简介：摘要Endoscopic ultrasound (EUS) has both diagnostic and therapeutic clinical applications. This review article focuses on recent advances in two commonly performed procedures: EUS-guided tissue acquisition and EUS-guided drainage. There is a shift from acquiring aspirates for cytology to obtaining tissue cores for histological diagnoses and molecular analyses. There is growing interest and research about artificial intelligence in EUS. Artificial intelligence may potentially be useful to guide clinical decision making if biopsy results are non-diagnostic. The range of EUS-guided drainage procedures has expanded. EUS-guided drainage of walled-off pancreatic fluid collections is an accepted first line treatment option. EUS-guided palliative drainage of malignant biliary obstruction after unsuccessful endoscopic retrograde cholangiopancreatography (ERCP) is now an accepted alternative to percutaneous transhepatic biliary drainage. EUS-guided gallbladder drainage for management of acute cholecystitis is now a preferred option over percutaneous cholecystostomy for non-surgical candidates. Other EUS-created gastrointestinal anastomoses such as EUS-guided gastroenterostomy in the context of gastric outlet obstruction, and EUS-directed transgastric ERCP for Roux-en-Y gastric bypass are now technically feasible, but further prospective randomized studies are needed to establish the actual clinical impact.

简介：AbstractTransoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) is a recently described surgical technique where the thyroid and central neck can be accessed without a cutaneous incision. To date nearly 700 cases have been described within the English literature demonstrating the feasibility, safety, and efficacy of the technique. As more institutions begin to adopt the surgical approach, it is important that surgeons pay close attention to appropriate patient selection and surgical optimization to prevent experience-related complications. A valuable tool to facilitate these considerations is the utilization of surgeon-performed ultrasonography (US). While the merits of surgeon-performed US are well-documented within head & neck endocrine surgery as a whole, its value may be of even greater importance when implementing a novel surgical technique such as TOETVA. Here we highlight and summarize the role of surgeon-performed US within head & neck endocrine surgery, focusing on how it may influence patient selection and surgical planning with TOETVA.

简介：瞄准：为了评估胰腺的织物的组织学的评估的诊断精确性，一个修改方法为恢复并且处理内视镜的超声(EUS)获得的样品指导了好针渴望(FNA)在胰腺的固体的鉴别诊断的材料集中。方法：有胰腺的群众的62个连续病人有希望地被学习。EUS被线性扫描PentaxFG-38UX回响内诊镜执行。三FNA(22G针)在每个过程期间被执行。与第一和第二根刺获得的材料为cytological学习被处理。第三根刺的材料被盐溶液的小心的注射通过针为摩尔答案恢复进10%，并且为组织学的学习处理了。结果：一些为组织学的分析获得的核心标本是6.5+/-5.3公里(范围1-22公里)。Cytological和组织学的样品在51被看作足够(82.3%)并且52个盒子(83.9%)分别地。为恶意的诊断的胰腺的细胞学和组织学的全面敏感是68.4%。与细胞学相反，组织学能诊断除煽动性的群众的腺癌，和所有情况以外的瘤。细胞学和组织学的联合允许在56种情况(90.3%)中获得一件足够的样品，与84.21%的全球敏感，100%的特性和90.32%的全面精确性。复杂并发症率是1.6%。结论：为组织学的检查的足够的胰腺的核心标本能被指导EUS的FNA获得。这种技术为胰腺的瘤的不同类型和良性的疾病的评估的诊断主要是有用的。

简介：Middleearsurgeryisusuallyperformedusingasurgicalmicroscope.Initially,inotorhinolaryngologypractice,endoscopeswereusedforparanasalsinussurgeries.Itwasonlylaterthattheywereappliedintheareaofotology.Inotologicsurgeries,endoscopeswerefirstusedtovisualizethemiddleear,beforebeingusedtoassistwithvisualizationofinstrumentsduringcholesteatomasurgeries,althoughtheyarestillnotusedaloneinvariousotologicsurgeries.Asinothersurgicalfields,thereisalsoatrendtowardsminimallyinvasiveinterventioninthefieldofotorhinolaryngology.Smallerincisionsperformedundertheguidanceofendoscopesarepreferredoverconventionallargeincisions.Usingthisapproach,improvedoutcomescanbeachievedandpostoperativemorbiditiescanbereduced.Inaddition,theoutcomesofgraftsperformedusingtheendoscopicapproacharesimilartothatachievedbythemicroscopicapproach.Therefore,endoscopicearsurgeryimplementationsarebecomingincreasinglypopular.

