Khaya belongs to the family Meliaceae. In Nigeria the genus is represented by three species viz; K. senegalensis A. Juss.,K. grandifoliola C. DC. and K. ivorensis A. Chev. Comparative foliar anatomy of the three Khaya...Khaya belongs to the family Meliaceae. In Nigeria the genus is represented by three species viz; K. senegalensis A. Juss.,K. grandifoliola C. DC. and K. ivorensis A. Chev. Comparative foliar anatomy of the three Khaya species was carried out to identify and describe distinctive anatomical characters that could possibly be used to delimit the three taxa. Transverse section, epidermal peels and cleared leaves of these three species were made. Characteristic similarity and disparity in the tissues arrangement as well as cell inclusions were noted for description and delimitation. The three Khaya species studied had essentially the same anatomical features, e.g., venation pattern having open polygonal areoles and the veins terminals biforkated. However, there were characters that seem to be species specific, e.g., vien termination number and areole width. The leaf epidermal studies of the three species revealed similarities in stomatal type which are generally staurocytic,epidermal cells and undulating anticlinal cell walls but stomata density varied. Hexacytic stomata is only observed in the abaxial surface of K. grandifoliola which distinguished this species from the others. The leaf petiole shape of the three species are round and difficult to distinguish into adaxial and abaxial surfaces. The cuticle is striated, vascular bundles are heart shape, conjoint, concentric and amphivasal, but are different in epidermal and collenchyma cell layer numbers. The leaf transverse sections of the three Khaya species studied have conjoint, concentric and amphicribral bundles while the leaf cuticle of K. senegalensis and K. grandifoliola are striated but that of Khaya ivorensis is non-striated.展开更多
Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches.Methods Totally 55...Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches.Methods Totally 55 sympathetic trunks available in 28 Chinese adult cadavers(18 males and 10 females)were investigated in this study.The thoracic cavity was thoroughly exposed and then sympathetic ganglia and its affiliated rami were observed and measured with microscopic instruments.Results Rami from thoracic nerve 1(T1)intercostal nerve entered the stellate ganglion above the upper border of the second rib in all specimens,The distance between the rami and the upper border of the second rib was(5.1±1.4)mm.The incidence that T2⁃T5 ganglions located at the corresponding intercostal space was 92.7%,85.5%,40.0%and 36.4%,respectively.The rami communicantes were classified into 3 types(type a,b and c)according to the anatomical relationship between the thoracic sympathetic ganglia and the intercostal nerves.The distance from 3 types of rami communicantes to lateral sympathetic trunk at the middle point of relative rib was(10.2±3.4)mm(type a),(9.5±2.6)mm(type b)and(8.4±2.0)mm(type c),respectively.We found that 74.5%superior intercostal artery crossed the neck of the first rib.The distance between the superior intercostal artery and the lateral sympathetic trunk was(3.4±1.3)mm.Conclusion Sympathectomy performed at rib level should be the ideal choice for clinical surgical treatment of palmar or craniofacial hyperhidrosis with less denervation scope to achieve more definite therapeutic effect.展开更多
China ranked first worldwide in the production and export of electric bicycles.As an emerging market for electric bicycles,Malaysia holds significant potential for trade collabor ation with China in this sector.This s...China ranked first worldwide in the production and export of electric bicycles.As an emerging market for electric bicycles,Malaysia holds significant potential for trade collabor ation with China in this sector.This study presents a compar ative analysis of the national electric bicycle standards in China and Malaysia,offering technical insights from a standardization perspective.These insights aim to support Chinese enterprises in strategically positioning their technologies in the Malaysian market.The findings reveal significant differences in technical parameters,safety requirements,and testing methods,highlighting the need for tailored product adapt ation.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to t...Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to the biliary tree.Over the past two decades,device-assisted enteroscopy(DAE),including singleballoon,double-balloon,and motorized spiral enteroscopy,has expanded the feasibility of ERCP in this population,with overall technical success rates generally reported between 70%and 90%.Nevertheless,these techniques are technically demanding,time-consuming,and frequently affected by limited reach and unstable positioning.More recently,interventional endoscopic ultrasound(EUS)-guided procedures have emerged as highly effective alternatives,significantly improving clinical outcomes in selected patients,particularly in those with long-limb Roux-en-Y reconstructions where conventional methods are less effective.Percutaneous transhepatic biliary drainage continues to represent a valuable salvage option when endoscopic approaches fail,though it is associated with a greater burden of reinterventions and adverse events.This minireview provides a comprehensive overview of the main endoscopic strategies for biliary drainage in altered anatomy,focusing on technical considerations,efficacy,and safety profiles of DAE-assisted ERCP,EUS-guided interventions,and motorized systems.The evolving landscape of biliary drainage in this setting highlights the need for tailored treatment strategies,multidisciplinary collaboration,referral to high-volume centers,and further prospective studies to refine patient selection and optimize clinical outcomes.展开更多
This study integrates explicit input enhancement into comparative continuation writing,defined as a task in which learners produce a continuation by comparing their own expression with an input text,aligning with its ...This study integrates explicit input enhancement into comparative continuation writing,defined as a task in which learners produce a continuation by comparing their own expression with an input text,aligning with its discourse structure and linguistic features,while developing their own ideas.It aims to examine whether English as a Foreign Language(EFL)learners in China exhibit differences in discourse competence and writing performance when completing comparative continuation writing combined with different input enhancement techniques,and whether the alignment effect occurs at the discourse level.Sixty first-year Chinese senior middle school students were divided into four groups:three groups engaged in comparative continuation writing with varying input enhancement,achieved by combining different techniques,while a control group performed a designated-topic writing task.The results revealed that three comparative continuation writing groups outperformed the designated-topic writing group in discourse competence,particularly in the use of temporal connectives.However,differences and some inconsistencies were observed among the comparative continuation writing groups across individual indices.The study highlights effective ways to incorporate comparative continuation writing into English instruction and demonstrates how explicit input enhancement can complement the task,simultaneously activating the alignment effect proposed by the xu-argument and enhancing discourse competence in writing.展开更多
