Challenging the Limits
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最后的冲刺——365天辟⾕最后的15天(中英⽂对照版)最后的冲刺——365天辟⾕/最后的15天原创:陈⽲塬⼗堰市武当养⽣堂 2019年2⽉25⽇The final sprint - the last 15 days of 365- days (bigu辟⾕) fastingOriginal: Chen Heyuan(陳⽲塬), Shiyan Wudang Health Hall (⼗堰巿武當養⽣堂) Feb. 25, 2019翻译:李张奥(欧洲)1. 辟⾕是道家的⼀种苦修⾏,英⽂⾥虽然定义为fasting,但是并没有完全准确的诠释辟⾕的真正内涵,因为fasting只是简单的断⾷,即不吃任何的⾷物。
道家的辟⾕并不是简单的不吃⾷物,⽽是有⼀定的内功修⾏和辅助的⽅法,如“餐风饮露”和导引及服⾷外丹(⾦丹或草⽊丹)来配合,以增强辟⾕的效果和安全性,道家的术语叫内丹的修炼。
道家的辟⾕,从易到难也分为若⼲等级,⽐如,半辟⾕(可以吃⼀点蔬菜和⽔果),全辟⾕(不吃任何⾷物),全辟⾕加辟⽔(最后连⼀滴⽔也不能喝);或初关(七⽇)、中关(40⽇)、上关(100⽇以上);或强制性辟⾕(前述均为强制性辟⾕,也叫⼈为辟⾕)、⾃然辟⾕(修炼内丹达到“⽓⾜不思⾷”的状态⾃然出现的辟⾕现象)等。
⽽本⼈此次尝试的,就是道家最严酷的365天强制性辟⾕体验。
Bi gu(辟⾕) is a kind of ascetic practice of Taoism. Although it is defined as fasting in English, the word ‘fasting’ does not completely explain the true meaning of Bi gu, since fasting is simply a behavior that people do not eat any food but can drink water during a period of time. However, Bigu is not only about eating nothing, but also requiring participants to do certain specialized exercise of Qigong, a process that could also be facilitated by some auxiliary techniques, such as taking energy from wind and dew in the nature, and eating some alchemical medicine to enhance the effect and safety of Bigu.Bigu can be divided into several levels from easy to difficult. For example, on the entry level (semi- fasting), participants can eat a little vegetables and fruits. On the medium level (complete fasting), participants cannot eat any food. On the advanced level (complete fasting without drinking water), people cannot eat and drink anything at all. In addition, based on the days of the acetic practice, Bigu can be divided into 7 days, 40 days and more than 100 days. In this article, I will introduce my 365 days acetic practice experience of Bigu, which is one of the most difficult practice in Taoism.2. 今天,是我实修(亲⾝体验,⽽不是光说不练或者只是指导、观摩别⼈修炼)辟⾕上关的第350天。
The future is a canvas,vast and uncolored,waiting for the strokes of the brave to bring it to life.As we stand on the precipice of the new era,it is the courageous hearts that will chart the course and venture into the unexplored realms of tomorrow.Embracing the future means stepping out of our comfort zones and daring to dream.It is the innovators and the risktakers who will shape the world we live in.They are the ones who will push the boundaries of science,technology,and human understanding.By questioning the status quo and challenging the limits of what we believe is possible,they pave the way for progress and advancement.The journey into the future is not without its obstacles.It is fraught with uncertainty and the unknown.Yet,it is the very essence of human spirit to confront these challenges headon.We must equip ourselves with the knowledge and skills necessary to navigate the complexities of the modern cation is the key that unlocks the door to the future, providing us with the tools to innovate,create,and lead.As we venture into the future,we must also cultivate a sense of adaptability and resilience.The world is constantly evolving,and we must be prepared to adapt to these changes.This requires a mindset that is open to new ideas and willing to learn from our experiences.It is through this continuous process of growth and selfimprovement that we can truly thrive in the future.Moreover,the path to the future is a collective journey.It requires collaboration and unity among individuals,communities,and nations.We must work together to address the global challenges that we face,such as climate change,poverty,and inequality.By pooling our resources,knowledge,and expertise,we can create a more sustainable and equitable world for future generations.In conclusion,the future is a frontier that awaits the brave and the determined.It is a realm of endless possibilities,where the only limit is our imagination.As we embark on this journey,let us be guided by our courage,our curiosity,and our collective spirit. Together,we can create a future that is brighter,more inclusive,and more prosperous for all.。
中国式现代化道路演讲稿三分钟英语三篇中国式现代化道路演讲稿三分钟英语精选三篇We must adhere to the prehensive leadership of the Party as the fundamental guarantee. The report of the 20th CPC National Congress pointed out that Chinese path to modernization is a socialist modernization led by the CPC. We must implement the leadership of the Party in all fields and links of educational activities, and continuously strengthen and improve the Party"s leadership over the education cause. On the one hand, it is necessary to strengthen the Party"s ideological and political leadership over the education industry, always adhere to the guiding position of Marxism, integrate ideological and political work throughout the entire process of school education management, focus on building a "three prehensive education" system, and promote the ideological and political curriculum to go hand in hand with the ideological and political curriculum. On the other hand, it is necessary to strengthen the Party"s organizational leadership over the education industry. Party mittees at all levels should regard strengthening the prehensive leadership of education work as an important responsibility, and place the development of education in an important position.Placing innovation at the core of China"s modernization