In the 2010s,laparoscopic hepatectomy(LH) rapidly gained popularity in Japan as a minimally invasive approach for liver resections.It offers significant advantages,such as reduced postoperative pain and faster recover...In the 2010s,laparoscopic hepatectomy(LH) rapidly gained popularity in Japan as a minimally invasive approach for liver resections.It offers significant advantages,such as reduced postoperative pain and faster recovery.The Glissonean pedicle approach,employed during LH,enables precise anatomical resection,particularly for hepatocellular carcinoma and metastatic liver tumors.Innovations in training,including the use of animal models and the Japan Society for Endoscopic Surgery certification program,have been instrumental in improving surgical expertise.However,complex hepatectomies involving vascular or biliary reconstruction pose substantial technical challenges.Robotassisted hepatectomy(RAH) has shown great potential for improved precision and visualization,though its high costs and uncertain long-term benefits limit its widespread adoption.Further technological advancements,enhanced training programs,and large-scale comparative trials are necessary to evaluate the longterm efficacy of both LH and RAH.展开更多
As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinician...As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinicians or basic scientists define as such.展开更多
Background:The surgical management of patients with benign prostatic hyperplasia(BPH)has considerably evolved through recent years.Nonetheless,benefits and harms of several laser procedures are still to be determined....Background:The surgical management of patients with benign prostatic hyperplasia(BPH)has considerably evolved through recent years.Nonetheless,benefits and harms of several laser procedures are still to be determined.The study aimed to report perioperative and early functional results of patients treated with anatomical photo vaporization of the prostate(aPVP).Methods:Data from consecutive patients treated with aPVP by using a 180-W XPS GreenLight laser were prospectively collected in a single tertiary center between 2020 and 2023.The surgical procedure was divided into a modular step-by-step fashion.Patients were asked to complete self-administered questionnaires at baseline and during follow-up visits.Results:Overall,176 consecutive patients were enrolled.Median age was 65[interquartile range(IQR)63–72]years.The baseline median prostate volume was 61.2(IQR 52.5–71.0)mL,and the median max flow rate(Qmax)was 9.3(IQR 7.8–11.5)mL/s.Median preoperative International Prostate Symptom Score(IPSS)was 25(IQR 22–29).Overall,the median operative time was 42(IQR 31–47)minutes with a median energy/mL of tissue delivered of 2447 kJ/mL.At 3 month-evaluation,significant improvements were observed,with a median Qmax of 28(IQR:24–32)mL/s and a median IPSS reduction of 15(IQR:11–18)points.A strong inverse correlation was identified between energy delivery during initial procedural steps and the severity of postoperative storage symptoms(all p<0.05),underscoring the importance of precise energy modulation.Multivariate analysis identified increased prostate volume(odds ratio[OR]:1.02;95%confidence interval[CI]1.01–1.11;p=0.001)and higher prostate width-to-length ratio(OR:1.28;95%CI 1.04–1.78;p=0.03)as independent predictors of increased energy requirements.Conclusions:aPVP with 180-W XPS GreenLight laser is a safe and effective technique showing worthy early functional results.The limitation of the energy delivered in some key phases of the procedure may be associated with a significant reduction in postoperative irritative symptoms.The shape and dimensions of the prostate also play a critical role in determining the total energy required for complete adenoma removal.展开更多
To the Editor:Liver resection,particularly anatomical hepatectomy,has become a vital surgical approach for managing a range of liver diseases[1].Owing to its deep anatomical position,the caudate lobe is frequently imp...To the Editor:Liver resection,particularly anatomical hepatectomy,has become a vital surgical approach for managing a range of liver diseases[1].Owing to its deep anatomical position,the caudate lobe is frequently implicated in hepatobiliary diseases,necessitating precise evaluation and targeted treatment during anatomical liver resection[2,3].The caudate lobe's vascular anatomy is complex:the left portal vein branch(G1L,LPb)primarily supplies the Spiegel lobe,the bifurcation branch(G1F,HBb)feeds the paracaval region or caudate process,and the right posterior portal branch(G1C,RPb)serves the caudate process[4,5].展开更多