简介：现在的学习是为检测HIFU调查微分成像方法(高紧张集中了超声)导致的损害和为有木头的损害评估的变细的变化的评价光谱差别算法。在vitro的牛的肌肉和肝的实验结果被获得。为损害察觉的几个算法-绝对差别(广告)，加绝对差别(悲伤)并且加摆平的差别(SSD)-与几种窗户尺寸和阀值价值被分析。当时，三个变细参数与相比评估织物的度损坏。它被发现吝啬的变细的那个变化()是一个有效参数评估损害。

简介：AbstractBackground:Endoscopic ultrasound (EUS)-guided transmural drainage for pancreatic fluid collections (PFCs) has become the first-line treatment with quicker recovery and more minor injury compared with surgery and percutaneous drainage. The efficacy of stents implantation and drainage for different PFCs remains controversial, especially lumen-apposing metal stents (LAMS). This study aimed to compare the efficacy and safety of LAMS drainage for pancreatic pseudocysts (PPC) and walled-off necrosis (WON).Methods:A meta-analysis was performed for LAMS drainage for WON and PPC by systematically searching PubMed, Cochrane, and Embase databases from January 2010 to January 2020. From 2017 to 2019, 12 patients who were treated with LAMS drainage for PFCs in our medical center were also reviewed and included in this study.Results:Combining 11 copies of documents with the data from our medical center, a total of 585 patients with PFCs were enrolled in this meta-analysis, including 343 patients with WON and 242 with PPC. The technical success rate in WON is not significantly different from that of PPC (P = 0.08 > 0.05). The clinical success of LAMS placement was achieved in 99% vs 89% in PPC and WON, respectively (RR = 0.92, 95% CI: 0.86-0.98, P = 0.01 < 0.05). The further intervention of direct endoscopic necrosectomy was required by 60% of patients in WON group. There was no significant difference in the incidence of adverse events, including infection, bleeding, stent migration and stent occlusion, after LAMS placement between WON and PPC.Conclusions:Endoscopic ultrasound-guided LAMS for PFCs are feasible, effective with preferable technical and clinical success rates. The clinical effect of LAMS on PPC is slightly better than that of WON, but its adverse reactions still need to be verified in a large-sample prospective study.

简介：ThisworkisconductedinMansouraUniversityHospitals,Egypt,toshowtheadvantagesanddisadvantagesofendoscopicstapedotomyincomparisontomicroscopicstapedotomy.Theworkdescribedhasnotbeenpublishedpreviouslynorunderconsiderationforpublicationelsewhere.Theauthorsdeclarethatthereisnoconflictofinterest.ThisstudyisapartofamasterdegreethesissubmittedbyEslamMahmoudaspartialfulfillmentforamasterdegree.Institutionalreviewboardapproval,FacultyofMedicine-MansouraUniversity,wasobtainedforthestudy(IRB:MS/15.09.49).

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简介：为了更方便地并且更快速理解超声图象的内容，在这份报纸，我们建议一个coarse-to-fine超声图象captioning整体模型，它能自动地产生由相关n克构成在超声图象描述疾病信息的注解文章。首先，在超声图象的机关被粗糙的分类模型检测。第二，超声图象被相应有细密纹理的分类模型根据机关标签编码。最后，我们输入编码向量到产生模型自动地产生的语言产生模型，和语言在超声描述疾病信息的注解文本想象。在我们的实验，编码模型能在超声图象识别获得高精确性率。并且语言产生模型能自动地产生高质量的注解文本。在实际应用，coarse-to-fine超声图象captioning整体模型能帮助病人和医生获得很好超声图象的内容理解。

