atypical forms of KD can be associated with serious coronary artery complications, the pediatrician can ill afford to miss these diagnoses. The American Heart Association has enunciated consensus guidelines to facilitate the clinical diagnosis and treatment of this condition. However, there are still several issues that remain controversial. Intravenous immunoglobulin remains the cornerstone of management but several other treatment modalities, especially glucocorticoids, are increasingly finding favour. We review here some of the contemporary issues, and the controversies thereon, pertaining to management of KD. | Rakesh Kumar Pilania Dharmagat Bhattarai Surjit Singh | 2018 | World Journal of Clinical Pediatrics2018，7，1： | 16 |
| 7 | Fluid resuscitation in acute pancreatitis显示文摘Acute pancreatitis remains a clinical challenge,despite an exponential increase in our knowledge of its complex pathophysiological changes.Early fluid therapy is the cornerstone of treatment and is universally recommended;however,there is a lack of consensus regarding the type,rate,amount and end points of fluid replacement.Further confusion is added with the newer studies reporting better results with controlled fluid therapy.This review focuses on the pathophysiology of fluid depletion in acute pancreatitis,as well as the rationale for fluid replacement,the type,optimal amount,rate of infusion and monitoring of such patients.The basic goal of fluid epletion should be to prevent or minimize the systemic response to inflammatory markers.For this review,various studies and reviews were critically evaluated,along with authors’recommendations,for predicted severe or severe pancreatitis based on the available evidence. | Aakash Aggarwal Manish Manrai Rakesh Kochhar | 2014 | World Journal of Gastroenterology2014，20，48： | 14 |
| 8 | Endoscopic incisional therapy for benign esophageal strictures: Technique and results显示文摘Benign esophageal strictures refractory to the conventional balloon or bougie dilatation may be subjected to various adjunctive modes of therapy, one of them being endoscopic incisional therapy(EIT). A proper delineation of the stricture anatomy is a prerequisite. A host of electrocautery and mechanical devices may be used, the most common being the use of needle knife, either standard or insulated tip. The technique entails radial incision and cutting off of the stenotic rim. Adjunctive therapies, to prevent re-stenosis, such as balloon dilatation, oral or intralesional steroids or argon plasma coagulation can be used. The common strictures where EIT has been successfully used are Schatzki's rings(SR) and anastomotic strictures(AS). Short segment strictures(< 1 cm) have been found to have the best outcome. When compared with routine balloon dilatation, EIT has equivalent results in treatment na?ve cases but better long term outcome in refractory cases. Anecdotal reports of its use in other types of strictures have been noted. Post procedure complications of EIT are mild and comparable to dilatation therapy. As of the current evidence, incisional therapy can be used for management of refractory AS and SR with relatively short stenosis(< 1 cm) with good safety profile and acceptable long term patency. | Jayanta Samanta Narendra Dhaka Saroj Kant Sinha Rakesh Kochhar | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，19： | 14 |
| 9 | Pancreatic fluid collections: What is the ideal imaging technique?显示文摘Pancreatic fluid collections(PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liquid alone or a mixture of fluid and necrotic debris. Management of these different types of collections differs because of the variable quantity of debris; while patients with pseudocysts can be drained by straight-forward stent placement, walledoff necrosis requires multi-disciplinary approach. Differentiating these collections on the basis of clinical severity alone is not reliable, so imaging is primarily performed. Contrast-enhanced computed tomography is the commonly used modality for the diagnosis and assessment of proportion of solid contents in PFCs; however with certain limitations such as use of iodinated contrast material especially in renal failure patients and radiation exposure. Magnetic resonance imaging(MRI) performs better than computed tomography(CT) in characterization of pancreatic/peripancreatic fluid collections especially for quantification of solid debris and fat necrosis(seen as fat density globules), and