To the Editor:Laparoscopic liver resection(LLR)is widely used as a standard procedure for liver malignancies and benign diseases.Consensus guidelines stated that LLR may be feasible and safe in experienced centers.Evi...To the Editor:Laparoscopic liver resection(LLR)is widely used as a standard procedure for liver malignancies and benign diseases.Consensus guidelines stated that LLR may be feasible and safe in experienced centers.Evidence has shown that LLR is less invasive and has bet-ter patient prognosis than conventional procedures[1].However,laparoscopic anatomic liver resection(LALR)such as segment 8(S8)resection is still challenging due to difficulties in segmental mapping and surgical techniques[2,3].Liver S8 is in a deep-seated area surrounded by the ribs and the diaphragm,and closely con-nected to the right and middle hepatic veins and inferior vena cava.Furthermore,the Glissonean pedicle of segment 8(G8)is lo-cated deep in the liver parenchyma,lacking anatomical landmarks,and making forceps manipulation difficult.Therefore,LALR-S8 has been described as the most challenging procedure[4].展开更多
The kidney is essential for maintaining fluid,electrolyte,and metabolite homeostasis,and for regulating blood pressure.The pig serves as a valuable biomedical model for human renal physiology,offering insights across ...The kidney is essential for maintaining fluid,electrolyte,and metabolite homeostasis,and for regulating blood pressure.The pig serves as a valuable biomedical model for human renal physiology,offering insights across different physiological states.In this study,single-cell RNA sequencing was used to profile 138469 cells from 12 pig kidney samples collected during the embryonic(E),fattening(F),and pregnancy(P)periods,identifying 29 cell types.Proximal tubule(PT)cells exhibited elevated expression of metabolism-related transcription factors(TFs),including GPD1,ACAA1,and AGMAT,with validation across multiple individuals,periods,and species.Fluorescence homologous double-labeling of paraffin sections further confirmed the expression of ACAA1 and AGMAT in PT cells.Comparative analysis of pig and human kidneys revealed a high degree of similarity among corresponding cell types.Analysis of cell-type heterogeneity highlighted the diversity of thick ascending limb(TAL)cells,identifying a TAL subpopulation related to immune function.Additionally,the functional heterogeneity of kidney-resident macrophages(KRM)was explored across different anatomical sites.In the renal medulla,KRM were implicated in phagocytosis and leukocyte activation,whereas in the renal pelvis,they functioned as ligands,recruiting neutrophils with bactericidal activity to the renal pelvis to combat urinary tract infections.展开更多
AIM:To describe ocular biometric parameters among Han and Uyghur myopic adults in Xinjiang,China.METHODS:A cross-sectional study was conducted.The different ocular biometric parameters collected using Pentacam were an...AIM:To describe ocular biometric parameters among Han and Uyghur myopic adults in Xinjiang,China.METHODS:A cross-sectional study was conducted.The different ocular biometric parameters collected using Pentacam were analyzed,including corneal curvature,corneal astigmatism(CA),horizontal corneal diameter(white-to-white,WTW),corneal volume(CV),pupil diameter(PD),anterior chamber angle(ACA),anterior chamber depth(ACD),anterior chamber volume(ACV)and axial length(AL).RESULTS:In total,2932 participants were included in the final analysis,comprising 2310 Han and 622 Uyghur adults.Adults in the high myopia(HM)group had steeper K2,larger CA,smaller WTW and longer AL in both the Uyghur and Han adults(all P<0.05).The moderate myopia(MM)and HM group had deeper ACV,ACD and wider ACA than the low myopia(all P<0.05)in Han adults,however there were no differences in anterior chamber indices with Uyghur adults.In the Uyghur adults,we noticed that CV,WTW,and ACD were smaller,ACA was narrower,PD was larger,and AL was shorter(all P<0.05).We also noticed sex differences:males had flatter corneas,deeper ACD and ACV,and larger WTW than females(all P<0.05).In the correlation analysis,WTW was positively correlated with ACD and ACV but negatively correlated with K1,K2 and CV(all P<0.05).Narrower ACA was associated with larger PD(rU=-0.25,rH=-0.16,all P<0.01).CONCLUSION:The Han population have different biometric parameters in eyes with HM compared to the Uyghur population,and the Uyghur population may anatomically more susceptible to primary angle closure glaucoma than the Han population.展开更多
