End Of Duct Research Articles

Common bile duct web: Managed with excision and primary anastomosis of bile duct over ERCP stent

Congenital biliary web formations are extremely rare, with only a few cases reported till date in the literature. We report a case of a four years old female child, presented to us for evaluation of jaundice and recurrent attacks of cholangitis. Intra-operatively, we found a nodular mass near the distal end of common bile duct causing extrinsic compression on extra-hepatic biliary tree. Biopsy revealed reactive lymphoid hyperplasia. Four weeks after the first surgery a second procedure was planned. The child then underwent exploratory laparotomy with resection of common bile duct web and anastomosis over an ERCP (Endoscopic retrograde cholangiopancreatography) stent. The reported treatment for biliary web commonly consists of Roux-en-Y hepatico-jejunostomy, excision of the diaphragm with t-tube insertion or excision of the web with a cholecystectomy. However, we performed excision of the web and primary anastomosis of CBD (Common Bile Duct) over an ERCP stent preserving native common bile duct.

Diagnosis and minimally invasive treatment of type III choledochal cysts

BackgroundType III choledochal cysts (CCs) are the rarest and least well-characterized of the five variants of biliary cysts. Only a few relevant studies have been conducted and a gold standard treatment for type III CCs is still lacking because of their scarcity. An unusual case of type III CC with choledochocele at the end of the distal common bile duct (CBD) with no bulging of the duodenum is presented here.Case presentationA 61-year-old woman presented to our department with repeated upper abdominal pain for one year. Laboratory examination revealed abnormal liver function and a slight increase in the white blood cell (WBC) count and proportion of neutrophils. In an MRCP of the patient, the distal CBD was found to have a cystic structure indicative of a type III CC. Endoscopic retrograde cholangiopancreatograpy (ERCP) revealed cystic findings compatible with Todani type III CCs. However, duodenoscopy did not show a bulge in the duodenum so laparoscopic cholecystectomy and Roux-en-Y hepaticojejunostomy were performed. In her 6-month follow-up, the patient reported that recovery from the operation was uneventful.ConclusionsERCP has become the gold standard for diagnosing type III CCs. Type III CCs can be treated minimally invasively with laparoscopic cholecystectomy and Roux-en-Y hepaticojejunostomy.

Theoretical analysis of sound propagation and entropy generation across a distributed steady heat source

Acoustic and entropy waves interacting in a duct with a steady heat source and mean flow are analysed using an asymptotic expansion (AE) for low frequencies. The analytical AE solutions are obtained by taking advantage of flow invariants and applying a multi-step strategy. The proposed solutions provide first-order corrections to the compact model in the form of integrals of mean flow variables. An eigenvalue system is then built to predict the thermoacoustic modes of a duct containing a distributed heat source or sink. Predictions from the AE solutions agree well with the numerical results of the linearised Euler equations for both frequencies and growth rates, as long as the low-frequency condition is satisfied. The AE solutions are able to accurately reconstruct the acoustic and entropy waves and correct the significant errors in the predicted entropy wave associated with the compact model. The analysis illustrates that the thermoacoustic system needs to account for the entropy wave generated by the interaction of acoustic wave and the distributed steady heat source, especially when density- or entropy-dependent boundary conditions are prescribed at the duct ends. Furthermore, a combination of the AE method and the modified WKB approximation method is discussed for a cooling case. The AE solutions remedy the disadvantage of the WKB solution in the low and very low-frequency domain and facilitate full-frequency theoretical analyses of sound propagation and entropy generation in inhomogeneous duct flow fields.