construction is of great strategic and global significance. Only innovation can achieveendogenous driving force, and only by relying on connotative growth can we ensure high-quality development. In the past decade, strategic emerging industries such as manned spaceflight, puter and quantum information have made significant achievements, and China has entered the ranks of innovative countries. Tianhe puting has achieved breakthroughs from billions to billions, and then to billions. Continuously challenging the limits of puting speed has also e a microcosm of China"s technological self-reliance and self-reliance. Through independent innovation and achievement transformation, China has successively established the world"s first thousand kilometer quantum secure munication Beijing-Shanghai trunk line, and launched the world"s first quantum science experimental satellite, Mozi, which has propelled us into the world"s first tier in the field of quantum.Always adhere to deepening the reform of the talent development system and mechanism. To establish a scientific and market-oriented talent evaluation and incentive system, and to leverage the active role of employers in talent cultivation, introduction, and use; To fully leverage the dual incentive effects of economic interests and social honor values, so that talents can have benefits, honor, and status in innovation and creation; We need to create an atmosphere of respect for talents, openness and inclusiveness, create a fairer and broader platform for work and entrepreneurship, and fully respect and realize the value of talentsthemselves.The magnificent journey inspires people to move forward, and the blueprint for rejuvenation inspires people"s hearts. Chinese path to modernization is also a modernization with world significance. We will unswervingly follow the path of Chinese path to modernization, secure China"s own future and destiny, strengthen historical self-confidence, enhance historical initiative, work hard and resolutely, and strive for greater victory and glory for the prehensive promotion of the great rejuvenation of the Chinese nation.Today, my mother and I went to the China Science and Technology Museum near the bird"s nest in Beijing. From afar, the newly built Chinese science and Technology Museum is grand and spectacular.We walked in and found that it was a four story building with a main exhibition hall and an attached hall. Among them, the main exhibition hall is divided into four exhibition halls according to the Chinese light, exploration and discovery, science and life, challenge and future theme, which has many exhibits and large area, which is really breathtaking. I often go to the Tianjin Museum of science and technology, in contrast, is simply pale into insignificance by parison.modernization will bring a number of benefits to the chinese people. advances in science and technology will resnlt in better industrial and consumer products. new roads, tracks and trains will improvetransportation for both people and goods. with new health care methods people will live happier and longer.however, modernization also gives rise to a number of new problems. pollution of the air, land, and water has e a serious problem in many parts of china. an increase in vehicles on the roads has also caused more traffic accidents with more injuries and deaths.we can, however, deal with these problems if we are careful. we can train many environmental scientists who can help factories operate cleanly. we can pass new laws to regulate our traffic more safely. finally, we must improve cur education system to prepare better educated people for tomorrow.。
英语作文,我心中的珠穆朗玛峰Everest, the Mountain in My HeartTowering majestically above the world, Everest has long captured the imagination of adventurers and explorers. As the highest peak on Earth, it stands as a testament to the power and grandeur of nature, challenging the limits of human endurance and ambition. For me, Everest is more than just a mountain it is a symbol of the indomitable human spirit, a constant source of inspiration and wonder that has captivated my heart and mind.From a young age, I was drawn to the stories of those who had dared to conquer Everest. The tales of bravery, perseverance, and triumph in the face of unimaginable adversity ignited a spark within me that would only grow stronger with time. I pored over accounts of historic expeditions, marveling at the courage and determination of the climbers who had risked everything to stand atop the world.As I grew older, my fascination with Everest only deepened. I studied the mountain's geology, its treacherous terrain, and the extremeconditions that climbers face. I learned about the rich cultural heritage of the Sherpa people, whose intimate knowledge of the mountain has been integral to the success of countless expeditions. With each new piece of information, my admiration for Everest and its unique place in human history only grew.But it was not until I had the opportunity to visit Nepal and witness the grandeur of Everest with my own eyes that I truly understood the profound impact this mountain has had on my life. Standing in the shadow of the colossal peak, I was struck by its sheer scale and power, a humbling reminder of the insignificance of the human form in