Root anatomical traits play an important role in understanding the link between root physiological function and ecological process. To determine how plants change root anatomical traits to adapt to distinct environmen...Root anatomical traits play an important role in understanding the link between root physiological function and ecological process. To determine how plants change root anatomical traits to adapt to distinct environments, we measured four key root anatomical traits-stele diameter(SD), cortex thickness(CT), root diameter(RD), and the stele to root diameter ratio(SDRD)-of first-order roots of 82species collected from different vegetation zones along a 2000 m altitudinal gradient on the northern slope of Taibai Mountain. Compared with other altitudes, plants located in temperate birch and fir forests had thinner SD, CT, RD, and SDRD. We found that elevational variation in root anatomical traits could largely be explained by phylogenetic taxonomy(clade). In addition, changes in SD were driven by soil bulk density, whereas variations in CT and RD were influenced by soil available nitrogen. When phylogenetic factors were removed from our analysis, allometric relationships between RD and root anatomical traits(SD and CT) were observed across different altitudes. Our study reveals the influence of phylogeny and environment on the elevational variation in root anatomical traits and further supports the allometric relationship between root anatomical traits(SD and CT) and RD. These findings enhance our understanding of the evolutionary and adaptive mechanisms of root anatomical structures, providing a basis for predicting how root anatomical traits respond to global changes.展开更多
Background:Dorsal approach is the potentially effective strategy for minimally invasive liver resection.This study aimed to compare the outcomes between robot-assisted and laparoscopic hemihepatectomy through dorsal a...Background:Dorsal approach is the potentially effective strategy for minimally invasive liver resection.This study aimed to compare the outcomes between robot-assisted and laparoscopic hemihepatectomy through dorsal approach.Methods:We compared the patients who underwent robot-assisted hemihepatectomy(Rob-HH)and who had laparoscopic hemihepatectomy(Lap-HH)through dorsal approach between January 2020 and December 2022.A 1:1 propensity score-matching(PSM)analysis was performed to minimize bias and confounding factors.Results:Ninety-six patients were included,41 with Rob-HH and 55 with Lap-HH.Among them,58 underwent left hemihepatectomy(LHH)and 38 underwent right hemihepatectomy(RHH).Compared with LapHH group,patients with Rob-HH had less estimated blood loss(median:100.0 vs.300.0 m L,P=0.016),lower blood transfusion rates(4.9%vs.29.1%,P=0.003)and postoperative complication rates(26.8%vs.54.5%,P=0.016).These significant differences consistently existed after PSM and in the LHH subgroups.Furthermore,robot-assisted LHH was associated with decreased Pringle duration(45 vs.60 min,P=0.047).RHH subgroup analysis showed that compared with Lap-RHH,Rob-RHH was associated with less estimated blood loss(200.0 vs.400.0 m L,P=0.013).No significant differences were found in other perioperative outcomes among pre-and post-PSM cohorts,such as Pringle duration,operative time,and hospital stay.Conclusions:The dorsal approach was a safe and feasible strategy for hemi-hepatectomy with favorable outcomes under robot-assisted system in reducing intraoperative blood loss,transfusion,and postoperative complications.展开更多
BACKGROUND Sigmoid colon cancer faces challenges due to anatomical diversity,including variable inferior mesenteric artery(IMA)branching and tumor localization complexities,which increase intraoperative risks.AIM To c...BACKGROUND Sigmoid colon cancer faces challenges due to anatomical diversity,including variable inferior mesenteric artery(IMA)branching and tumor localization complexities,which increase intraoperative risks.AIM To comprehensively evaluate the impact of three-dimensional(3D)visualization technology on enhancing surgical precision and safety,as well as optimizing perioperative outcomes in laparoscopic sigmoid cancer resection.METHODS A prospective cohort of 106 patients(January 2023 to December 2024)undergoing laparoscopic sigmoid cancer resection was divided into the 3D(n=55)group and the control(n=51)group.The 3D group underwent preoperative enhanced computed tomography reconstruction(3D Slicer 5.2.2&Mimics 19.0).3D reconstruction visualization navigation intraoperatively guided the following key steps:Tumor location,Toldt’s space dissection,IMA ligation level selection,regional