Noise distribution law of air-conditioning ducts for metro vehicles

The passenger comforts are directly affected by the air supply uniformity and noise of air-conditioning duct inside the metro vehicle. In order to solve the integrated design problem of air supply uniformity and noise control of air-conditioning ducts, a theoretical model is established to analyze the air supply uniformity, noise attenuation, and airflow regeneration noise of the air-conditioning duct. The distribution law of the sound pressure level along the longitudinal air outlet was calculated, and the calculated results were compared with test ones. For a typical air supply duct with a constant cross section: (1) In order to ensure air supply uniformity at the outlet of the static pressure chamber, the area of the side air hole should be gradually increased in an exponential form along the direction of the main flow, and cannot be designed in the equal area form. (2) The airflow speed of each side hole decreased in sequence along the air duct length. In order to ensure the uniformity air supply of each side hole, the area of each side hole must be gradually increased. (3) The noise in the air conditioner duct was mainly concentrated at the front end of the air duct, and the noise at the subsequent air outlet can fully meet the current requirements of subway vehicles for indoor noise. Therefore, the front end of the air duct is the most important area for noise control.

Explosion behavior of non-uniform methane/air mixture in an obstructed duct with different blockage ratios

An experimental investigation on explosion behavior of non-uniform methane/air explosion in obstructed duct with different blockage ratios is conducted. The methane/air mixture that the methane concentration decreases from top to bottom and from ignition end to opposite end of duct is tested. The results show that the vertical concentration gradient of methane upstream along the obstacle increases with blockage ratio. After ignition, the flame speed and overpressure increase exponentially when the flame propagates with a finger-liked shape. In the poorly mixed methane/air, the flame speed and overpressure reduce with the appearance of pronounced triple flame. The flame in duct without obstacle propagates with triple shape until it approaches the vent. In the obstructed duct, the flame speed increases again after the flame passes the obstacle and then the triple flame disappears as the flame becomes turbulent. In the more evenly mixed methane/air, the flame speed decreases with the disappearance of finger shaped flame. The flame speed decreases continuously in duct without obstacle but increases again when the flame passes the obstacle in obstructed duct, in which an incomplete mushroom-shape flame forms downstream the obstacle. Generally, both the flame speed and overpressure are larger in methane/air that mixes more fully.

Potential prognosis index for m6A-related mRNA in cholangiocarcinoma

BackgroundCholangiocarcinoma (CHOL) is a malignant tumor that originates in the extrahepatic bile duct and can extend from the hilar region to the lower end of the common bile duct. The prognosis of CHOL patients is particularly poor; therefore, in this study, we screened mRNAs correlated with N6-methyladenosine (m6A) to construct a risk model for prognosis in CHOL.MethodsThe TCGA-CHOL dataset was applied to obtain and analyze the coexpression of 1281 m6A-related mRNAs, from which 14 were selected for further analysis through univariate proportional hazards (cox) regression analysis. Aryl hydrocarbon receptor interacting protein (AIP), CCAAT/enhancer binding protein beta (CEBPB), syndecan1 (SDC1), vacuolar protein sorting 25 homolog (VPS25) and syntaxin binding protein 2 (STXBP2) were then screened out through the least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analysis to develop a precise m6A-related mRNA prognosis risk model (MRMRPM) with an area under curve (AUC) of 0.908 and 0.923 after 1 and 2 years, respectively. We divided the samples into high-risk and low-risk groups using the m6A-related mRNA prognosis risk model.ResultsKaplan–Meier analysis indicated poor overall survival (OS) for the high-risk group. Two Gene Expression Omnibus (GEO) datasets (GSE89748 and GSE107943) were used to validate the risk model. The results of drug sensitivity and immune cell infiltration analysis showed that the risk model could serve as a prognosis index of potential immunotherapeutic characteristics and drug sensitivity. Furthermore, the proportion of resting dendritic cells and regulatory T cells was positively associated with an increased expression of four m6A-related mRNAs — AIP, CEBPB, SDC1, and VPS25 — in the high-risk CHOL group.ConclusionsOur findings suggest that this model can be a prognostic indicator for CHOL patients.