the face of such natural magnificence.As I trekked through the Khumbu region, following in the footsteps of legendary mountaineers, I was overwhelmed by a sense of awe and reverence. The rugged beauty of the landscape, the crisp mountain air, and the resilience of the local people all combined to create an experience that was both physically and emotionally transformative.It was on that journey that I truly came to understand the deeper meaning of Everest. It is not just a physical challenge to be conquered, but a symbol of the human spirit's capacity for greatness. Every step taken towards the summit represents the triumph of the will over the limitations of the body, a testament to the power ofdetermination, courage, and perseverance.For me, Everest has become a source of inspiration, a constant reminder that no goal is too lofty, no challenge too great, if one is willing to put in the hard work and dedication required to achieve it. When the path ahead seems daunting, I think of the countless climbers who have faced the same obstacles and emerged victorious, their stories serving as a guiding light in my own journey.But Everest is more than just a symbol of human achievement it is also a powerful reminder of the fragility of our planet and the urgent need to protect it. The effects of climate change are already being felt on the mountain, with glaciers receding and the environment becoming increasingly unstable. As a passionate advocate for environmental conservation, I am deeply committed to ensuring that Everest and other natural wonders are preserved for future generations to experience and cherish.In many ways, Everest has become a part of my identity, a constant presence in my life that has shaped my values, my aspirations, and my worldview. When I gaze upon its snow-capped peaks, I am filled with a sense of humility and wonder, a deep appreciation for the power and beauty of the natural world. And as I continue to explore and learn about this magnificent mountain, I know that my love and respect for it will only continue to grow.Ultimately, Everest is not just a physical place it is a state of mind, a symbol of the human spirit's capacity for greatness. And for me, it is a mountain that will forever hold a special place in my heart, a constant source of inspiration and wonder that will continue to guide me on my own personal journey of discovery and achievement.。
跨越再跨越的体育英语作文Surpassing Boundaries: Pushing the Limits of Human Potential in Sports.Throughout history, the realm of sports has witnessedan extraordinary lineage of athletes whose unwavering determination and indomitable spirit have transcended the confines of human limitations. These individuals have not merely achieved success; they have shattered records, redefined boundaries, and inspired generations to come.Their relentless pursuit of excellence has elevated the human experience to unparalleled heights, leaving an enduring legacy that continues to ignite aspirations and motivate countless individuals around the globe.One such luminary is the legendary track and field star, Usain Bolt. Hailing from Jamaica, Bolt emerged as a global phenomenon at the 2008 Beijing Olympics, where he captured an unprecedented triple gold in the 100m, 200m, and 4x100m relay. With his signature "Lightning Bolt" celebration,Bolt became an icon of speed and agility, transcending the boundaries of what was deemed possible in the realm of sprinting.Bolt's remarkable achievements were not simply the product of superior physical attributes. They were the culmination of years of unwavering dedication, tireless training, and an unshakeable belief in his abilities. Through countless hours on the track and in the gym, he honed his technique, pushed his body to the brink, and relentlessly pursued perfection. His legacy extends far beyond his Olympic medals; he has inspired a generation of young athletes to dream big and strive for greatness, demonstrating that with unwavering determination, anything is possible.Another athlete who has defied expectations and broken barriers is gymnast Simone Biles. The American superstar burst onto the international scene at the 2013 World Championships, where she became the first woman to win three consecutive all-around titles. At the 2016 Rio Olympics, Biles cemented her status as one of the greatestgymnasts of all time, capturing four gold medals and one bronze. Her extraordinary athleticism and innovativeroutines have revolutionized the sport, challenging the limits of human flexibility and balance.Beyond her unparalleled technical abilities, Biles is known for her resilience and strength of character. In 2021, she courageously withdrew from several Olympic events to prioritize her mental health, inspiring countlessindividuals to prioritize their own well-being. Her advocacy for mental health awareness has sparked important conversations and paved the way for a more inclusive and supportive athletic environment.The journeys of Usain Bolt and Simone Biles exemplify the transformative power of sports. Their unwavering determination, relentless pursuit of excellence, andability to overcome adversity have not only secured theirместа in history but have also inspired countless others to strive for greatness. Their legacy serves as a reminder that human