lymph node dissection,and marginal artery preservation.Outcomes included operative parameters,lymph node yield,and recovery metrics.RESULTS The 3D group demonstrated a significantly shorter operative time(172.91±20.69 minutes vs 190.29±32.29 minutes;P=0.002),reduced blood loss(31.5±11.8 mL vs 44.1±23.4 mL,P=0.001),earlier postoperative flatus(2.23±0.54 days vs 2.53±0.61 days;P=0.013),shorter hospital length of stay(13.47±1.74 days vs 16.20±7.71 days;P=0.013),shorter postoperative length of stay(8.6±2.6 days vs 10.5±4.9 days;P=0.014),and earlier postoperative exhaust time(2.23±0.54 days vs 2.53±0.61 days;P=0.013).Furthermore,the 3D group exhibited a higher mean number of lymph nodes harvested(16.91±5.74 vs 14.45±5.66;P=0.030).CONCLUSION The 3D visualization technology effectively addresses sigmoid colon anatomical complexity through surgical navigation,improving procedural safety and efficiency.展开更多
BACKGROUND Ectopic gallbladder,occurring in 0.1%to 0.7%of the population,is rarely found in the left liver lobe without situs inversus totalis.Functional gallbladder disorder(FGBD),characterized by biliary pain withou...BACKGROUND Ectopic gallbladder,occurring in 0.1%to 0.7%of the population,is rarely found in the left liver lobe without situs inversus totalis.Functional gallbladder disorder(FGBD),characterized by biliary pain without stones or sludge,affects 8%of men and 21%of women.No prior cases of concomitant FGBD and left-sided gallbladder have been reported,posing diagnostic and surgical challenges.CASE SUMMARY A 73-year-old woman with a 20-year history of epigastric pain was diagnosed with a left-sided gallbladder and FGBD based on imaging findings and impaired gallbladder contraction.Laparoscopic cholecystectomy was performed and confirmed the ectopic gallbladder adherent to the left liver lobe.Postoperative pathology revealed no abnormalities,and the patient achieved complete symptom resolution at three-month follow-up.CONCLUSION This is the first reported case of FGBD with a left-sided gallbladder.Preoperative imaging,such as magnetic resonance cholangiopancreatography or computed tomography,is crucial for identifying anatomical variations of the gallbladder.Laparoscopic cholecystectomy is feasible but requires careful planning to avoid complications.展开更多
Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventiona...Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventional M-mode(MM)offers high-resolution imaging but requires precise alignment,which can be diffi cult in ICU patients.[3-5]Anatomical M-mode(AMM)allows flexible line adjustment,enabling accurate DE measurements despite poor acoustic windows.[6]However,comparative data between MM and AMM are limited.This retrospective study evaluated the concordance between MM and AMM for assessing right DE.展开更多
Soil salinization is a major abiotic stress that hampers plant development and significantly reduces agricultural productivity,posing a serious challenge to global food security.Akebia trifoliata(Thunb.)Koidz,a specie...Soil salinization is a major abiotic stress that hampers plant development and significantly reduces agricultural productivity,posing a serious challenge to global food security.Akebia trifoliata(Thunb.)Koidz,a species within the genus Akebia Decne.,is valued for its use in food,traditionalmedicine,oil production,and as an ornamental plant.Curcumin,widely recognized for its pharmacological properties including anti-cancer,anti-neuroinflammatory,and anti-fibrotic effects,has recently drawn interest for its potential roles in plant stress responses.However,its impact on plant tolerance to saline-alkali stress remains poorly understood.In this study,the effects of curcumin on saline-alkali resistance in A.trifoliata were examined by subjecting plants to a saline-alkali solution containing 150 mmol/L sodium ions(a mixture of Na_(2)SO_(4),Na_(2)CO_(3),and NaHCO_(3)).Curcumin treatment under these stress conditions leads to anatomical improvements in leaf structure.Furthermore,A.trifoliatamaintained a favorable Na^(+)/K^(+)ratio through increased potassium uptake and reduced sodium accumulation.Biochemical analysis revealed elevated levels of proline,soluble sugars,and soluble proteins,along with improved activities of antioxidant enzymes such as superoxide dismutase(SOD),catalase(CAT),and peroxidase(POD).Similarly,the concentrations of hydrogen peroxide(H_(2)O_(2))and malondialdehyde(MDA)were significantly reduced.Transcriptome analysis under saline-alkali stress conditions showed that curcumin influenced seven keymetabolic pathways annotated in the Kyoto Encyclopedia of Genes and Genomes(KEGG)database,with differentially expressed unigenes primarily enriched in transcription factor families such as MYB,AP2/ERF,NAC,bHLH,and C2C2.Moreover,eight differentially expressed genes(DEGs)associated with plant hormone signal transduction were linked to the auxin and brassinosteroid pathways,critical for cell elongation and plant growth.These findings indicate that curcumin increases saline-alkali stress tolerance in A.trifoliata by modulating physiological,biochemical,and transcriptional responses,ultimately supporting improved growth under adverse conditions.展开更多