Numerical simulation of sound propagation in and around ducts using thin boundary elements

Investigating the sound field in and around ducts is an important topic in acoustics, e.g. when simulating musical instruments or the human vocal tract. In this paper a method that is based on the boundary element method in 3D combined with a formulation for infinitely thin elements is presented. The boundary integral equations for these elements are presented, and numerical experiments are used to illustrate the behavior of the thin elements. Using the example of a closed benchmark duct, boundary element solutions for thin elements and surface elements are compared with the analytic solution, and the accuracy of the boundary element method as function of element size is investigated. As already shown for surface elements in the literature, an accumulation of the error along the duct can also be found for thin elements, but in contrast to surface elements this effect is not as big and a damping of the amplitude cannot be seen. In a second experiment, the impedance at the open end of a half open duct is compared with formulas for the radiation impedance of an unflanged tube, and a good agreement is shown. Finally, resonance frequencies of a tube open at both ends are calculated and compared with measured spectra. For sufficiently small element sizes frequencies for lower harmonics agree very well, for higher frequencies a difference of a few Hertz can be observed, which may be explained by the fact that the method does not consider dampening effects near the duct walls. The numerical experiments also suggest, that for duct simulations the usual six to eight elements per wavelength rule is not enough for accurate results.

Contrastive study on MRI signs of intestinal and pancreatobiliary-type periampullary carcinoma

Objective: The magnetic resonance imaging (MRI) features of intestinal-type periampullary carcinoma (IPAC) and pancreatobiliary-type periampullary carcinoma (PPAC) were compared and analyzed to discuss the optimal diagnosis scheme. Method: Preoperative MRI images of 59 patients (32 males, 27 females, aged 37-80 years) diagnosed with periampullary carcinoma (PAC) confirmed by surgery and pathology in Nanjing Drum Tower Hospital from January 2017 to July 2020 were retrospectively analyzed. The patients were divided into 21 cases in the IPAC group (11 males, 10 females) and 38 cases in the PPAC group (21 males, 17 females) according to histopathological results. The conventional MRI plain scan signs included in the analysis include lesion morphology, the largest diameter of the lesion, lesion location, duodenal papilla morphology, plain scan lesion signal (with the normal pancreatic signal as reference), diffusion weighted imaging (DWI) signal. Magnetic resonance cholangiopancreatography (MRCP) image signs include the dilatation of common bile duct and main pancreatic duct and quantitative analysis of their diameter, the presence of a round filling defect in the distal end of the common bile duct, the morphology of common bile duct stenosis, the dilatation of lateral branches around the obstructed pancreatic duct, the ductal sign, the distance from the end of the obstructed common bile duct to the duodenal papilla, the distance from the end of the obstructed pancreatic duct to the duodenal papilla, and the angle of the pancreaticobiliary duct. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of single meaningful factors. The MRI features of PAC were summarized according to the significant single factor indicators and were classified into 5 image types. And the diagnostic efficacy of the classification criteria for pathological subtypes of PAC was evaluated by the ROC curve. The DeLong test was used to compare the area under the ROC curve (AUC) of multiple diagnostic methods. Results: In univariate analysis, there were statistically significant differences between IPAC and PPAC in lesion location, duodenal papilla morphology, the circular filling defect in the distal end of the common bile duct, the distance from the obstructed pancreatic duct to the duodenal papilla, the angle of the pancreaticobiliary duct, and lesion signal characteristics on plain T2WI fat suppressant images (all P<0.05). Among the 5 types of MRI images, IPAC is mostly manifested as duodenal papillary nodules(15/21,71.4%), while PPAC is more manifested as pancreatic mass type(18/38,47.4%), thickened common bile duct wall type(9/38,23.7%) or ampullary mass type(9/38,23.7%). Both IPAC(2/21,9.5%) and PPAC(0,0) rarely showed the nodular type of common bile duct lumen. In the DeLong test of the significant univariate index(lesion location, duodenal papilla morphology, the circular filling defect in the distal end of the common bile duct, the distance from obstructed pancreatic duct to duodenal papilla, the angle of the pancreaticobiliary duct, and lesion signal characteristics on plain T2WI fat suppressant images) and the 5 classification of MRI images, the AUC of the 5 classifications of MRI images was 0.932(95%CI:0.867-0.997), which was higher than that of any of the significant univariate indexes (all P<0.05). In addition, the 5 classifications of MRI images have the same high diagnostic power as the logistic regression analysis model(P>0.05). Conclusions: The 5 classification of MRI images can improve the accuracy of differential diagnosis of IPAC and PPAC before surgery, and the diagnostic efficiency is better than any single factor meaningful index and comparable to that of the logistic regression analysis model.