potential is limitless when coupledwith unwavering belief, hard work, and the courage to pushboundaries.As we look to the future, it is imperative to foster an environment that nurtures and empowers athletes to surpass their perceived limitations. This means providing access to quality training facilities, resources, and support systems, while also fostering a culture of respect, inclusivity, and fair play. By investing in the potential of our athletes,we invest in the future of our society, creating a world where anything is possible for those who dare to dream big and work tirelessly to achieve their goals.The pursuit of surpassing boundaries in sports is not solely confined to elite athletes; it is a fundamental human endeavor that can be realized by individuals of all ages and abilities. Whether it is running a personal bestin a local race, learning a new sport, or simplychallenging oneself to step outside of one's comfort zone, the act of pushing limits fosters resilience, confidence, and a sense of accomplishment. In the words of famed mountaineer Sir Edmund Hillary, "It is not the mountain we conquer, but ourselves."As we navigate the ever-evolving landscape of sports, it is essential to embrace the spirit of innovation and creativity. Technology and advancements in training methods have the potential to unlock unprecedented levels of human performance. However, it is crucial to ensure that these advancements are harnessed in a responsible and ethical manner, with the well-being of athletes always at the forefront.In conclusion, the relentless pursuit of surpassing boundaries in sports is a testament to the indomitablespirit of humanity. Through the extraordinary achievements of athletes like Usain Bolt and Simone Biles, we are reminded that human potential is boundless when fueled by determination, hard work, and the courage to challenge the status quo. As we continue to push the limits of what is possible, let us embrace the power of sports to inspire, unite, and empower individuals around the globe to reach their full potential both on and off the field of play.。
惊讶的的英文高级词汇"Stupefying Epiphany: A Revelation of Astonishing Proportions"Article:In the annals of human history, there have been moments of profound revelation that have altered the course of civilization. These moments, often characterized by their stupefying nature, have left individuals and societies in a state of awe and disbelief. Such a revelation occurred recently, shaking the very foundations of our understanding and challenging the limits of human knowledge.The discovery, made by a team of esteemed scientists, has sent shockwaves through the scientific community. It has unveiled a truth so astonishing, so paradigm-shifting, that it has left even the most seasoned researchers dumbfounded. The implications of this revelation are far-reaching, with the potential to revolutionize ourunderstanding of the universe and our place within it.The stupefying epiphany revolves around the existence of a parallel dimension, previously thought to be purely theoretical. Through a series of groundbreaking experiments and observations, researchers have amassed irrefutable evidence of the existence of this alternate realm. The implications of this discovery are staggering, challenging the very fabric of our understanding of reality and opening up a myriad of new possibilities for exploration and understanding.The ramifications of this revelation are not limited to the realm of science. The existence of a parallel dimension has profound implications for philosophy, spirituality, and our understanding of the nature of existence itself. It forces us to confront the limitations of our perception and contemplate the vastness of the unknown.As the scientific community grapples with the implications of this stupefying epiphany, the world at large is left in a state of awe and wonder. The discoveryhas sparked a global conversation, igniting the imagination of people from all walks of life. It serves as a potent reminder of the boundless potential of human curiosity and the capacity for astonishment in the face of the unknown.In the wake of this revelation, one thing is certain: the world will never be the same. The stupefying epiphany has shattered the boundaries of our understanding, opening up new frontiers of exploration and challenging us to reevaluate our place in the cosmos. It is a reminder that, despite our advances, there is still much to be discovered and understood, and that the universe is infinitely more wondrous and mysterious than we can possibly imagine.。