BACKGROUND Periampullary diverticulum(PAD)is a common anatomical variant,but its association with post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)remains controversial.While PAD may alter amp...BACKGROUND Periampullary diverticulum(PAD)is a common anatomical variant,but its association with post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)remains controversial.While PAD may alter ampullary anatomy,increasing technical difficulty during ERCP,existing studies report inconsistent findings on its role in PEP pathogenesis.We hypothesize that PAD presence,particularly type B,shows a significant association with PEP development and may interact with procedural factors like pancreatic duct guidewire insertion.AIM To examine the association between PAD(including subtypes A/B)and PEP incidence after ERCP for choledocholithiasis.METHODS We conducted a retrospective cohort study of 615 patients undergoing ERCP at two tertiary hospitals from 2023 to 2025.Participants were stratified into PAD(n=183;subtype A=125,subtype B=58)and non-PAD(n=432)groups.The primary outcome was PEP incidence.Multivariable logistic regression adjusted for age,sex,hypertension,diabetes,gallbladder surgery,and guidewire insertion.Statistical significance was set at P<0.05(two-tailed).RESULTS PAD prevalence was 29.8%(183/615).PEP occurrence was more frequent in PAD patients[15.3%(28/183)]than in non-PAD patients[4.2%(18/432)],odds ratio(OR)=3.86,95%confidence interval:2.03-7.35,P<0.001.Type B PAD showed a stronger association with PEP than type A(OR=14.16,95%confidence interval:5.84-34.34,P<0.001).Guidewire pancreatic duct entry was linked to higher PEP odds in PAD patients(adjusted OR=5.02,P<0.05).Hypertension also demonstrated an association with PEP in the PAD subgroup(P=0.012).CONCLUSION PAD,particularly type B,is independently associated with PEP after ERCP.Patients with these features,especially those with hypertension or pancreatic duct instrumentation,may benefit from enhanced monitoring and prophylaxis.展开更多
BACKGROUND Certain implant combinations change leg length and offset in primary total hip arthroplasty(THA).Poor restoration of leg biomechanics is a frequently cited reason for patient dissatisfaction following prima...BACKGROUND Certain implant combinations change leg length and offset in primary total hip arthroplasty(THA).Poor restoration of leg biomechanics is a frequently cited reason for patient dissatisfaction following primary THA.A pure high-offset stem should provide direct lateralization without affecting femoral length when compared to a standard stem.However,clinical experience with preoperative planning software based on computed tomography-based three-dimensionalmodels reveals that using pure high-offset stems in THA may cause a difference between expected(no change in femoral length)and actual(small increase)in postoperative femoral length.AIM To elucidate the causes of these femoral length discrepancies using preoperative planning software.METHODS Preoperative templating for 43 robotic-assisted THAs,optimizing acetabular size and orientation,center of rotation,stem size and offset,and prosthetic head diameter were obtained.The preoperative planning software was used to calculate differences between preoperative and postoperative femoral length for standard and pure high-offset stems,unique to each patient.RESULTS Whilst the increase in femoral length between standard and high-offset stems was not significant(P=0.93),35 femurs(81.4%)experienced a 1-mm increase,and 3(7.0%)experienced a 2-mm increase in femoral length while using high-offset stem compared to the standard stem.The incidence of femoral length increase was lower for patients with shorter femurs(18/22;81.8%)compared to patients with longer femurs(20/21;95.2%).CONCLUSION When pure high-offset stems were used in preoperative planning software,we demonstrated an unexpected increase in leg length between 1-2-mm in 88.4%of patients.This unexpected increase in femoral length is due to a function of the preoperative planning software’s planned stem alignment with the anatomical axis,and not an inherent fault in the stem design.With expanding accessibility of robotic-assisted THA platforms,all potential sources of postoperative leg length discrepancy should be identified during preoperative templating and necessary alterations to the surgical plan should be made to accommodate this unexpected difference when using a pure high-offset stem.展开更多