Pay attention to endoscopic diagnosis and treatment for confluence disease of pancreaticobiliary ducts

The confluence of pancreaticobiliary ducts refers to the area between the end of common bile duct, the opening of main pancreatic duct and duodenal papilla. Those confluence diseases of pancreaticobiliary ducts will cause obstruction of biliary and pancreatic outflow tract, cholestasis, pancreatic juice deposition or pancreaticobiliary reflux, and thus induce gallstones, cholangitis, pancreatitis and other diseases. Endoscopic ampullary sphincterotomy is an important way to treat biliary and pancreatic diseases, but the length of incision is determined by the anatomy of Oddi sphincter. The endoscopic approach aims to relieve biliary and pancreatic outflow tract obstruction and pancreatic biliary reflux, and avoid enterobiliary reflux.

JUSTIFICATION OF THE STRUCTURAL AND TECHNOLOGICAL PARAMETERS OF THE ADAPTIVE THREE-PIPE HEAT EXCHANGER FOR ANIMAL ROOM

As a result of the research, an adaptive three-pipe heat exchanger was developed, containing coaxially installed pipes, a condensate drain pipe, an exhaust shaft passing through the outer pipe, a supply fan, an exhaust fan, distribution openings, an air filter, and a duct electric heater. The adaptive three-pipe heat exchanger is additionally equipped with servo drives with dampers, temperature sensors, air velocity sensors installed on all distribution openings, an air quality sensor located in the room, a control unit that is connected to the supply fan, exhaust valve by means of signal wires. heater, servo drives, temperature sensors, air speed sensors and air quality sensor As a result of theoretical studies, confirmed experimentally (correlation coefficient R = 0.98), a method was developed and based on it an algorithm for determining the area of holes in the air duct of an adaptive three-pipe heat exchanger for livestock buildings was developed . It has been established that the distance between the holes gradually decreases to a certain value in the opposite direction of the air flow. However, there is a slight reduction in distance at the end of the heat exchanger duct due to the backflow of air that collides with the plugged end.

Comparison of the premixed flame dynamics of CH4/O2/CO2 mixtures in closed and half-open ducts

The premixed flame dynamics of CH4/O2/CO2 mixtures ignited in two duct configurations, i.e., both ends closed and half-open (open at one end and closed at the opposite end), were investigated. The influence of the combustion-generated gas compression on the chemical kinetics was analyzed. The results show that CH4/O2/CO2 mixtures formed thrice distorted tulip flames (DTF) in the closed duct. The shortened time scale β impairs the interaction between the flame front and the Rayleigh-Taylor instability, resulting in the gradual reduction of the flame distortion degree. Moreover, the deeper primary cusps generated by the stronger Darrieus-Landau instability is favorable for forming a distorted tulip flame with more times of distortions. The duct configuration exerts a significant influence on the relationship between the maximum flame velocity (Vmax) and pressure (Pmax) versus the peak mole fraction [H + O + OH]max. The higher flow velocity of unburned gas induced by the duct-venting and the expansion waves generated by the collapses of secondary cusps as an additional contribution promote the flame velocity for the half-open duct and the pressure rise for the closed duct, respectively. In addition, R1: H + O2 = O + OH exhibits the most positive effect on the laminar burning velocity Sl. R97: CH3 + H (+M) <=> CH4 (+M) and R39: HCO + OH <=> H2O + CO show the most negative influence on Sl for the oxygen fraction γ ≤ 0.45 and γ > 0.45, respectively. The gas compression owing to the pressure waves especially discernible in the closed duct inhibits [H + O + OH]max, and is further enhanced by the oxygen enrichment. This entails to a certain extent a much lower flame velocity in the closed duct as compared to in the half-open duct.