In clinical diagnosis,conventional X-ray absorption-contrast computed tomography(XACT)technology cannot effectively differentiate diseased tissues from the healthy ones.X-ray phase-contrast CT(XPCT)and dual-energy CT(...In clinical diagnosis,conventional X-ray absorption-contrast computed tomography(XACT)technology cannot effectively differentiate diseased tissues from the healthy ones.X-ray phase-contrast CT(XPCT)and dual-energy CT(DECT),emerging X-ray imaging technologies with superior diagnostic capabilities,address this issue through different principles.While both XPCT and DECT have advantages and disadvantages in medical applications,their systematic comparison is lacking.Using GEANT4 and MATLAB,in this study,we established an X-ray phase-contrast imaging(XPCI)model based on single-mask and single-shot edge illumination for fast XPCT imaging,comparing it with DECT on soft-tissue phantom.XACT served as a reference for comparison.The study introduces an evaluation system using statistical measures including absolute error,mean absolute error,structure similarity index measure,peak signal-to-noise ratio,and contrast-to-noise ratio.Results show XPCT images are superior to DECT.The XPCI model can be improved on existing medical CT for widespread medical application.展开更多
Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy live...Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy liver tissues.This review meticulously synthesizes current evidence regarding the clinical efficacy,underlying therapeutic mechanisms,patient selection criteria,and comparative advantages of Y-90 therapy.Clinical studies consistently demonstrate significant improvements in overall survival and progression-free survival,coupled with robust tumor response rates and manageable adverse events.The therapy’s efficacy is substantially enhanced by advanced dosimetric techniques,enabling precise radiation delivery tailored to individual tumor profiles.Comparative analyses reveal that Y-90 therapy provides superior local tumor control and a preferable safety profile compared to conventional treatments such as transarterial chemoembolization and external beam radiation therapy.Additionally,its clinical outcomes are comparable to those achieved with contemporary systemic therapies.Ongoing research into combination treatments incorporating Y-90 with systemic therapies,including targeted agents and immune checkpoint inhibitors,suggests promising advancements in comprehensive HCC management.Future directions highlight the necessity for continued refinement of dosimetry and patient stratification approaches,aiming to further optimize therapeutic outcomes.展开更多
The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporat...The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.展开更多
Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospit...Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospital Center of Kpalimé (PHC-K) in Togo. Methodology: It was a retrospective, descriptive and comparative study carried out over five years (2018-2022) focusing on abdominal wall hernias in adults. Information was gathered from the patients’clinical notes and registers on the frequency of hernias, the anatomo-clinical forms of hernias, the type of anesthesia, the hernia repair technique and the postoperative evolution. Results: Of the 1022 and 1026 operations performed, 312 and 412 were hernial repairs, representing 30.5% and 41.2% of operations at RHC-T and PHC-K respectively (p = 0.001). The inguinal hernia was the most often found in 83.7% (n = 261) at RHC-T versus 76.6% (n = 324) at PHC-K. Herniorrhaphy was the most frequently used repair method, in 93.6% (n = 292) of patients at RHC-T and in 91.3% (n = 376) at PHC-K (p = 0.11). Postoperative complications were noted in 5.1% of cases (n = 16) at RHC-T versus 3.5% of cases (n = 15) at PHC-K (p = 0.307). These complications included scrotal hematomas, surgical areas infections, and orchitis. We recorded 1.3% (n = 4) and 0.8% (n = 3) deaths at RHC-T and PHC-K respectively (p = 0.496). Conclusion: There is homogeneity in the treatment of hernia in these two hospitals in Togo.展开更多
In the vast field of medical education,systematic anatomy serves as a solid cornerstone,firmly supporting medical students in their journey towards clinical professional knowledge.It is not just a course but also a ke...In the vast field of medical education,systematic anatomy serves as a solid cornerstone,firmly supporting medical students in their journey towards clinical professional knowledge.It is not just a course but also a key to unlocking the mysteries of medicine.This course is as rich as a vast treasure trove of knowledge,covering the fine structures and functions of various human body systems.Each knowledge point is like a bright pearl in the treasure trove.It is the foundation of clinical professional courses.Many subsequent clinical courses,such as diagnostics and surgery,rely on the basic understanding provided by systematic anatomy.Its professional vocabulary is also an important source of medical field terminologies,acting as the root of medical language and constructing the entire edifice of medical communication.Although the vocabulary of this course is rich,it is not complex.It is like a set of orderly-arranged jigsaw puzzles.As long as the correct methods are mastered,it is easy to piece them together.However,in the current teaching environment,the traditional cramming-style teaching method is like an old-fashioned carriage,showing obvious disadvantages on the road of the times.The pre-study link is like a rehearsal for a wonderful performance,having a direct and crucial impact on students’listening efficiency in class.Nevertheless,such an important teaching link is often overlooked,like a precious treasure forgotten in the corner.High-quality pre-study,for lecturers,is like giving wings to classroom teaching,which can greatly improve the efficiency of classroom teaching and make the teaching process smoother and more efficient.For students,it is like a magnifying glass that can deepen their understanding of knowledge points and their impression of the text,making the knowledge more clearly engraved in their minds.This article will focus on exploring the methods to achieve effective pre-study for systematic anatomy,hoping to contribute to the development of medical education.展开更多
Infertility,defined as the inability to conceive after 1 year of regular unprotected intercourse,impacts 10%–20%of couples globally.Both male and female factors contribute equally to this condition.Azoospermia,partic...Infertility,defined as the inability to conceive after 1 year of regular unprotected intercourse,impacts 10%–20%of couples globally.Both male and female factors contribute equally to this condition.Azoospermia,particularly nonobstructive azoospermia(NOA),which affects 10%–15%of infertile men,represents a significant challenge in male infertility.The advent of assisted reproductive technology(ART),specifically microdissection testicular sperm extraction(micro-TESE)followed by intracytoplasmic sperm injection(ICSI),offers a possibility for men with NOA to father biological children.Recent studies have focused on the predictors of sperm retrieval in NOA patients,such as age,testicular volume,and follicle-stimulating hormone(FSH)level.This review aims to explore the limited data on the anatomical characteristics of NOA patients and provide surgical considerations for micro-TESE,thereby enhancing understanding and improving outcomes for this challenging condition.展开更多