is an alternative in those situations where CT is contraindicated. Also magnetic resonance cholangiopancreatography is highly sensitive for detecting pancreatic duct disruption and choledocholithiasis. Endoscopic ultrasound is an evolving technique with higher reproducibility for fluid-to-debris component estimation with the added advantage of being a single stage procedure for both diagnosis(solid debris delineation) and management(drainage of collection) in the same sitting. Recently role of diffusion weighted MRI and positron emission tomography/CT with ^(18)F-FDG labeled autologous leukocytes is also emerging for detection of infection noninvasively. Comparative studies between these imaging modalities are still limited. However we look forward to a time when this gap in literature will be fulfilled. | Narendra Dhaka Jayanta Samanta Suman Kochhar Navin Kalra Sreekanth Appasani Manish Manrai Rakesh Kochhar | 2015 | World Journal of Gastroenterology2015，21，48： | 13 |
| 10 | Intralesional steroid injection therapy in the management of resistant gastrointestinal strictures显示文摘Esophageal strictures are a problem frequently encountered by gastroenterologists. Dilation has been the customary treatment for benign esophageal strictures, and dilation techniques have advanced over the years. Depending on their characteristics and the response to treatment, esophageal strictures can be classified into two types: 1, simple (Schatzki rings, webs, peptic injury, and following sclerotherapy) - these are easily amenable to dilation, with a low recurrence rate after initial treatment; and 2, complex (caused by caustic ingestion, radiation injury, anastomotic strictures, and photodynamic therapy) - these are difficult to dilate and are associated with higher recurrence rates. Refractory strictures are those in which it is not possible to relieve the anatomic restriction successfully up to a diameter of 14 mm over five sessions at 2-weekly in- tervals, due to cicatricial luminal compromise or fibrosis; and recurrent strictures are those in which it is not possible to maintain a satisfactory luminal diameter for 4 wk once the target diameter of 14 mm has been achieved. There are no standard recommendations for the management of refractory strictures. The various techniques used include intralesional steroid injectioncombined with dilation; endoscopic incisional therapy, with or without dilation; placement of self-expanding metal stents, Polyflex stents, or biodegradable stents; self-bougienage; and endoscopic surgery. This review discusses the indications, technique, results, and complications of the use of intralesional steroid injections combined with dilation and endoscopic incisional therapy with dilation in refractory strictures. | Rakesh Kochhar Kuchhangi Suresh Poornachandra | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，2： | 11 |
| 11 | Novel association between sperm deformity index and oxidative stress-induced DNA damage in infertile male patients显示文摘Aim: To investigate the impact of abnormal sperm morphology using the sperm deformity index (SDI) on reactive oxygen species (ROS) production and its correlation with sperm DNA damage. Methods: Semen samples were collected from men undergoing infertility screening (n=7) and healthy donors (n=6). Mature spermatozoa were isolated and incubated with 5mmol/L β-nicotinamide adenine dinucleotide phosphate (NADPH) for up to 24h to induce ROS. Sperm morphology was evaluated using strict Tygerberg's criteria and the SDI. ROS levels and DNA damage were assessed using chemiluminescence and terminal deoxynucleotidyl transferase-mediated fluoresceindUTP nick end labeling (TUNEL) assays, respectively. Results: SDI values (median [interquartiles]) were higher in patients than donors (2 [1.8,2.1] vs. 1.53 [1.52, 1.58], P=0.008). Aliquots treated with NADPH showed higher ROS levels (1.22 [0.30, 1.87] vs. 0.39 [0.10, 0.57], P=0.03) and higher incidence of DNA damage than those not treated (10 [4.69, 24.85] vs. 3.85 [2.58, 5.10], P=0.008). Higher DNA damage was also seen following 24h of incubation in patients compared to donors. SDI correlated with the percentage increase in sperm DNA damage following incubation for 24h in samples treated with NADPH (r=0.7, P=0.008) and controls (r=0.58, P=0.04).Conclusion: SDI may be a useful tool in identifying potential infertile males with abnormal prevalence of oxidative stress (OS)-induced DNA damage. NADPH plays a role in ROS-mediated sperm DNA damage, which appears to be more evident in infertile patients with semen samples containing a high incidence of morphologically abnormalspermatozoa. | Tamer M.Said Nabil Aziz Rakesh K.Sharma Iwan Lewis-Jones AnthonyJ.ThomasJr AshokAgarwal | 2005 | Asian Journal of Andrology2005，7，2： | 10 |