Exosomes from human induced pluripotent stem cells derived mesenchymal stem cells improved myocardial injury caused by severe acute pancreatitis through activating Akt/Nrf2/HO-1 axis

ABSTRACT Human induced pluripotent stem cell-derived mesenchymal stem cells (iMSCs) have been believed to be a promising alternative for the stem cell transplantation therapy. The exosomes (Exo) from iMSCs play an important role in several kinds of life activities. The role of exosomes from iMSCs in severe acute pancreatitis (SAP) induced myocardial injury (MI) has not been investigated. The Exo were isolated from iMSCs through differential centrifugation method. The SAP rat model was established with 5% sodium taurocholate injection into the distal end of the bilepancreatic duct. RT-PCR and western blotting were used to measure related gene expression. Masson trichrome and Sirius Red stainings were used to evaluate MI injury. Cardiac function was detected through cardiac ultrasound.Exo promoted cell viability through activating Akt/nuclear factor E2 related factors 2 (Nrf2)/heme oxygenase 1 (HO-1) signaling pathway in vitro. Exo improved MI induced by SAP through activating Akt/Nrf2/HO-1 signaling pathway. Exo improved cardiac function, and suppressed oxidative status in the SAP model. Exo increased the expression of von Willebrand Factor (vWF) and vascular endothelial growth factor (VEGF) through activating Nrf2/HO-1 signaling pathway. Our data indicated that the Exo from iMSCs could improve MI caused by SAP through activating Nrf2/HO-1 axis. These findings firstly unfold the potential application of Exo from iMSCs in treating MI induced by SAP. Abbreviations: LVEF: Left ventricular ejection fraction; LVFS: left ventricular fractional shorten; LVDd: left ventricular end-diastolic diameter; LVDs: left ventricular end-systolic diameter; MI: Myocardial infarction; MSCs: Mesenchymal stem cells; iPSCs: Human-induced pluripotent stem cells; SAP: Severe acute pancreatitis; iMSCs: iPSCs derived VEGF: MSCs; vascular endothelial growth factor; Nrf2: Nuclear factor erythroid 2-related factor; RT-PCR: Real-time polymerase chain reaction; HE: Hematoxylin-eosin; MODS: Multiple organ dysfunction syndrome; PI3K: Phosphatidylinositol 3-kinase; SOD: Superoxide dismutase; FBS: Fetal bovine serum; ECL: Enhanced chemiluminescence; IHC: Immunohistochemistry.

Outcome of monocanalicular intubation for complex congenital nasolacrimal duct obstruction: the role of age.

Objective: Complex congenital nasolacrimal duct obstruction (CNLDO) is caused by pathologies other than the typical incomplete perforation of the thin membrane in the distal end of the nasolacrimal duct (NLD). Our purpose was to determine the success of silicone tube insertion for such complex CNLDO cases.Methods: Children who met the defined criteria for complex CNLDO and underwent monocanalicular silicone tube insertion between April 2016 and December 2020 were included. The tube was retained for 6-8 weeks and the final outcome was measured 3-4 months after tube removal. If the patients were totally symptom free, the outcome was recorded as complete success. Acceptable outcome was defined as Munk score ≤ 1 (requiring less than twice daily dabbing) and others were classified as failed.Results: Initially, 147 eyes of 132 patients underwent NLD intubation. However, after exclusion of the 11 cases with spontaneous tube extrusion (7.48%), 136 eyes of 121 patients entered the final analysis. The mean age was 23.9 ± 13.0 months (range 8-73 months). The outcome was complete success in 100 eyes (73.5%), acceptable in 16 (11.8%), and failure in 20 eyes (14.7%). The differences in the outcome of the procedure for the eyes based on history of previous probing and age was not statistically significant.Conclusions: NLD intubation with monocanalicular stent is effective in the resolution of complex CNLDO in 85% of cases. This procedure is associated with infrequent complications, like tube loss. The success is not negatively affected by older age and previously failed probing history.Abbreviations: CNLDO = congenital nasolacrimal duct obstruction, NLD = nasolacrimal duct

Multi-institutional study of long-term outcomes of a ventral versus lateral approach for mandibular and sublingual sialoadenectomy in dogs with a unilateral sialocele: 46 cases (1999-2019).