The first metatarsophalangeal(MTP)joint plays a crucial role in foot biomechanics,particularly in weight-bearing activities such as walking and running.It is frequently affected by conditions like hallux valgus(HV)and...The first metatarsophalangeal(MTP)joint plays a crucial role in foot biomechanics,particularly in weight-bearing activities such as walking and running.It is frequently affected by conditions like hallux valgus(HV)and hallux rigidus,with HV impacting approximately 23%-35% of the population.This narrative review explores the embryology,anatomy,and biomechanics of the first MTP joint(MTPJ),highlighting its significance in maintaining foot stability and function.A comprehensive literature search was conducted using PubMed,Scopus,and Google Scholar,analyzing 50 relevant studies,including 12 clinical trials.The joint’s complex structure and mechanical demands make it susceptible to degenerative and structural disorders.Studies indicate that 25%-40%of individuals with HV experience significant pain and functional impairment,affecting mobility and quality of life.Biomechanical stress,abnormal gait patterns,and joint instability contribute to disease progression.Understanding the anatomical and biomechanical properties of the first MTPJ is essential for improving diagnostic and therapeutic approaches.Emerging surgical techniques,such as osteotomy and joint resurfacing,show promise in reducing recurrence rates and enhancing longterm outcomes.Further research is needed to refine minimally invasive interventions and optimize treatment strategies for first MTPJ disorders.展开更多
Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students'spatial understanding and 3D reconstruction skills,and strengthening their ana...Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students'spatial understanding and 3D reconstruction skills,and strengthening their anatomical foundation and clinical competence.This approach aims to bridge the gap between basic science and clinical practice while cultivating clinical thinking abilities.Methods In this study,the medical imaging knowledge was introduced into the anatomy curriculum in Peking University,enabling students to better understand the human body structure and its relationship to the clinical practice with aid of the ultrasound and MRI method.After the course concluded,we evaluated the examination result and learning satisfaction data from the anatomy course.Results The result showed that students provided positive feedback,showing increased interest in learning,enhanced initiative,significant improvement in their anatomy grades(P<0.01),and a notable enhancement in their ability to apply basic knowledge to solve clinical problems(P<0.05).Conclusion The integrated teaching approach of medical imaging and human anatomy courses provides innovative ideas and practical method for medical students to learn the basic medical course and enhance their clinical skills in the future.展开更多
The plastid genome(plastome)represents an indispensable molecular resource for studying plant phylogeny and evolution.Although plastome size is much smaller than that of nuclear genomes,accurately and efficientlyannot...The plastid genome(plastome)represents an indispensable molecular resource for studying plant phylogeny and evolution.Although plastome size is much smaller than that of nuclear genomes,accurately and efficientlyannotating and utilizing plastome sequences remain challenging.Therefore,a streamlined phylogenomic pipeline spanning plastome annotation,phylogenetic reconstruction and comparative genomics would greatly facilitate research utilizing this important organellar genome.Here,we develop PlastidHub,a novel web application employing innovative tools to analyze plastome sequences.In comparison with existing tools,key novel functionalities in PlastidHub include:(1)standardization of quadripartite structure;(2)improvement of annotation flexibility and consistency;(3)quantitative assessment of annotation completeness;(4)diverse extraction modes for canonical and specialized sequences;(5)intelligent screening of molecular markers for biodiversity studies;(6)genelevel visual comparison of structural variations and annotation completeness.PlastidHub features cloud-based web applications that do not require users to install,update,or maintain tools;detailed help documents including user guides,test examples,a static pop-up prompt box,and dynamic pop-up warning prompts when entering unreasonable parameter values;batch processing capabilities for all tools;intermediate results for secondary use;and easy-to-operate task flows between fileupload and download.A key feature of PlastidHub is its interrelated task-based user interface design.Give that PlastidHub is easy to use without specialized computational skills or resources,this new platform should be widely used among botanists and evolutionary biologists,improving and expediting research employing the plastome.PlastidHub is available at https://www.plastidhub.cn.展开更多
The oscillating hydrofoil represents a promising technology for harvesting energy from tidal currents.While previous research has primarily focused on oscillating hydrofoils utilizing a fully activated control strateg...The oscillating hydrofoil represents a promising technology for harvesting energy from tidal currents.While previous research has primarily focused on oscillating hydrofoils utilizing a fully activated control strategy,the industry predominantly employs a semi-activated control strategy in existing tidal current energy converters.It is essential to identify the differences in predicted energy-harvesting performance between these two controlling strategies through experimental modeling or numerical studies.Furthermore,the suitability of the fully activated control strategy in predicting the energy-harvesting capabilities of oscillating hydrofoils is evaluated.The 2D numerical models of hydrofoil based on fully activated and semi-activated control strategies have been developed and validated.The amplitudes of heaving and pitching movements for the fully activated hydrofoil are determined to match those of the semi-activated hydrofoil.The results show that the main difference between the two control strategies lies in the phase shift occurring between the pitching and heaving motions.This phase shift affects the lift force and its coordination with the heaving velocity,which in turn affects the power output.Notably,the maximum relative efficiency difference obtained between the fully activated and semi-activated control strategies can reach 191%.展开更多
Bathymodiolus mussels distribute in both deep-sea cold seep and hydrothermal vent environments,whose endosymbiotic gill tissue is a prominent character for the adaptation of extreme habitats.However,few studies explor...Bathymodiolus mussels distribute in both deep-sea cold seep and hydrothermal vent environments,whose endosymbiotic gill tissue is a prominent character for the adaptation of extreme habitats.However,few studies explored the adaptation mechanisms through comparative transcriptome sequencing and analysis of different tissues between seep mussels and vent mussels.We performed the comparative transcriptome sequencing and analysis for three tissue types(gill,mantle,and adductor muscle)of Bathymodiolus mussels collected from a cold seeping site Station S 11 and the 50-km away hydrothermal field Minami-Ensei Knoll in the Okinawa Trough.Results show that gene expression patterns had distinct tissue specificity.Compared with the non-endosymbiotic tissues(mantle and adductor muscle),the significantly strengthened gene functions in endosymbiotic gill included microbial recognition(fibrinogen C domain-containing protein 1-B-like(fibcd),fibrinogen-related protein 8(frp),peptidoglycan recognition proteins(pgrp),and C-type lectin(clec)),cell apoptosis and immunity(interferon regulatory factor 1/2-like 1(ir f),cathepsin D(ctsd),caspase 2(casp 2)),and antioxidant capacity(copper/zinc superoxide dismutase(czsod),glutathione peroxidase(gpx),selenoprotein(sel)),in both seep and vent individuals.Consistent with metal accumulation,high expression levels of genes related to heavy metal detoxification(cytochrome P 450(cyp),ferritin-like(ftl),metallothionein(mt),glutathione S-transferase(gst))were also observed in gill.Moreover,to adapt to high hydrostatic pressure in the deep sea,the Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways associated with cellular community were significantly enriched in all three tissues,suggesting the regulation of cell structure and cell adhesion at transcriptional level.This study obtained gene expression profiles of deep-sea mussels subsisting at cold seep and hydrothermal vent sites,which could lay foundations for comprehensive investigations of molecular basis in adaptation of deep-sea mussels to the two extreme ecosystems.展开更多