| 12 | 术中射频消融后病灶刮除治疗脊柱转移瘤显示文摘目的:探讨术中射频消融(RFA)后再行病灶刮除术治疗脊柱转移瘤的可行性及疗效。方法:2004年~2006年,对11例脊柱转移瘤患者术中实施RFA后再行病灶刮除术,将FRA前后病灶标本进行光镜和电镜病理检查,随访患者疼痛缓解情况及肿瘤复发情况。结果:术中未出现脊髓和神经根损伤,RFA后瘤组织固缩,刮除顺利,出血量350~3800ml,平均1024.5ml。全部病例得到6个月以上随访,平均9.8个月,全部患者生存期超过6个月,VAS评分术前平均5.8分,术后6个月时平均1.9分。1例出现局部肿瘤复发。RFA前的标本光、电镜检查均未见肿瘤组织坏死。RFA后光镜检查3例无明显坏死,9例肿瘤细胞完全坏死;电镜检查10例肿瘤细胞完全坏死,1例肿瘤细胞部分坏死,1例无明显坏死。结论:术中RFA后再行病灶刮除治疗脊柱转移瘤安全可行,有利于肿瘤的刮除,减少局部复发的风险。 | 李浩淼 Alessandro Gasbarrini Michele Cappuccio Rakesh Donthineni Luca Boriani Stefano Bandiera Laura Foroni Gianandrea Pasquinelli Stefano Boriani | 2008 | 中国脊柱脊髓杂志2008，18，11： | 10 |
| 13 | Redox therapeutics in hepatic ischemia reperfusion injury显示文摘Ischemia-reperfusion plays a major role in the injury experienced by the liver during transplantation. Much work has been done recently investigating the role of redox species in hepatic ischemia-reperfusion. As animal models are better characterized and developed, and more insights are gained into the pathophysiology of hepatic ischemia reperfusion injury in humans the questions into exactly how oxidants participate in this injury are becoming more refined. These questions include effects of cellular location, timing of injury, and ability of therapeutics to access this site are increasing our appreciation of the complexity of ischemia reperfusion and improving attempts to ameliorate its effects. In this review, we aim to discuss the various methods to alter redox chemistry during ischemia reperfusion injury and future prospects for preventing organ injury during hepatic ischemia reperfusion. | Rakesh P Patel John D Lang Alvin B Smith Jack H Crawford | 2014 | World Journal of Hepatology2014，6，1： | 9 |
| 14 | Infection of Schistosomiasis japanicum is likely to enhance proliferation and migration of human breast cancer cells:mechanism of action of differential expression of MMP2 and MMP9显示文摘Objective:To study whether the infection of Schistosomiasis japanicum(S.japanicum) is related to enhanced proliferation and migration of cancer cells,and the molecular mechanism pertains to cancer cell metastasis in human host.Methods:The gene of S.japanicum glutathione transferase(sjGST) cloned from 5.japanicum was expressed,purified and applied in a series of assays to explore the effect of sjGST on proliferation and migration of MDA-MB-435S,and the expression of MMP2 and MMP9.Immunofluorescence assay for the binding of sjGST to MDA-MB-435S was also carried out.Results:Results showed that sjGST enhanced proliferation and migration in human breast cancer cell MDA-MB-435S signifycantly at 50-200 nM,but did not enhance them in human lung cancer cell A549.Immunofluorescence assay for the binding of sjGST to MDA-MB-435S and A549 showed that GST was readily hound to the breast cancer cells,but showed almost no binding to human lung cancer cells.The assays for gelatinase activity showed that both MMP2 and MMP9 activities were increased significantly in the presence of sjGST(50-200 nM) in MDA-MB-435S, but they were not significant in A549.Conclusions:Our current results show strongly that S. japanicum GST binds to MDA-MB-435S probably via its i'eceptor,and enhances proliferation and migration of the cancer cells by up-regulatory expression of MMP2 and MMP9. | Ya-Ling Lin Rakesh Ramanujum Shiping He | 2011 | Asian Pacific Journal of Tropical Biomedicine2011，1，1： | 9 |
| 15 | Potentially fatal haemobilia due to inappropriate use of an expanding biliary stent显示文摘AIM: To highlight the fatal complication caused by expanding biliary stents and the importance of avoiding use of expanding stent in potentially curable diseases.METHODS: Arteriobiliary fistula is an uncommon cause of haemobilia. We describe a case of right hepatic artery pseudoaneurysm causing arteriobiliary fistula and presenting as severe malena and cholangitis, in a patient with a mesh metal biliary stent. The patient had lymphoma causing bile duct obstruction.RESULTS: Gastroduodenoscopy failed to establish the exact source of bleeding and hepatic artery angiography and selective embolisation of the pseudo aneurysm successfully controlled the bleeding.CONCLUSION: Bleeding from the pseudo aneurysm of the hepatic artery can be fatal. Mesh metal stents in biliary tree can cause this complication as demonstrated in this case.So mesh metal stent insertion should be avoided in potentially benign or in curable conditions. Difficulty in diagnosis and management is discussed along with the review of the literature. | Rakesh Rai John Rose Derek Manas | 2003 | World Journal of Gastroenterology2003，9，10： | 9 |