To compare the long-term outcomes of a ventral versus lateral surgical approach for mandibular and sublingual sialoadenectomy in dogs with a unilateral sialocele. 46 client-owned dogs. Medical records of dogs that underwent unilateral sialoadenectomy between 1999 and 2019 were retrospectively reviewed, and information was collected regarding signalment, clinical signs, historical treatment, swelling location, diagnostic imaging findings, sialoadenectomy approach, adjunctive treatments, intraoperative complications, hospitalization time, postoperative complications, recurrence, and contralateral sialocele development. There were no significant differences in incidences of intraoperative complications, recurrence, or postoperative complications between dogs in which a lateral versus ventral approach was used. Clinically important intraoperative complications included iatrogenic tears in the oral mucosa, ligature slippage from the duct end, hemorrhage, and possible lingual nerve transection. Surgical experience was associated with the likelihood that intraoperative complications would develop. Suspected recurrence was reported in 2 of 26 (8%) dogs that underwent a lateral approach and 2 of 12 (17%) dogs that underwent a ventral approach. Hospitalization time was significantly shorter with the lateral approach than with the ventral approach. Postoperative complications had a short-term onset and occurred in 4 of 25 (16%) dogs that underwent a lateral approach and 3 of 12 (25%) dogs that underwent a ventral approach. Age and presence of a pharyngeal sialocele were associated with development of postoperative complications. Long-term outcomes for ventral and lateral approaches to sialoadenectomy were favorable and appeared to be comparable. Further prospective study into potential associations of sialoadenectomy approach, age, and pharyngeal sialoceles on outcome is needed.

Mix Laparoscopic and Endoscopic Bile Duct Repair

Common bile duct injuries are serious and challenging surgical complications. These Complex injuries are most often a consequence of laparoscopic cholecystectomy. Most of the time, proper management requires a skilled and experienced hepatobiliary surgical team. We develop a mixed technique for a bile duct injury, type E2 Strasberg classification. First, we have to study the patient with ERCP, MRCP. Most of the time we receive patients with this type of injury from other hospitals. After determining the type of injury and the possibility of performing this technique, we perform an ERCP, installing a guidewire in the proximal bile duct end. Then we perform laparoscopic surgery, finding the distal end of the bile duct and progressing the guidewire previously installed, from the proximal to the distal end of the bile duct. Then we put a biliary stent through ERCP, in the bile duct and approximate the bile duct with 5-0 absorbable suture. Finally, we install a drain in the subhepatic space; remove the trocars, and finish the surgery. We obtain good results using this novel technique, which we think is feasible to perform and brings our patients the opportunity to access more easily to the bile ducts if there is any complication.

Laparoscopic lithotripsy and lithotomy of impacted stone at the terminal end of the common bile duct using a laparotomy biliary lithotomy spoon: A case report.