Lactococcus lactis,a major starter culture in the dairy industry,has been widely applied in food fermentation.While current research has primarily focused on evaluating its role during fermentation,genomic investigati...Lactococcus lactis,a major starter culture in the dairy industry,has been widely applied in food fermentation.While current research has primarily focused on evaluating its role during fermentation,genomic investigations into its genetic diversity and functional adaptability remain limited.In this study,199 L.lactis strains isolated from Chinese traditional artisanal cheeses(72 bovine,71 goat,and 56 yak milk cheese isolates)were subjected to comparative genomic analysis.Genomic characteristic analysis indicated that bovine milk strains possess larger genomes and the highest number of unique genes.Functional characterization further demonstrated notable differences in carbohydrate metabolism among strains from different sources,with yak milk strains enriched in enzymes involved in complex polysaccharide degradation,including members of the carbohydrate esterases family.Moreover,strains from different sources exhibit distinct strategies for lactose hydrolysis and metabolic utilization,reflecting adaptive evolution to their specific nutritional niches.Analysis of the antibiotic resistance profile suggests that L.lactis predominantly harbors glycopeptide and lincosamide resistance genes,encompassing four distinct resistance mechanisms.Collectively,this study reveals the genetic diversity and adaptive evolution of L.lactis strains from different sources and identifies key genes associated with carbohydrate degradation,lactose metabolism,and antibiotic resistance,providing concrete genetic evidence for the selection of efficient and safe industrial fermentation strains.展开更多
This paper conducts clustering,potential semantic indexing,comparison,and inductive analysis of research papers on marketing between China and the UK from January 2020 to September 2024.The study found that the Chines...This paper conducts clustering,potential semantic indexing,comparison,and inductive analysis of research papers on marketing between China and the UK from January 2020 to September 2024.The study found that the Chinese marketing research focuses on digital transformation,policy impact,value co-creation,and emerging e-commerce models.In contrast,the UK marketing research focuses more on sustainability,technology integration,real-time research,and personalized marketing strategies.The study also found that there were few marketing articles published in Chinese and CSSCI journals in China,while the SSCI journals published in English were 62 times more than in Chinese.According to the research,digital marketing and data-driven decision-making,diversified marketing channels,sustainability and circular economy,technological innovation and cutting-edge technology application,meta-universe and blockchain technology,AI+marketing development,brand building,and international market expansion will become the research hotspots in the field of marketing in the future.The research suggests that China should strengthen the construction of an academic marketing platform,and China and the UK should strengthen cooperation in marketing research,learn from each other's strengths,and jointly give full play to their advantages in technology application,market and economy,strategy and innovation,and social media,to contribute to global economic development and marketing research.展开更多
Objective:This study aimed to investigate the anatomy of the accessory pudendal artery(APA)in Asian men and to describe APA preservation techniques during robot-assisted radical prostatectomy(RARP).Methods:APA was def...Objective:This study aimed to investigate the anatomy of the accessory pudendal artery(APA)in Asian men and to describe APA preservation techniques during robot-assisted radical prostatectomy(RARP).Methods:APA was defined as“any artery located in the periprostatic region running parallel to the dorsal vascular complex and extending caudally toward the anterior perineum”.The anatomical variations of the APA were reviewed in 589 consecutive Japanese men who underwent conventional RARP at our institution between April 2019 and November 2023,including the number,laterality,side,size,and local distribution(apical vs.lateral).The apical APA emerges near the prostatic apical region,whereas the lateral APA courses along the lateral aspect of the prostate.They are further classified as the prostatic,fascial,and pubic APAs.Our APA identification and preservation techniques were described based on this classification.Results:Of the 589 Japanese men,299(51%)men were with one or more APAs:169 with one APA,115 with two APAs,14 with three APAs,and one with four APAs;and a total of 445 APAs were found.Approximately 97% of the APAs(432/445)were preserved.More lateral APAs were found than apical APAs(243/589[41%]vs.79/589[13%];p<0.001).Lateral APAs had a higher proportion of large-caliber arteries than apical APAs(59/359[16%]vs.1/86[1.2%];p<0.001),particularly prostatic and fascial APAs(14/59[24%]and 40/163[25%],respectively).Conclusion:This study identified anatomical variations of APAs in Japanese men and demonstrated that nearly all could be preserved during RARP.Further research is needed to evaluate the clinical benefits of APA preservation.展开更多
文摘Khaya belongs to the family Meliaceae. In Nigeria the genus is represented by three species viz; K. senegalensis A. Juss.,K. grandifoliola C. DC. and K. ivorensis A. Chev. Comparative foliar anatomy of the three Khaya species was carried out to identify and describe distinctive anatomical characters that could possibly be used to delimit the three taxa. Transverse section, epidermal peels and cleared leaves of these three species were made. Characteristic similarity and disparity in the tissues arrangement as well as cell inclusions were noted for description and delimitation. The three Khaya species studied had essentially the same anatomical features, e.g., venation pattern having open polygonal areoles and the veins terminals biforkated. However, there were characters that seem to be species specific, e.g., vien termination number and areole width. The leaf epidermal studies of the three species revealed similarities in stomatal type which are generally staurocytic,epidermal cells and undulating anticlinal cell walls but stomata density varied. Hexacytic stomata is only observed in the abaxial surface of K. grandifoliola which distinguished this species from the others. The leaf petiole shape of the three species are round and difficult to distinguish into adaxial and abaxial surfaces. The cuticle is striated, vascular bundles are heart shape, conjoint, concentric and amphivasal, but are different in epidermal and collenchyma cell layer numbers. The leaf transverse sections of the three Khaya species studied have conjoint, concentric and amphicribral bundles while the leaf cuticle of K. senegalensis and K. grandifoliola are striated but that of Khaya ivorensis is non-striated.