Various approaches to laparoscopic anatomic liver resection have been described.In this paper,the authors present a technique that utilizes the ventral avascular areas above the inferior vena cava.While many liver sur...Various approaches to laparoscopic anatomic liver resection have been described.In this paper,the authors present a technique that utilizes the ventral avascular areas above the inferior vena cava.While many liver surgeons partially adopt this elements of this method,few employ it to the full extent outlined here.Main-taining low central venous pressure during anesthesia is critical to this approach,as demonstrated by the operative images showing collapsed hepatic veins.This technique is particularly advantageous when the patient’s body mass index is low,the tumor is small(or large but deeply embedded within the liver parenchy-ma),and the overlying liver tissue is not excessively bulky or heavy.Nonetheless,following the conventional course along the Glissonean pedicle can be beneficial.The authors demonstrate notable skill in completing these procedures laparosco-pically.However,concerns over margin positivity and tumor recurrence remain,and follow up studies are needed to further validate the approach.展开更多
This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical seg...This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical segment VIII resection,a challenging procedure due to the complex liver anatomy and difficulty in accessing deep-seated lesions.Peng and colleagues’experience with caudal and cranial approaches in 34 patients underscores the feasibility of these techniques while sparking debates about the optimal approach.Their study’s strengths lie in technique standardization and comprehensive analysis,although its limitations highlight the need for further research.As minimally invasive liver surgery progresses,larger,prospective trials and integration of advanced technologies are essential for establishing best practices.展开更多
Dear Editor,The importance of the medial entorhinal cortex(MEC)for memory and spatial navigation has been shown repeatedly in many species,including mice and humans[1,2].It is,therefore,not surprising that the connect...Dear Editor,The importance of the medial entorhinal cortex(MEC)for memory and spatial navigation has been shown repeatedly in many species,including mice and humans[1,2].It is,therefore,not surprising that the connectivity of this structure has been studied extensively over the past century,mainly using a range of anterograde and retrograde anatomical tracers[3].展开更多
[Objective] The aim was to study the effect of tomato yellow leaf curl virus （TYLCV） infection on leaf anatomical structure and protective enzyme system of tomato. [Method] The anatomical structure of infected and h...[Objective] The aim was to study the effect of tomato yellow leaf curl virus （TYLCV） infection on leaf anatomical structure and protective enzyme system of tomato. [Method] The anatomical structure of infected and healthy leaves of tomato were observed and compared by using paraffin section method. The activity changes of SOD, POD and CAT in the infected leaves of tomato were determined. [ Result] The results revealed that there were some differences in anatomical structure between healthy and infected leaves. Some cells of infected leaves were damaged so that the leaves curled and became yellow, which affected the normal function of organs. Compared with control, enzyme activities in the tomato plants infected by TYLCV were enhanced at the early periods and higher than that in control, then started to decline at the middle and late periods but lower than that in control.[ Conclusion] After infection by TYLCV, the leaf anatomical structure of tomato was changed greatly and the protective enzyme system was damaged severely, and affected the normal physJological metabolic functions of tissues and organs in tomato in further.展开更多