Introduction and importanceEndoscopic intervention is considered first-line therapy for common bile duct (CBD) stones, in recent times. However, surgically altered anatomy and consequent inaccessibility of the duodenal papilla necessitate surgery in some patients.Case presentationA 61-year-old woman presented with fever and right subcostal pain. She underwent total gastrectomy and Roux-en-Y reconstruction for gastric ulcer, 4 years prior to presentation. Based on the clinical findings, she was diagnosed with acute obstructive cholangitis secondary to a CBD stone. Endoscopic retrograde biliary drainage was attempted; however, the duodenal papilla was endoscopically inaccessible owing to the previous Roux-en-Y reconstruction, and we performed percutaneous transhepatic gallbladder drainage (PTGBD). She underwent laparoscopic cholecystectomy and choledocholithotomy, 6 days after the PTGBD. Choledocholithotomy was attempted using basket forceps under choledochoscopic guidance; however, this procedure was unsuccessful, and we performed laparoscopic choledocholithotomy using a laparotomy biliary lithotomy spoon.Clinical discussionUsually, laparoscopic cholecystectomy concomitant with CBD exploration is performed in patients with an endoscopically inaccessible duodenal papilla. However, an inadequately opened basket may not capture large impacted stones at the duodenal end of the CBD. Intraductal shock wave lithotripsy (electrohydraulic or laser lithotripsy) is considered in such cases; however, the specialized instruments required for this procedure are unavailable at all centers. Laparoscopic choledocholithotomy using a laparotomy biliary lithotomy spoon may be useful to overcome this surgically challenging situation.ConclusionA laparotomy biliary lithotomy spoon is a simple, user-friendly, and economical device that may be useful for laparoscopic lithotripsy and lithotomy of impacted stones.

Changes of farnesoid X receptor and Takeda G-protein coupled receptor 5 following biliary tract external drainage in hemorrhagic shock.

Since biliary tract external drainage (BTED) is increasingly used to treat patients with shock, it is necessary to clarify pathophysiological changes following BTED in hemorrhagic shock (HS). The present study aimed to investigate the effect of BTED on farnesoid X receptor (FXR) and Takeda G-protein coupled receptor 5 (TGR-5) expression in HS. A total of 24 Sprague-Dawley rats were randomly allocated to sham, BTED, HS and HS + BTED groups. Rat models of HS were induced by drawing blood from the femoral artery until a mean arterial pressure of 40±5 mmHg was achieved and maintained for 60 min. Rat models of BTED were induced by inserting a catheter into the bile duct. The distal end of the bile duct was ligated, and the catheter was passed through the rat flank to allow external collection of bile. Reverse transcription-quantitative PCR, western blotting and immunohistochemistry were performed to detect changes in expression levels of FXR and TGR-5 in the jejunum, ileum and liver. Expression levels of FXR and TGR-5 increased significantly in jejunum and liver following HS (P<0.05). BTED significantly decreased expression levels of FXR in the liver (P<0.05) and TGR-5 in the jejunum, ileum and liver (P<0.05). In conclusion, expression levels of FXR and TGR-5 increased in HS but BTED decreased expression levels of FXR and TGR-5 in HS.

Study on Methane Distribution in the Face Zone of the Fully Mechanized Roadway with Overlap Auxiliary Ventilation System

An overlap auxiliary ventilation system is very often used for driving roadways in methane-rich coal seams. An overlap zone between the outlets of the forcing duct ends with a whirl flow air-duct (WFAD) and the exhaust duct ends with a dust scrubber that is created by applying the overlap system. This study examines the distribution of methane concentrations at various distances in the overlap zone. Maintaining a long overlap zone could increase the advance of the face. Therefore, the impact of overlap zone length on the methane concentration distribution, in and beyond the overlap zone, is investigated. The evaluation of methane concentrations is performed utilizing a well-established computational fluid dynamics (CFD) approach. The mathematical model of methane emissions into the roadway is adopted. Moreover, the CFD model is validated. A vortex of the return air, caused by the free airstream flowing out of the dust scrubber, is found. This air vortex is responsible for higher methane concentrations at the end of the overlap zone. Therefore, the conclusion can be drawn that maintaining the length of the overlap zone at 5 m to 10 m should be done to control permissible methane concentrations.