简介：Ultrasound(US)-inducedcavitationisaneffectivewayinoxidizingorganiccontaminantsinwastewatereitherastheindependentoperationunitorincombinationwithotheroxidationmethods.Inthispaper,blackliquorandfiltrateafteracidifyingandsettlingweresonicated.Theeffectofworkingparametersonultrasonicdegradationofblackliquor,suchasdifferentcombinationmethods,frequency,powersupply,initialconcentration,pH,durationtime,ionicstrengthandcatalystwerestudied.Theresultswereasfollows:(1)Attheconditionsof40kHz,100W,4h,pHat6andtemperature30±2℃,utilizingUS/US-H2O2/US-Fenton,weak-orangefiltrateturnedtocolloidwiththeincreaseoftimeandlittlesedimentproducedaftersettling.EspeciallyfiltratecametobemilkwhitecollidesandupperwaterapproachedtonearlyachromaticbyUS-Fenton.ComparedwiththeUS,US-H2O2/US-FentonCOD(Chemicaloxidationdemand)removalratiocanincrease15%,30%respectively.Becauseofmorehydroxylradicalsproducedinthereactionprocess;(2)Attheconditionof100Wand4h,thedegradationefficiencyofblackliquorwasbetterat40kHzoverat20kHz.Moreoverblackliquorcanbebiodegradedeasily.Thosebasedonthatthebigmoleculeofcontaminantsinaqueoussolutioncanbechangedintothelittlemoleculewithultrasound(3)Attheconditionof40kHzand4h,theCODremovalratioofblackliquorwasmorehigherat60Wthanat80W,whiletheremovalratioofCODat60Wwasnearlyclosetotheratioat100W;(4)Theinitialconcentrationofblackliquorinfluencedtheeffectofsonochemicaldegradation;(5)ThevariationofpHhadnoeffectondegradation;(6)Thelongerthedurationtime,thegreatertheremovalratioofCOD.Butthisratioincreasedslowlyafter4h;(7)Adding0.2g/LNaCltochangetheionicstrengthoftheblackliquor,theCODremovalratiocanincrease10%;(8)ThedegradationratesincreasedbythecoexistentcatalystsofTiO2,Co2+andAg+.

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简介：AbstractThe surgical approach to lesions of the ventral craniovertebral junction (CVJ) has evolved significantly in the last several years with the advent of endoscopic skull base surgery. Differing pathologies of the CVJ can result in irreducible compression of the cervicomedullary region. The endoscopic endonasal approach lends itself well to this region due to the ventral location, and while there is a steep learning curve, is a safe and effective way to perform decompression of the cervicomedullary region. Herein, we discuss the anatomy of the CVJ, preoperative evaluation and surgical considerations, our surgical approach, complications, and outcomes.

简介：OBJECTIVETodeservetheeffectsofFG(FibrinGlue)onendoscopicliposuction.Methods:FromOct.1998toAug.2000fortycaseswereundergoingfortheliposuction.Attheaidsoftumescentteachnique,endoscopyandFGwereused,ofwhich20casesoperationontheirabdominalwalls,8casesupperabdomenwallsand12casesownerabdominal.

简介：Endoscopicsubmucosaldissection(ESD)inventedinJapan,playsanimportantroleinthetreatmentofearlygastrointestinalcancer(EGC)anddysplasia.Endoscopicproceduresarenowwidelyspreadingaroundtheworld.ESDhastheadvantagethatenblocresectionaswellaspathologicalviewcanbeachievedwhencomparedwithconventionalendoscopicmucosalresection(1).Thankstothe