Plants usually suffer drought stress during their growth process. As the photosynthetic activity center of plants, the leaf is the most sensitive organ under drought stress. In order to support the research on drought...Plants usually suffer drought stress during their growth process. As the photosynthetic activity center of plants, the leaf is the most sensitive organ under drought stress. In order to support the research on drought resistance of higher plants, this study reviewed the adaptation response and damage performance of epidermal structure, palisade tissue and spongy tissue, thickness, veins and stomata of plant leaves under drought stress.展开更多
文摘In the 2010s,laparoscopic hepatectomy(LH) rapidly gained popularity in Japan as a minimally invasive approach for liver resections.It offers significant advantages,such as reduced postoperative pain and faster recovery.The Glissonean pedicle approach,employed during LH,enables precise anatomical resection,particularly for hepatocellular carcinoma and metastatic liver tumors.Innovations in training,including the use of animal models and the Japan Society for Endoscopic Surgery certification program,have been instrumental in improving surgical expertise.However,complex hepatectomies involving vascular or biliary reconstruction pose substantial technical challenges.Robotassisted hepatectomy(RAH) has shown great potential for improved precision and visualization,though its high costs and uncertain long-term benefits limit its widespread adoption.Further technological advancements,enhanced training programs,and large-scale comparative trials are necessary to evaluate the longterm efficacy of both LH and RAH.
文摘As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinicians or basic scientists define as such.
文摘Background:The surgical management of patients with benign prostatic hyperplasia(BPH)has considerably evolved through recent years.Nonetheless,benefits and harms of several laser procedures are still to be determined.The study aimed to report perioperative and early functional results of patients treated with anatomical photo vaporization of the prostate(aPVP).Methods:Data from consecutive patients treated with aPVP by using a 180-W XPS GreenLight laser were prospectively collected in a single tertiary center between 2020 and 2023.The surgical procedure was divided into a modular step-by-step fashion.Patients were asked to complete self-administered questionnaires at baseline and during follow-up visits.Results:Overall,176 consecutive patients were enrolled.Median age was 65[interquartile range(IQR)63–72]years.The baseline median prostate volume was 61.2(IQR 52.5–71.0)mL,and the median max flow rate(Qmax)was 9.3(IQR 7.8–11.5)mL/s.Median preoperative International Prostate Symptom Score(IPSS)was 25(IQR 22–29).Overall,the median operative time was 42(IQR 31–47)minutes with a median energy/mL of tissue delivered of 2447 kJ/mL.At 3 month-evaluation,significant improvements were observed,with a median Qmax of 28(IQR:24–32)mL/s and a median IPSS reduction of 15(IQR:11–18)points.A strong inverse correlation was identified between energy delivery during initial procedural steps and the severity of postoperative storage symptoms(all p<0.05),underscoring the importance of precise energy modulation.Multivariate analysis identified increased prostate volume(odds ratio[OR]:1.02;95%confidence interval[CI]1.01–1.11;p=0.001)and higher prostate width-to-length ratio(OR:1.28;95%CI 1.04–1.78;p=0.03)as independent predictors of increased energy requirements.Conclusions:aPVP with 180-W XPS GreenLight laser is a safe and effective technique showing worthy early functional results.The limitation of the energy delivered in some key phases of the procedure may be associated with a significant reduction in postoperative irritative symptoms.The shape and dimensions of the prostate also play a critical role in determining the total energy required for complete adenoma removal.
基金supported by the grants from the Natural Science Foundation of China(82173129 and 82203330)China Post-doctoral Science Foundation(2022M711589)+1 种基金Distinguished Youth Project of Nanjing Drum Tower HospitalNanjing Health Science and Technology Development Project(YKK22065)。
文摘To the Editor:Liver resection,particularly anatomical hepatectomy,has become a vital surgical approach for managing a range of liver diseases[1].Owing to its deep anatomical position,the caudate lobe is frequently implicated in hepatobiliary diseases,necessitating precise evaluation and targeted treatment during anatomical liver resection[2,3].The caudate lobe's vascular anatomy is complex:the left portal vein branch(G1L,LPb)primarily supplies the Spiegel lobe,the bifurcation branch(G1F,HBb)feeds the paracaval region or caudate process,and the right posterior portal branch(G1C,RPb)serves the caudate process[4,5].