Don't Limit Your Challenges, Challenge Your LimitsIn the journey of life, we often encounter obstacles that test our resilience and determination. While some may see these challenges as insurmountable barriers, others view them as opportunities to push their boundaries and achieve greatness. The mantra "Don't limit your challenges, challenge your limits" serves as a powerful reminder to embrace difficulties and use them as a catalyst for personal growth and success.One of the most inspiring aspects of challenging our limits is the discovery of our true potential. Many individuals have accomplished extraordinary feats by refusing to be confined by their circumstances. Take, for instance, the story of Michael Jordan. Despite being cut from his high school basketball team, he used this setback as motivation to work harder and hone his skills. His relentless pursuit of excellence led him to become one of the greatest basketball players of all time. Jordan's story illustrates that by challenging our limits, we can surpass our own expectations and achieve remarkable success.Challenging our limits also fosters resilience and adaptability. In a rapidly changing world, the ability to adapt and persevere is crucial. Consider the case of J.K. Rowling, who faced numerous rejections before her Harry Potter series became a global phenomenon. Instead of allowing rejection to deter her, she used it as fuel to keep going. Her resilience not only led to her achieving her dreams but also inspired millions around the world. Rowling's journey underscores the importance of viewing challenges as opportunities to grow stronger and more adaptable.Moreover, challenging our limits encourages innovation and creativity. When we step out of our comfort zones, we are forced to think differently and come up with unique solutions. The Wright brothers, for example, faced countless failures and skepticism in their quest to build a flying machine. Their unwavering determination and willingness to challenge the limits of aviation led to the invention of the airplane, revolutionizing transportation and shaping the modern world. Their story demonstrates that by daring to challenge the impossible, we can achieve groundbreaking innovations.Embracing challenges also instills a sense of purpose and fulfillment. When we set ambitious goals and strive to overcome obstacles, we experience a profound sense of accomplishment. This sense of fulfillment is exemplified by individuals like Malala Yousafzai, who, despite facing life-threatening adversity, continued to advocate for girls' education. Her courage and determination not only brought about significant change but also gave her a sense of purpose and fulfillment. Malala's example shows that by challenging our limits, we can lead meaningful and impactful lives.In conclusion, the philosophy of not limiting our challenges but instead challenging our limits is a powerful approach to life. It enables us to discover our true potential, build resilience, foster innovation, and find fulfillment. By adopting this mindset, we can transform obstacles into opportunities and achieve greatness. As we navigate the complexities of life, let us remember to embrace challenges and use them as stepping stones to reach new heights.。
Title:Rock Climbing:Challenging the Limits of SelfIntroduction:In this essay,I will explore the exhilarating world of rock climbing and how it serves as a sport that challenges individuals to push their limits and conquer physical and mental obstacles.Rock climbing is a thrilling adventure that requires strength,skill,and mental fortitude,allowing climbers to test their abilities in a vertical environment.Body:Physical and Mental Challenge:Rock climbing is a physically demanding sport that engages the entire body.Climbers must possess strength,endurance,and flexibility to navigate challenging routes and overcome obstacles.The sport also demands mental focus,problem-solving skills,and the ability to manage fear and uncertainty.Climbers are constantly challenged to find creative solutions and adapt to changing situations.Connection with Nature:Rock climbing provides a unique opportunity to connect with nature and explore breathtaking landscapes.Climbers often find themselves surrounded by stunning natural formations,such as mountains,cliffs, and canyons.The sport allows individuals to appreciate the beauty of the outdoors and develop a deep respect for the environment.Self-Discovery and Personal Growth:Rock climbing is a journey of self-discovery and personal growth.Asclimbers face difficult challenges and overcome obstacles,they gain a deeper understanding of their own capabilities and limitations.The sport teaches resilience,determination,and the importance of perseverance.Climbers often discover inner strength and confidence that extends beyond the climbing wall.Trust and Collaboration:Rock climbing often involves trust and collaboration between climbers. In rope climbing,for example,climbers rely on their belayer to ensure their safety.This partnership fosters a sense of trust and teamwork,as climbers must communicate effectively and rely on each other's skills and support.Collaboration and effective communication are vital for success in the sport.Adventure and Exploration:Rock climbing offers a sense of adventure and exploration.Climbers have the opportunity to discover new routes,explore uncharted territories,and challenge themselves in different environments.The sport allows individuals to step out of their comfort zones and embrace the unknown,leading to personal growth and unforgettable experiences.Focus and Mindfulness:Rock climbing demands focus and mindfulness.Climbers must be fully present in the moment,paying attention to their movements,the rock surface,and their surroundings.The sport requires mental clarity and the ability to block out distractions,allowing climbers to enter a state of flow and experience a heightened sense of awareness.Community and Camaraderie:Rock climbing fosters a strong sense of community and camaraderie among climbers.The climbing community is known for its supportive and inclusive nature,where climbers of all levels can come together to share experiences,knowledge,and encouragement.The sense of belonging and shared passion for the sport creates lifelong friendships and a sense of belonging.Conclusion:Rock climbing is a sport that challenges individuals to push their limits, both physically and mentally.It offers a unique opportunity to connect with nature,discover personal strengths,and foster a sense of adventure and exploration.Embracing the world of rock climbing allows individuals to challenge themselves,develop resilience,and experience personal growth while enjoying the thrill of conquering vertical challenges.。