| 16 | A New Switching Sequences of SVPWM for Six-Phase Induction Motor with Features of Reduced Switching Losses显示文摘In this paper,new SVPWM switching sequences for six-phase asymmetrical induction motor drives are derived with the aim to reduce inverter’s switching losses.Total three switching sequences are introduced in this paper.These sequences are derived such that the phases get continuously clamped when a current of the phases is around its peak magnitude and hence reduced switching losses are recorded.The comparative performances of these modulation techniques are studied with two existing switching sequences.Simulation,analytical and experimental results are presented.Based on these results,it is found that new switching sequences reduce switching losses effectively in dual three phase inverters. | Shaikh Mohammed Suhel Rakesh Maurya | 2021 | CES Transactions on Electrical Machines and Systems2021，5，2： | 8 |
| 17 | Blumgart's technique of pancreaticojejunostomy: Analysis of safety and outcomes显示文摘Background: Blumgart's pancreaticojejunostomy(PJ) has been described with low pancreatic leak rates. This study aimed to evaluate our experience with this technique regarding the pancreatic leak and other perioperative outcomes. Methods: We performed a single-center retrospective analysis of a cohort of 81 patients who underwent pancreaticoduodenectomy in our department from January 2011 to February 2018. The primary endpoint was the occurrence of a clinically relevant postoperative pancreatic fistula(CR-POPF) and analysis of its risk factors. Results: The CR-POPF rate was 12.3%. Fistula risk score(FRS) was the only significant risk factor for the occurrence of overall POPF in multivariate analysis. However, none of the other factors including FRS was found to be significantly associated with CR-POPF risk. A strong positive correlation was found between the CR-POPF and the incidence of delayed gastric emptying, post-pancreatectomy hemorrhage and increased length of hospital stay. Conclusion: Blumgart's technique is a safe technique of pancreatico-enteric anastomosis with low rates of CR-POPF. CR-POPF with this technique is independent of most of the preoperative and intraoperative factors. Therefore, this technique can be used for all types of the pancreas with consistently good results. | Vishal Gupta Saket Kumar Vivek Gupta Pradeep Joshi Rahul Rahul Rakesh Kumar Yadav Amit Dangi Abhijit Chandra | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，2： | 8 |
| 18 | Progress in the treatment of pulmonary metastases after liver transplantation for hepatocellular carcinoma显示文摘Hepatocellular carcinoma(HCC) is the fifth most common cancer in the world, and is the third leading cause of cancer-related death. Liver transplantation(LT) has become a curative treatment for patients with HCC. However, recurrence and metastasis after LT are the main factors reducing long-term survival in patients, and the lung is the most common site of metastasis after LT for HCC, although metastasis to liver, para-aortic lymph nodes and renal periphery are observed. Thus, the treatment of pulmonary metastases after LT for HCC has become a hot research topic, the successful treatment of pulmonary metastases can significantly prolong the survival of LT patients. Although single conventional treatment(chemotherapy, surgery and external beam radiation therapy), immunosuppression, image-guided minimally invasive therapy(radiofrequency ablation, microwave ablation, cryoablation, and brachytherapy) and molecular targeted drugs have had a significant effect, patients do not have durable remission and the long-term survival rate is disappointing. Therefore, improving existing treatments and identifying a more effective combination therapy are important research issues in the prevention and treatment of pulmonary metastases after LT for HCC. The paper reviewed single conventional treatments, new treatments, and combination therapy, to provide a basis for the best treatment of these patients. | Zhan-Wang Xiang Lin Sun Guo-Hong Li Rakesh Maharjan Jin-Hua Huang Chuan-Xing Li | 2015 | World Journal of Hepatology2015，7，20： | 8 |