S1694 IgG4-Related Sclerosing Cholangitis - An EUS Diagnosis

Introduction: Sclerosing cholangitis is a heterogenous disease associated with choledocholithiasis, biliary tumor or infection. The participation of IgG4 subclass in the pathology of sclerosing cholangitis is typically associated with autoimmune pancreatitis (60%), sialadenitis (34%), tubulo-interstitial nephritis (23%) and peri-aortitis (20%). Isolated lower duct IgG4 related sclerosing cholangitis (IgG4-Sc) is extremely uncommon and we present one such rare case. Case Description/Methods: A 73-year-old former smoker presents with complaints of yellowish discoloration of the skin and decreased appetite for a month. He has lost 44 lbs and endorses diarrhea. His family history is remarkable for lung cancer and kidney disease. Laboratory data shows cholestatic jaundice- total bilirubin of 14.2 mg/dL, AST 61 U/L, ALT 60 U/L and Alkaline phosphatase 328 U/L. CT Abdomen and Pelvis shows intra and extra-hepatic biliary ductal dilatation with common bile duct distension up to 1.4 cm. Subsequent MRCP notable for focal wall thickening involving the mid and lower portion of the common bile duct causing severe stenosis, concerning for CBD malignancy. ERCP shows proximal dilatation of the CBD with stricture of the distal end of bile duct. Biopsies obtained from the stricture were negative and tumor markers showed CEA 2.4 and CA 19-9 212. ANA screen was positive with high DsDNA antibody and elevated IgG4 at 761 mg/dL. Serum lipase was normal, anti-smooth muscle antibody and anti-mitochondrial antibody were negative. He subsequently underwent EUS/ERCP, and the CBD stricture and peri-portal lymph nodes were biopsied. Pathology from CBD stricture showed fibrosis and chronic inflammation with increased IgG4 positive plasma cells by immunohistochemistry. Hence, the patient was diagnosed with IgG4-related sclerosing cholangitis and initiated on 40 mg of Prednisone. Discussion: IgG4 related disease is a multiorgan fibro-inflammatory disease that involves infiltration of IgG4 positive plasma cells into multiple organs. IgG4-Sc is observed in elderly men who present with obstructive jaundice. HISORt criteria is used to make the diagnosis and was initially designed for diagnosis of autoimmune pancreatitis. Radiographically, Type 1 IgG4-Sc involves stenosis of only the lower bile duct and may resemble cholangiocarcinoma. Additionally, IgG4 levels may be normal further confounding the diagnostic picture. A high degree of clinical suspicion and biopsy (via EUS guidance or cholangioscopy) is imperative in making a diagnosis.Figure 1.: Endoscopic ultrasound revealing pancreatic body pseudocyst measuring 11x10 cm in diameter.

Design and Optimization of Centralized Pneumatic Fertilizer Transporting System for Deep Fertilization Device in Paddy Field

To improve the airflow distribution consistency of each branch in the pneumatic fertilizer transportation system, so as to reduce the influence of airflow instability on the uniformity and stability of fertilizer transportation, as well as the energy waste in the process of pneumatic fertilizer transportation, a centralized pneumatic fertilizer transportation system for deep fertilization device was designed. Through theoretical calculation, the needed air flow rate, airflow speed and fertilizer pipe diameter of the system were obtained, and the fan was selected. Based on the Fluent simulation and bench tests, the influence of three air distribution method of placing fan at the end of main duct, placing fan in the middle of main duct and centralized air distribution on the airflow velocity and consistency of each branch was analyzed. The results showed that the airflow consistency of each branch in the centralized air distribution method was the best. Taking the air velocity at the outlet of each branch and its variation coefficient as the evaluation index, single factor and orthogonal simulation tests was carried out to optimize the structural parameters of centralized air distribution device. The simulation results showed that the primary and secondary factors affecting the air distribution consistency were: A (sidewall inclination angle), B (branch diameter), C (branch distance), A×B (interaction between A and B), B×C (interaction between B and C), A×C (interaction between A and C), and all the factors and their interactions had significant effects. The best parameter combination was sidewall inclination angle 15°, branch diameter 32 ㎜, branch distance 43 ㎜. With the combination, the variation coefficient of airflow velocity was 0.27% in simulation test and 1.23% in bench test. This research optimized the structure and parameters of pneumatic fertilizer transporting system, and provided references for the design and optimization of pneumatic fertilization and seeding device.