文摘Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches.Methods Totally 55 sympathetic trunks available in 28 Chinese adult cadavers(18 males and 10 females)were investigated in this study.The thoracic cavity was thoroughly exposed and then sympathetic ganglia and its affiliated rami were observed and measured with microscopic instruments.Results Rami from thoracic nerve 1(T1)intercostal nerve entered the stellate ganglion above the upper border of the second rib in all specimens,The distance between the rami and the upper border of the second rib was(5.1±1.4)mm.The incidence that T2⁃T5 ganglions located at the corresponding intercostal space was 92.7%,85.5%,40.0%and 36.4%,respectively.The rami communicantes were classified into 3 types(type a,b and c)according to the anatomical relationship between the thoracic sympathetic ganglia and the intercostal nerves.The distance from 3 types of rami communicantes to lateral sympathetic trunk at the middle point of relative rib was(10.2±3.4)mm(type a),(9.5±2.6)mm(type b)and(8.4±2.0)mm(type c),respectively.We found that 74.5%superior intercostal artery crossed the neck of the first rib.The distance between the superior intercostal artery and the lateral sympathetic trunk was(3.4±1.3)mm.Conclusion Sympathectomy performed at rib level should be the ideal choice for clinical surgical treatment of palmar or craniofacial hyperhidrosis with less denervation scope to achieve more definite therapeutic effect.
文摘China ranked first worldwide in the production and export of electric bicycles.As an emerging market for electric bicycles,Malaysia holds significant potential for trade collabor ation with China in this sector.This study presents a compar ative analysis of the national electric bicycle standards in China and Malaysia,offering technical insights from a standardization perspective.These insights aim to support Chinese enterprises in strategically positioning their technologies in the Malaysian market.The findings reveal significant differences in technical parameters,safety requirements,and testing methods,highlighting the need for tailored product adapt ation.
文摘Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to the biliary tree.Over the past two decades,device-assisted enteroscopy(DAE),including singleballoon,double-balloon,and motorized spiral enteroscopy,has expanded the feasibility of ERCP in this population,with overall technical success rates generally reported between 70%and 90%.Nevertheless,these techniques are technically demanding,time-consuming,and frequently affected by limited reach and unstable positioning.More recently,interventional endoscopic ultrasound(EUS)-guided procedures have emerged as highly effective alternatives,significantly improving clinical outcomes in selected patients,particularly in those with long-limb Roux-en-Y reconstructions where conventional methods are less effective.Percutaneous transhepatic biliary drainage continues to represent a valuable salvage option when endoscopic approaches fail,though it is associated with a greater burden of reinterventions and adverse events.This minireview provides a comprehensive overview of the main endoscopic strategies for biliary drainage in altered anatomy,focusing on technical considerations,efficacy,and safety profiles of DAE-assisted ERCP,EUS-guided interventions,and motorized systems.The evolving landscape of biliary drainage in this setting highlights the need for tailored treatment strategies,multidisciplinary collaboration,referral to high-volume centers,and further prospective studies to refine patient selection and optimize clinical outcomes.
文摘This study integrates explicit input enhancement into comparative continuation writing,defined as a task in which learners produce a continuation by comparing their own expression with an input text,aligning with its discourse structure and linguistic features,while developing their own ideas.It aims to examine whether English as a Foreign Language(EFL)learners in China exhibit differences in discourse competence and writing performance when completing comparative continuation writing combined with different input enhancement techniques,and whether the alignment effect occurs at the discourse level.Sixty first-year Chinese senior middle school students were divided into four groups:three groups engaged in comparative continuation writing with varying input enhancement,achieved by combining different techniques,while a control group performed a designated-topic writing task.The results revealed that three comparative continuation writing groups outperformed the designated-topic writing group in discourse competence,particularly in the use of temporal connectives.However,differences and some inconsistencies were observed among the comparative continuation writing groups across individual indices.The study highlights effective ways to incorporate comparative continuation writing into English instruction and demonstrates how explicit input enhancement can complement the task,simultaneously activating the alignment effect proposed by the xu-argument and enhancing discourse competence in writing.