简介：AbstractObjective:The aim of this study was to analyze the outcomes and complications of endoscopic tympanoplasties and review the strategies for endoscopic revision surgeries.Methods:Revision endoscopic surgeries are performed on patients with unsatisfactory outcomes after endoscopic tympanoplasties. This study was approved by the Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China (approval No. 2020-0045-1).Results:Residual or recurrent tympanic membrane marginal perforation is treated by autogenous fat and cartilage grafting; graft collapse is treated using tissue from the tragus; and graft displacement is treated by endoscopic fixation of the cartilage-perichondrium complex. Lateral healing of the tympanic membrane, prosthesis fracture, prosthesis extrusion, middle ear adhesions, and recurrent perforation also required revision surgeries.Conclusion:Residual or recurrent tympanic membrane marginal perforation is the most common cause of unsatisfactory outcomes after endoscopic tympanoplasty; fat grafting is effective only for small perforations. Small cartilage grafts are an effective means of dealing with residual marginal perforation; the cartilage and perichondrium complex should be fixed securely. Patients with prosthesis implants require regular examination.

简介：AbstractEndoscopic endonasal orbital surgery is evolving. With increasing knowledge, expertise, and technology, the historical limits of the endonasal endoscopic approach to the orbit have been redefined. This review discusses the clinical presentation and etiology, and highlights the pertinent anatomy, and discusses the diagnostic workup and surgical approach to orbital tumors and post-operative care. The role of the multidisciplinary team is not to be underestimated. The introduction of a classification system to ensure standardization of technical difficulty and outcome data will assist with international collaboration and further consolidate our attainment of knowledge in this developing field.

简介：Duodenalpolypsorlesionsareuncommonlyfoundonupperendoscopy.Duodenallesionscanbecategorizedassubepithelialormucosally-based,andthetypeoflesionoftendictatesthework-upandpossibletherapeuticoptions.Subepitheliallesionsthatcanariseintheduodenumincludelipomas,gastrointestinalstromaltumors,andcarcinoids.Endoscopicultrasonographywithfineneedleaspirationisusefulinthecharacterizationanddiagnosisofsubepitheliallesions.Duodenalgastrointestinalstromaltumorsandlargeormultifocalcarcinoidsarebestmanagedbysurgicalresection.Brunner＇sglandtumors,solitaryPeutz-Jegherspolyps,andnon-ampullaryandampullaryadenomasaremucosally-basedduodenallesions,whichcanrequireremovalandaretypicallyamenabletoendoscopicresection.Severalanatomiccharacteristicsoftheduodenummakeendoscopicresectionofduodenallesionschallenging.However,advancedendoscopictechniquesexistthatenabletheresectionoflargemucosally-basedduodenallesions.Endoscopicpapillectomyisnotwithoutrisk,butthisprocedurecaneffectivelyresectampullaryadenomasandallowspatientstoavoidsurgery,whichtypicallyinvolvespancreaticoduodenectomy.Endoscopicmucosalresectionanditsvariations（suchascap-assisted,cap-band-assisted,andunderwatertechniques）enablethesafeandeffectiveresectionofmostduodenaladenomas.Endoscopicsubmucosaldissectionispossiblebutverydifficulttosafelyperformintheduodenum.

简介：粉末的超声的microfeeding是为在稳固的freeforming和药品的dosing的使用的一个新、有希望的方法。在这个工作，用超声的颤动的控制计算机的microfeeding系统一毛状被造。流动和切换的控制的大量控制的、稳定的率在声学的颤动系统被完成，一致粉末剂量在超声的系统被获得。试验性的结果证明那条嘴直径，传播液体深度，波形，电压振幅，频率和摆动持续时间都影响剂量团。在这些之中，因素，嘴直径，电压振幅和摆动持续时间能是过去常控制剂量团的最好。一种人工的神经网络(ANN)技术被使用预言剂量团。基于这些研究结果，microfeeding的四种类型被建议。

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简介：AbstractEndoscopic drainage of pancreatic fluid collections (PFCs) with fewer complications and less trauma has gradually replaced surgery or percutaneous drainage to become the first-line treatment for PFCs. In recent years, the differential efficacy of various stent techniques to drain different types of PFCs has been controversial. This review summarizes the clinical applications of endoscopic ultrasound-guided stent placement for PFCs drainage.