浑源恒山悬空寺的故事和传说浑源恒山悬空寺,位于山西省浑源县恒山之巅,始建于1500多年前的北魏时期。
The Hanging Temple of Mount Heng in Hunyuan County, Shanxi Province, was built at the top of Mount Heng over 1500 years ago during the Northern Wei dynasty.悬空寺采用了雕凿岩石的独特结构,悬挂在悬崖峭壁上,是中国现存三大悬空寺之一。
The Hanging Temple adopts a unique structure carved from the rock, hanging on the steep cliffs, and is one of the three existing hanging temples in China.传说中,悬空寺建于公元5世纪,由一位叫做慧空的和尚亲手建造。
According to legend, the Hanging Temple was built in the 5th century AD by a monk named Hui Kuang.悬空寺建造时,慧空禅师曾亲自在悬崖上挥斧劈石,非常不容易。
When the Hanging Temple was built, Master Hui Kuang personally wielded an axe to cut the stones on the cliff, which was very difficult.悬空寺里供奉了佛教、道教和儒教的神祇,体现了中国传统宗教的交融。
The Hanging Temple enshrines the gods of Buddhism, Taoism, and Confucianism, embodying the integration of traditional Chinese religions.寺内有各式佛像、道家、儒家、以及众多历代文人题写的香火,敬畏万物的景象令人叹为观止。
英语经典绕口令练习大全In the realm of linguistic agility, the art of the tongue twister reigns supreme, challenging the limits of articulation and rhythm. Here, we delve into an exquisite collection of classic English tongue twisters, designed to not only hone your oral dexterity but also to ignite the spark of joy and amusement in your linguistic endeavors.Picture yourself standing on the precipice of a quaint cobblestone street, the wind whispering through the leaves of the ancient trees that line the pathway. As you begin to recite, the words dance on your lips like the flittering of butterflies in a garden of springtime."Peter Piper picked a peck of pickled peppers. A peck of pickled peppers Peter Piper picked. If Peter Piper picked a peck of pickled peppers, where's the peck of pickled peppers Peter Piper picked?"Now, envision a grand, golden field, the wheat swaying gently under the warm, sunlit sky. Listen to the rustling leaves and the distant chirping of birds as you take on the challenge of this delightful ditty: "Six sick siamese cats, sick of sick socks. Would a sick siamese cat sick of sick socks, sick a sick siamese cat of sick socks?"Imagine yourself in a bustling marketplace, the scent of fresh bread and the sound of merchants hawking their wares filling the air. Here, letyour voice carry the vibrant energy of the marketplace as you attempt this lively tongue twister:"How many hip hippos hopped on a hill? How many hip hippos hopped? How many hip hippos hopped on a hill? How many hip hippos hopped?"Stepping into a cozy, dimly lit tavern, the clinking of glasses and the laughter of patrons echo in the distance. Let your voice echo with the warmth of the tavern as you weave through this charming tale: "Sam Slick, the livery stable boy, sold shovels, shovels, and shovels. Sam Slick sold shovels, shovels, and shovels, and shovels, shovels, and shovels."In the serene tranquility of a sun-drenched meadow, listen to the gentle hum of bees and the soft rustle of grass as you tackle this enchanting tongue twister:"Fifteen fat friars fried forty fried fish. Fifteen friars fried forty fried fish, and forty friars fried fifteen fried fish."As you continue your linguistic journey, remember that each twister is not just a series of words, but a melody, a rhythm, a story waiting to be told. Let your voice become the instrument, and these tongue twisters, the music.In the world of language, there is no end to the creativity that can be unleashed. So, embrace the challenge, let your voice flow, and immerse yourself in the timeless beauty of English tongue twisters. May your recitations be as captivating as the tales of old, and as enchanting as the whispers of the wind through the trees.。
Imaging and Advanced TechnologyMichael B.Wallace,Section Editor Challenging the Limits of Esophageal ManometryPETER J.KAHRILAS,SUDIP K.GHOSH,and JOHN E.PANDOLFINODepartment of Medicine,The Feinberg School of Medicine,Northwestern University,Chicago,IllinoisA fter steady improvement until about1980,the tech-nology behind esophageal manometry saw little change until recent years.A variety of sensor technologies existed,including solid-state strain gauge transducers, circumferentially sensitive transducers,multilumen per-fused catheters with external pressure transducers,and the Dentsleeve device(Dentsleeve International,Ltd,Mis-sissauga,Ontario).However,irrespective of transducer design,the basic format of manometric studies was of multiple line tracings representing pressure change ver-sus time at several discrete esophageal loci.Furthermore, of the sensor designs available,only the Dentsleeve device provided a validated