基金supported by the National Natural Science Foundation of China(No.12105267)National Natural Science Foundation of China(No.11975006)+2 种基金Major Special Program of Science and Technology of Gansu Province(No.1ZD8JA002)the Fundamental Research Funds for the Central Universities(No.lzujbky-2020-pd02)the China Postdoctoral Science Foundation(No.2019M653792)。
文摘In clinical diagnosis,conventional X-ray absorption-contrast computed tomography(XACT)technology cannot effectively differentiate diseased tissues from the healthy ones.X-ray phase-contrast CT(XPCT)and dual-energy CT(DECT),emerging X-ray imaging technologies with superior diagnostic capabilities,address this issue through different principles.While both XPCT and DECT have advantages and disadvantages in medical applications,their systematic comparison is lacking.Using GEANT4 and MATLAB,in this study,we established an X-ray phase-contrast imaging(XPCI)model based on single-mask and single-shot edge illumination for fast XPCT imaging,comparing it with DECT on soft-tissue phantom.XACT served as a reference for comparison.The study introduces an evaluation system using statistical measures including absolute error,mean absolute error,structure similarity index measure,peak signal-to-noise ratio,and contrast-to-noise ratio.Results show XPCT images are superior to DECT.The XPCI model can be improved on existing medical CT for widespread medical application.
文摘Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy liver tissues.This review meticulously synthesizes current evidence regarding the clinical efficacy,underlying therapeutic mechanisms,patient selection criteria,and comparative advantages of Y-90 therapy.Clinical studies consistently demonstrate significant improvements in overall survival and progression-free survival,coupled with robust tumor response rates and manageable adverse events.The therapy’s efficacy is substantially enhanced by advanced dosimetric techniques,enabling precise radiation delivery tailored to individual tumor profiles.Comparative analyses reveal that Y-90 therapy provides superior local tumor control and a preferable safety profile compared to conventional treatments such as transarterial chemoembolization and external beam radiation therapy.Additionally,its clinical outcomes are comparable to those achieved with contemporary systemic therapies.Ongoing research into combination treatments incorporating Y-90 with systemic therapies,including targeted agents and immune checkpoint inhibitors,suggests promising advancements in comprehensive HCC management.Future directions highlight the necessity for continued refinement of dosimetry and patient stratification approaches,aiming to further optimize therapeutic outcomes.
文摘The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.
文摘Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospital Center of Kpalimé (PHC-K) in Togo. Methodology: It was a retrospective, descriptive and comparative study carried out over five years (2018-2022) focusing on abdominal wall hernias in adults. Information was gathered from the patients’clinical notes and registers on the frequency of hernias, the anatomo-clinical forms of hernias, the type of anesthesia, the hernia repair technique and the postoperative evolution. Results: Of the 1022 and 1026 operations performed, 312 and 412 were hernial repairs, representing 30.5% and 41.2% of operations at RHC-T and PHC-K respectively (p = 0.001). The inguinal hernia was the most often found in 83.7% (n = 261) at RHC-T versus 76.6% (n = 324) at PHC-K. Herniorrhaphy was the most frequently used repair method, in 93.6% (n = 292) of patients at RHC-T and in 91.3% (n = 376) at PHC-K (p = 0.11). Postoperative complications were noted in 5.1% of cases (n = 16) at RHC-T versus 3.5% of cases (n = 15) at PHC-K (p = 0.307). These complications included scrotal hematomas, surgical areas infections, and orchitis. We recorded 1.3% (n = 4) and 0.8% (n = 3) deaths at RHC-T and PHC-K respectively (p = 0.496). Conclusion: There is homogeneity in the treatment of hernia in these two hospitals in Togo.
文摘In the vast field of medical education,systematic anatomy serves as a solid cornerstone,firmly supporting medical students in their journey towards clinical professional knowledge.It is not just a course but also a key to unlocking the mysteries of medicine.This course is as rich as a vast treasure trove of knowledge,covering the fine structures and functions of various human body systems.Each knowledge point is like a bright pearl in the treasure trove.It is the foundation of clinical professional courses.Many subsequent clinical courses,such as diagnostics and surgery,rely on the basic understanding provided by systematic anatomy.Its professional vocabulary is also an important source of medical field terminologies,acting as the root of medical language and constructing the entire edifice of medical communication.Although the vocabulary of this course is rich,it is not complex.It is like a set of orderly-arranged jigsaw puzzles.As long as the correct methods are mastered,it is easy to piece them together.However,in the current teaching environment,the traditional cramming-style teaching method is like an old-fashioned carriage,showing obvious disadvantages on the road of the times.The pre-study link is like a rehearsal for a wonderful performance,having a direct and crucial impact on students’listening efficiency in class.Nevertheless,such an important teaching link is often overlooked,like a precious treasure forgotten in the corner.High-quality pre-study,for lecturers,is like giving wings to classroom teaching,which can greatly improve the efficiency of classroom teaching and make the teaching process smoother and more efficient.For students,it is like a magnifying glass that can deepen their understanding of knowledge points and their impression of the text,making the knowledge more clearly engraved in their minds.This article will focus on exploring the methods to achieve effective pre-study for systematic anatomy,hoping to contribute to the development of medical education.
文摘Infertility,defined as the inability to conceive after 1 year of regular unprotected intercourse,impacts 10%–20%of couples globally.Both male and female factors contribute equally to this condition.Azoospermia,particularly nonobstructive azoospermia(NOA),which affects 10%–15%of infertile men,represents a significant challenge in male infertility.The advent of assisted reproductive technology(ART),specifically microdissection testicular sperm extraction(micro-TESE)followed by intracytoplasmic sperm injection(ICSI),offers a possibility for men with NOA to father biological children.Recent studies have focused on the predictors of sperm retrieval in NOA patients,such as age,testicular volume,and follicle-stimulating hormone(FSH)level.This review aims to explore the limited data on the anatomical characteristics of NOA patients and provide surgical considerations for micro-TESE,thereby enhancing understanding and improving outcomes for this challenging condition.