| 19 | Characterization of biofilms in biliary stents and potential factors involved in occlusion显示文摘AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospital, all consecutive patients who required endoscopic biliary stent exchange/removal were included. Etiology of the biliary disease was diagnosed by imaging, cytology and on follow-up. Clinical details of patients with biliary stent retrieval were noted. All extracted stents were collected in sterile containers and immediatelyprocessed for quantification of biofilm proteins and polysaccharides. Molecular identification of commonly known and unknown bacteria was performed by polymerase chain reaction and density gradient gel electrophoresis methods. RESULTS Eighty one patients(41 males) with age range of 20-86 years were studied. The underlying causes for stent insertion were bile duct stones(n = 46; 56.8%) benign stricture(n = 29; 35.8%) and malignancy(n = 6; 7.4%) with cholangitis in 50(61.7%) patients. The retrieved stent sizes were 7 Fr(n = 62; 76.5%) and 10 Fr(n = 19; 23.5%) with 65 days median insertion duration. Polybacterial consortia were detected in 90.1% of the stents. The most common bacteria identified by polymerase chain reaction alone and/or sequencing were Pseudomonas(n = 38), Citrobacter(n = 23), Klebsiella(n = 22), Staphylococcus(n = 20), Serratia(n = 16), Escherichia coli(n = 14), Streptococcus(n = 13), Enterococcus(n = 13), Aeromonas(n = 12), Proteus(n = 10) and Enterobacter(n = 9). Protein concentration according to gender(0.547 ± 0.242 mg/ml vs 0.458 ± 0.259 mg/ml; P = 0.115) as well as age > 60 years and < 60 years(0.468 ± 0.295 mg/ml vs 0.386 ± 0.238 mg/ml; P = 0.205) was non-significant. However, polysaccharide concentration was significant both according to gender(0.052 ± 0.021 mg/ml vs 0.049 ± 0.016 mg/ml; P < 0.0001) and age(0.051 ± 0.026 mg/ml vs 0.038 ± 0.016 mg/ml; P < 0.011). Protein concentration in the biofilm was significantly higher(0.555 ± 0.225 mg/ml vs 0.419 ± 0.276 mg/ml; P = 0.018) in patients with cholangitis, lower(0.356 ± 0.252 mg/ml vs 0.541 ± 0.238 mg/ml; P = 0.005) in the 10 Fr group than the 7 Fr group, and significantly higher(0.609 ± 0.240 mg/ml vs 0.476 ± 0.251 mg/ml; P = 0.060) in stents of ≥ 6 mo of indwelling time. However presence/absence of cholangitis, size of stent, indication of stent insertion and indwelling time did not affect the quantity of polysaccharide concentration.CONCLUSION Plastic stents retrieved from patients with biliary tract disease showed polymicrobial organisms with higher protein content among patients with cholangitis and those with smaller diameter stents. longer indwelling duration had more biofilm formation. | Chetana Vaishnavi Jayanta Samanta Rakesh Kochhar | 2018 | World Journal of Gastroenterology2018，24，1： | 8 |
| 20 | Design,Modeling,and Control of Biomimetic Fish Robot:A Review显示文摘A comprehensive review on bio-inspired fish robots has been done in this article with an enhanced focus on swimming styles,actuators,hydrodynamics,kinematic-dynamic modeling,and controllers.Swimming styles such as body and/or caudal fin and median and/or paired fin and their variants are discussed in detail.Literature shows that most fish robots adapt carangiform in body and/or caudal fin type swimming as it gives significant thrust with a maximum speed of 3.7 ms 1 in iSplash-II.Applications of smart or soft actuators to enhance real-time dynamics was studied from literature,and it was found that the robot built with polymer fiber composite material could reach a speed of 0.6 m s However,dynamic modeling is relatively complex,and material selection needs to be explored.The numerical and analytical methods in dynamic modeling have been investigated highlighting merits and demerits.Hydrodynamic parameter estimation through the data-driven model is widely used in offline,however online estimation of the same need to be explored.Classical controllers are frequently used tor navigation and stabilization,which often encounters the linearization problem and hence,can be replaced with the state-of-the-art adaptive and intelligent controller.This article also summarizes the potential research gaps and future scopes. | Palmani Duraisamy Rakesh Kumar Sidharthan Manigandan Nagarajan Santhanakrishnan | 2019 | Journal of Bionic Engineering2019，16，6： | 7 |
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