method for assessing sphincter re-laxation.However,the Dentsleeve accomplished this at the expense of pressure response rate and spatial resolu-tion,leading some experts to focus instead on these limitations.In brief,little standardization existed in methodology among centers and there was no agreement regarding optimal assembly design or study interpretation.High-Resolution ManometrySomewhat ironically,for all the attention histor-ically given to the response characteristics of manometric transducers,the problem of providing adequate spatial resolution within the esophageal lumen was left largely ignored.The concept of high-resolution manometry (HRM)is to vastly increase the number of pressure sen-sors on the manometric assembly so as to completely define the intraluminal pressure profile.Pressure sensors are placed in such close proximity to each other that,by interpolating between adjacent sensors,intraluminal pressure becomes a spatial continuum.The2key inno-vations facilitating the widespread application of HRM were(1)the introduction of a practical manometric de-vice with36solid-state,circumferentially sensitive sen-sors spaced at1-cm intervals(Sierra Scientific Instru-ments,Inc,Los Angeles,CA);and(2)the development of sophisticated algorithms to display the expanded mano-metric dataset as pressure topography plots rather than 36overlapping line tracings.1Together,these develop-ments permit the visualization of esophageal motility as a continuum along the length of the esophagus with isobaric conditions among sensors indicated by color continuums(Figure1).The relative timing of sphincter relaxation and segmental contraction as well as the po-sition and length of the striated and smooth muscle segments are readily demonstrated.2Furthermore,repro-ducible measurements of sphincter relaxation can be made,no longer confounded by crural diaphragm con-traction or movement of the sphincter.3Because intralu-minal pressure gradients can be analyzed in detail,con-ditions conducive to successful or failed bolus transport can be defined.4These strengths are evident in Figure2, illustrating one of the most common pressure topogra-phy signatures of achalasia,panesophageal pressuriza-tion.5Once the clinician becomes familiar with the HRM pressure topography format,recordings can be quickly appraised as technically adequate or not based on posi-tioning of the assembly so as to encompass both upper and lower esophageal sphincters and normal perfor-mance of the pressure sensors.However,with the adop-tion of the pressure topography display methodology, the classification of esophageal motility developed for conventional manometric systems requires some revi-sion.Toward that goal,we performed a comprehensive characterization of esophageal HRM data in75normal subjects and400patients using analysis paradigms unique to pressure topography interpretation.5,6In the process,we developed a systematic,pressure topography–oriented classification of motor disorders of the distal esophagus.The2major strengths of pressure topography plots compared with conventional manometric record-ings are(1)the ability to easily delineate the spatial limits and contractile characteristics of individual contractile segments along the esophagus(Figure1),and(2)the ability to easily distinguish between loci of compartmen-talized esophageal pressurization(Figure2)and rapidly propagated esophageal contractions.Making these dis-tinctions was of great utility in distinguishing distal esophageal spasm,vigorous achalasia,functional ob-struction,and subtypes of nutcracker esophagus.©2008by the AGA Institute0016-5085/08/$34.00doi:10.1053/j.gastro.2007.11.031GASTROENTEROLOGY2008;134:16–18The Next Horizon:High-Definition ManometryHRM provides a sufficient degree of spatial detail to characterize motor function and dysfunction along the length of the esophagus.Intraesophageal pressure gradients can be demonstrated and understood in the context of peristaltic activity and outflow obstruction.Sphincter relaxation can be precisely quantified.How-ever,the potential exists to even further enhance spatial pressure resolution with a technology recently dubbed high-definition manometry.With high-definition ma-nometry,not only are pressure sensors spaced even more closely together than the 1-cm standard of HRM,but the radial characteristics at each axial position are preserved.Figure 3illustrates a prototype high-definition manomet-ric assembly (Sierra Scientific Instruments,Inc)alongside what has become a standard HRM assembly.On the high-definition assembly,there are 4banks of 4rings each (16rings in all)with the rings spaced 3mm apart and the banks spaced 4mm apart.Each ring has 8radial sensors,resulting in 128independent pressure recordings spanning 4.8cm.High-definition manometry has the potential to define the pressure morphology of complex anatomical zones such as the esophagogastric junction (EGJ)in ways pre-viously not possible.Figure 4was constructed from re-cordings made with the prototype high-definition assem-bly in Figure 3in a normal volunteer (A )and a patient with a small hiatal hernia (B ).Note how clearly the technology isolates the crural diaphragm contribution to the EGJ in terms of its axial position,degree of radial asymmetry,and magnitude.Similarly,baseline and