文摘The first metatarsophalangeal(MTP)joint plays a crucial role in foot biomechanics,particularly in weight-bearing activities such as walking and running.It is frequently affected by conditions like hallux valgus(HV)and hallux rigidus,with HV impacting approximately 23%-35% of the population.This narrative review explores the embryology,anatomy,and biomechanics of the first MTP joint(MTPJ),highlighting its significance in maintaining foot stability and function.A comprehensive literature search was conducted using PubMed,Scopus,and Google Scholar,analyzing 50 relevant studies,including 12 clinical trials.The joint’s complex structure and mechanical demands make it susceptible to degenerative and structural disorders.Studies indicate that 25%-40%of individuals with HV experience significant pain and functional impairment,affecting mobility and quality of life.Biomechanical stress,abnormal gait patterns,and joint instability contribute to disease progression.Understanding the anatomical and biomechanical properties of the first MTPJ is essential for improving diagnostic and therapeutic approaches.Emerging surgical techniques,such as osteotomy and joint resurfacing,show promise in reducing recurrence rates and enhancing longterm outcomes.Further research is needed to refine minimally invasive interventions and optimize treatment strategies for first MTPJ disorders.
基金2024 Higher Education Science Research Planning Project(24KC0413)Peking University Health Science Center Medical Education Research Funding Project(2023YB43)+3 种基金The University-Industry Collaborative Education Program of the Ministry of Education(220903132204624)2022 Peking University Graduate Course Construction Funding2023 Peking University Medical Graduate Course Ideological and Political Construction ProjectZhejiang Natural Science Foundation Exploration Project Q-class Funding Project(242szhfhYB25)。
文摘Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students'spatial understanding and 3D reconstruction skills,and strengthening their anatomical foundation and clinical competence.This approach aims to bridge the gap between basic science and clinical practice while cultivating clinical thinking abilities.Methods In this study,the medical imaging knowledge was introduced into the anatomy curriculum in Peking University,enabling students to better understand the human body structure and its relationship to the clinical practice with aid of the ultrasound and MRI method.After the course concluded,we evaluated the examination result and learning satisfaction data from the anatomy course.Results The result showed that students provided positive feedback,showing increased interest in learning,enhanced initiative,significant improvement in their anatomy grades(P<0.01),and a notable enhancement in their ability to apply basic knowledge to solve clinical problems(P<0.05).Conclusion The integrated teaching approach of medical imaging and human anatomy courses provides innovative ideas and practical method for medical students to learn the basic medical course and enhance their clinical skills in the future.
基金the Natural Science Foundation of Shandong Province(ZR2020QC022)the Science and Technology Basic Resources Investigation Program of China(No.2019FY100900)+2 种基金the Major Program for Basic Research Project of Yunnan Province(202401BC070001)Yunnan Revitalization Talent Support Program:Yunling Scholar Project to Tingshuang Yithe open research project of“Cross Cooperative Team”of the Germplasm Bank of Wild Species,Kunming Institute of Botany,Chinese Academy of Sciences.
文摘The plastid genome(plastome)represents an indispensable molecular resource for studying plant phylogeny and evolution.Although plastome size is much smaller than that of nuclear genomes,accurately and efficientlyannotating and utilizing plastome sequences remain challenging.Therefore,a streamlined phylogenomic pipeline spanning plastome annotation,phylogenetic reconstruction and comparative genomics would greatly facilitate research utilizing this important organellar genome.Here,we develop PlastidHub,a novel web application employing innovative tools to analyze plastome sequences.In comparison with existing tools,key novel functionalities in PlastidHub include:(1)standardization of quadripartite structure;(2)improvement of annotation flexibility and consistency;(3)quantitative assessment of annotation completeness;(4)diverse extraction modes for canonical and specialized sequences;(5)intelligent screening of molecular markers for biodiversity studies;(6)genelevel visual comparison of structural variations and annotation completeness.PlastidHub features cloud-based web applications that do not require users to install,update,or maintain tools;detailed help documents including user guides,test examples,a static pop-up prompt box,and dynamic pop-up warning prompts when entering unreasonable parameter values;batch processing capabilities for all tools;intermediate results for secondary use;and easy-to-operate task flows between fileupload and download.A key feature of PlastidHub is its interrelated task-based user interface design.Give that PlastidHub is easy to use without specialized computational skills or resources,this new platform should be widely used among botanists and evolutionary biologists,improving and expediting research employing the plastome.PlastidHub is available at https://www.plastidhub.cn.
基金supported by the Shandong Natural Science Foundation Youth Project(No.ZR2023QE075)the Open Project Program of Shandong Marine Aerospace Equipment Technological Innovation Center(No.MAETIC202210)the Shandong Natural Science Foundation Project(No.ZR2022ME145)。
文摘The oscillating hydrofoil represents a promising technology for harvesting energy from tidal currents.While previous research has primarily focused on oscillating hydrofoils utilizing a fully activated control strategy,the industry predominantly employs a semi-activated control strategy in existing tidal current energy converters.It is essential to identify the differences in predicted energy-harvesting performance between these two controlling strategies through experimental modeling or numerical studies.Furthermore,the suitability of the fully activated control strategy in predicting the energy-harvesting capabilities of oscillating hydrofoils is evaluated.The 2D numerical models of hydrofoil based on fully activated and semi-activated control strategies have been developed and validated.The amplitudes of heaving and pitching movements for the fully activated hydrofoil are determined to match those of the semi-activated hydrofoil.The results show that the main difference between the two control strategies lies in the phase shift occurring between the pitching and heaving motions.This phase shift affects the lift force and its coordination with the heaving velocity,which in turn affects the power output.Notably,the maximum relative efficiency difference obtained between the fully activated and semi-activated control strategies can reach 191%.
基金Supported by the National Natural Science Foundation of China(Nos.91858208,92358301)the Laoshan Laboratory(No.LSKJ 202203500),the China Postdoctoral Science Foundation of China(No.2019M663209)the Fundamental Research Funds for the Central Universities in China(No.19lGPY100)。
文摘Bathymodiolus mussels distribute in both deep-sea cold seep and hydrothermal vent environments,whose endosymbiotic gill tissue is a prominent character for the adaptation of extreme habitats.However,few studies explored the adaptation mechanisms through comparative transcriptome sequencing and analysis of different tissues between seep mussels and vent mussels.We performed the comparative transcriptome sequencing and analysis for three tissue types(gill,mantle,and adductor muscle)of Bathymodiolus mussels collected from a cold seeping site Station S 11 and the 50-km away hydrothermal field Minami-Ensei Knoll in the Okinawa Trough.Results show that gene expression patterns had distinct tissue specificity.Compared with the non-endosymbiotic tissues(mantle and adductor muscle),the significantly strengthened gene functions in endosymbiotic gill included microbial recognition(fibrinogen C domain-containing protein 1-B-like(fibcd),fibrinogen-related protein 8(frp),peptidoglycan recognition proteins(pgrp),and C-type lectin(clec)),cell apoptosis and immunity(interferon regulatory factor 1/2-like 1(ir f),cathepsin D(ctsd),caspase 2(casp 2)),and antioxidant capacity(copper/zinc superoxide dismutase(czsod),glutathione peroxidase(gpx),selenoprotein(sel)),in both seep and vent individuals.Consistent with metal accumulation,high expression levels of genes related to heavy metal detoxification(cytochrome P 450(cyp),ferritin-like(ftl),metallothionein(mt),glutathione S-transferase(gst))were also observed in gill.Moreover,to adapt to high hydrostatic pressure in the deep sea,the Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways associated with cellular community were significantly enriched in all three tissues,suggesting the regulation of cell structure and cell adhesion at transcriptional level.This study obtained gene expression profiles of deep-sea mussels subsisting at cold seep and hydrothermal vent sites,which could lay foundations for comprehensive investigations of molecular basis in adaptation of deep-sea mussels to the two extreme ecosystems.
基金supported by the National Key Research and Development Project(2022YFD2100703)the National Natural Science Foundation of China(32394051 and U23A20259)the Fundamental Research Funds for the Central Universities(JUSRP622013).
文摘Lactococcus lactis,a major starter culture in the dairy industry,has been widely applied in food fermentation.While current research has primarily focused on evaluating its role during fermentation,genomic investigations into its genetic diversity and functional adaptability remain limited.In this study,199 L.lactis strains isolated from Chinese traditional artisanal cheeses(72 bovine,71 goat,and 56 yak milk cheese isolates)were subjected to comparative genomic analysis.Genomic characteristic analysis indicated that bovine milk strains possess larger genomes and the highest number of unique genes.Functional characterization further demonstrated notable differences in carbohydrate metabolism among strains from different sources,with yak milk strains enriched in enzymes involved in complex polysaccharide degradation,including members of the carbohydrate esterases family.Moreover,strains from different sources exhibit distinct strategies for lactose hydrolysis and metabolic utilization,reflecting adaptive evolution to their specific nutritional niches.Analysis of the antibiotic resistance profile suggests that L.lactis predominantly harbors glycopeptide and lincosamide resistance genes,encompassing four distinct resistance mechanisms.Collectively,this study reveals the genetic diversity and adaptive evolution of L.lactis strains from different sources and identifies key genes associated with carbohydrate degradation,lactose metabolism,and antibiotic resistance,providing concrete genetic evidence for the selection of efficient and safe industrial fermentation strains.
文摘This paper conducts clustering,potential semantic indexing,comparison,and inductive analysis of research papers on marketing between China and the UK from January 2020 to September 2024.The study found that the Chinese marketing research focuses on digital transformation,policy impact,value co-creation,and emerging e-commerce models.In contrast,the UK marketing research focuses more on sustainability,technology integration,real-time research,and personalized marketing strategies.The study also found that there were few marketing articles published in Chinese and CSSCI journals in China,while the SSCI journals published in English were 62 times more than in Chinese.According to the research,digital marketing and data-driven decision-making,diversified marketing channels,sustainability and circular economy,technological innovation and cutting-edge technology application,meta-universe and blockchain technology,AI+marketing development,brand building,and international market expansion will become the research hotspots in the field of marketing in the future.The research suggests that China should strengthen the construction of an academic marketing platform,and China and the UK should strengthen cooperation in marketing research,learn from each other's strengths,and jointly give full play to their advantages in technology application,market and economy,strategy and innovation,and social media,to contribute to global economic development and marketing research.
文摘Objective:This study aimed to investigate the anatomy of the accessory pudendal artery(APA)in Asian men and to describe APA preservation techniques during robot-assisted radical prostatectomy(RARP).Methods:APA was defined as“any artery located in the periprostatic region running parallel to the dorsal vascular complex and extending caudally toward the anterior perineum”.The anatomical variations of the APA were reviewed in 589 consecutive Japanese men who underwent conventional RARP at our institution between April 2019 and November 2023,including the number,laterality,side,size,and local distribution(apical vs.lateral).The apical APA emerges near the prostatic apical region,whereas the lateral APA courses along the lateral aspect of the prostate.They are further classified as the prostatic,fascial,and pubic APAs.Our APA identification and preservation techniques were described based on this classification.Results:Of the 589 Japanese men,299(51%)men were with one or more APAs:169 with one APA,115 with two APAs,14 with three APAs,and one with four APAs;and a total of 445 APAs were found.Approximately 97% of the APAs(432/445)were preserved.More lateral APAs were found than apical APAs(243/589[41%]vs.79/589[13%];p<0.001).Lateral APAs had a higher proportion of large-caliber arteries than apical APAs(59/359[16%]vs.1/86[1.2%];p<0.001),particularly prostatic and fascial APAs(14/59[24%]and 40/163[25%],respectively).Conclusion:This study identified anatomical variations of APAs in Japanese men and demonstrated that nearly all could be preserved during RARP.Further research is needed to evaluate the clinical benefits of APA preservation.