respi-ratory variation in intragastric pressure are readilycom-Figure 1.Typical pressure topography of a swallow spanning the entire esophagus from the pharynx (locations 0–2cm)to stomach (locations 32–35cm)of a normal subject with normal peristalsis and normal EGJ relaxation.Note that the transition zone demarcating the end of the proximal esophageal segment (striated muscle)and the beginning of the distal esophageal segment (smooth muscle)is readily identified as the pressure minimum between the sphincters.The onset of the deglutitive relaxation window is defined by the onset of upper sphincter relaxation and the offset is 10seconds later.The spatial domain within which EGJ relaxation spans at least 6cm,depending on the extent of esophageal shortening after theswallow.Figure 2.Achalasia associated with panesophageal pressurization depicted in terms of pressure topography and contrasted with conventional line tracings.In the pressure topography plot,pressure magnitude is indicated by color intensity and the black line indicates the 30-mm Hg isobaric pressure contour;note that the EGJ never relaxes to a pressure of Ͻ30mm Hg.Also note that although the intraesophageal pressure approaches 90mm Hg after the swallow,this is not indicative of spasm or vigorous achalasia because it occurs within a closed chamber sealed by the sphincter at either end.The conventional line tracings to the right are extracted from the same data as in the topography plot using only the sensors at 3,4,15,19,23,25–31(eSleeve),and 34cm.The blue line represents the eSleeve recording,which is the highest instantaneous pressure among sensors 26–32and a sensitive indicator of EGJ relaxation.Imaging and Advanced Technology continued17pared with pressure loci within the EGJ and distal esoph-agus.With the current focus on innovative reflux treatments predicated on anatomic and intraluminal ma-nipulation of the EGJ,the potential of this measurement technology is very promising.In summary,new tools have availed themselves in the recent years with the potential to redefine the science of esophageal manometry.Whereas the technology was his-torically encumbered by a variety of well-cataloged tech-nological constraints,advances in transducer technology and computer processing coupled with paradigm shifts in the way that pressure recordings are conceptualized have matured the science.For the first time,esophageal manometry has the potential to be not only a robust research tool,but also a well-standardized,objective clin-ical test.Furthermore,innovation begets discovery,and the pace of innovation continues to be rapid.Hence,the future of esophageal manometry is bright;much remains to be done to define the full potential of this technology.References1.Clouse RE,Staiano A,Alrakawi A,et al.Application of topograph-ical methods to clinical esophageal manometry.Am J Gastroen-terol 2000;95:2720–2730.2.Ghosh SK,Pandolfino JE,Zhang Q,et al.Quantifying esophageal peristalsis with high-resolution manometry:a study of 75asymp-tomatic volunteers.Am J Physiol 2006;290:G988–997.3.Ghosh SK,Pandolfino JE,Rice J,et al.Impaired deglutitive EGJ relaxation in clinical esophageal manometry:a quantitative analy-sis of 400patients and 75controls.Am J Physiol 2007;293:G878–G885.4.Ghosh SK,Kahrilas PJ,Lodhia N,et al.Utilizing intraluminal pres-sure differences to predict esophageal bolus flow dynamics.Am J Physiol 2007;293:G1023–G1028.5.Pandolfino JE,Ghosh SK,Rice J,et al.Classifying esophageal motility by pressure topography characteristics:a study of 400patients and 75controls.Am J Gastroenterol 2007Sep 27;[Epub ahead of print].6.Kahrilas PJ,Ghosh SK,Pandolfino JE.Esophageal motility in terms of pressure topography:the Chicago classification.J Clin Gastro-enterol (in press).Address requests for reprints to Peter J.Kahrilas,MD,Northwestern University,Feinberg School of Medicine,Department of Medicine,Division of Gastroenterology,676St Clair St,Suite 1400,Chicago,Illinois 60611-2951.e-mail:p-kahrilas@Supported by R01DC00646(PJK)from the Public HealthService.Figure 3.Standard clinical HRM assembly alongside a prototype high-definition manometry catheter.Although each of the sensors on the HRM assembly is circumferentially sensitive,the radial signals are aver-aged within the assembly so that a mean pressure is generated at each recording site.The prototype high-definition assembly houses 16rings of 8pressure sensors,oriented 45degrees apart.The active recording surface is only 4.8cm in length but incorporates 128discrete pressure signals,thereby preserving both axial and radial pressuredetail.Figure 4.High-definition recordings of the esophagogastric junction (EGJ )in a normal individual (A )and a patient with a 2-cm separation between the lower esophageal sphincter (LES )and the crural diaphragm (CD ).Pressure is scaled both by color and deflection from the central axis with the deepest blue being Ϫ5mm Hg relative to atmospheric pressure and red being 40mm Hg.For reasons of illustration,the quadrilateral sector of pressure contributed by each sensor is delin-eated by black lines on the surface of the solid.Although only the instants of peak inspiration and expiration are illustrated,pressures are acquired in real time and can also be displayed as movies.Imaging and Advanced Technology continued18。