文摘To the Editor:Laparoscopic liver resection(LLR)is widely used as a standard procedure for liver malignancies and benign diseases.Consensus guidelines stated that LLR may be feasible and safe in experienced centers.Evidence has shown that LLR is less invasive and has bet-ter patient prognosis than conventional procedures[1].However,laparoscopic anatomic liver resection(LALR)such as segment 8(S8)resection is still challenging due to difficulties in segmental mapping and surgical techniques[2,3].Liver S8 is in a deep-seated area surrounded by the ribs and the diaphragm,and closely con-nected to the right and middle hepatic veins and inferior vena cava.Furthermore,the Glissonean pedicle of segment 8(G8)is lo-cated deep in the liver parenchyma,lacking anatomical landmarks,and making forceps manipulation difficult.Therefore,LALR-S8 has been described as the most challenging procedure[4].
基金supported by the International Cooperation and Exchange Program of the National Natural Science Foundation of China(32261133531)。
文摘The kidney is essential for maintaining fluid,electrolyte,and metabolite homeostasis,and for regulating blood pressure.The pig serves as a valuable biomedical model for human renal physiology,offering insights across different physiological states.In this study,single-cell RNA sequencing was used to profile 138469 cells from 12 pig kidney samples collected during the embryonic(E),fattening(F),and pregnancy(P)periods,identifying 29 cell types.Proximal tubule(PT)cells exhibited elevated expression of metabolism-related transcription factors(TFs),including GPD1,ACAA1,and AGMAT,with validation across multiple individuals,periods,and species.Fluorescence homologous double-labeling of paraffin sections further confirmed the expression of ACAA1 and AGMAT in PT cells.Comparative analysis of pig and human kidneys revealed a high degree of similarity among corresponding cell types.Analysis of cell-type heterogeneity highlighted the diversity of thick ascending limb(TAL)cells,identifying a TAL subpopulation related to immune function.Additionally,the functional heterogeneity of kidney-resident macrophages(KRM)was explored across different anatomical sites.In the renal medulla,KRM were implicated in phagocytosis and leukocyte activation,whereas in the renal pelvis,they functioned as ligands,recruiting neutrophils with bactericidal activity to the renal pelvis to combat urinary tract infections.
基金Supported by the National Natural Science Foundation of China(No.81960181).
文摘AIM:To describe ocular biometric parameters among Han and Uyghur myopic adults in Xinjiang,China.METHODS:A cross-sectional study was conducted.The different ocular biometric parameters collected using Pentacam were analyzed,including corneal curvature,corneal astigmatism(CA),horizontal corneal diameter(white-to-white,WTW),corneal volume(CV),pupil diameter(PD),anterior chamber angle(ACA),anterior chamber depth(ACD),anterior chamber volume(ACV)and axial length(AL).RESULTS:In total,2932 participants were included in the final analysis,comprising 2310 Han and 622 Uyghur adults.Adults in the high myopia(HM)group had steeper K2,larger CA,smaller WTW and longer AL in both the Uyghur and Han adults(all P<0.05).The moderate myopia(MM)and HM group had deeper ACV,ACD and wider ACA than the low myopia(all P<0.05)in Han adults,however there were no differences in anterior chamber indices with Uyghur adults.In the Uyghur adults,we noticed that CV,WTW,and ACD were smaller,ACA was narrower,PD was larger,and AL was shorter(all P<0.05).We also noticed sex differences:males had flatter corneas,deeper ACD and ACV,and larger WTW than females(all P<0.05).In the correlation analysis,WTW was positively correlated with ACD and ACV but negatively correlated with K1,K2 and CV(all P<0.05).Narrower ACA was associated with larger PD(rU=-0.25,rH=-0.16,all P<0.01).CONCLUSION:The Han population have different biometric parameters in eyes with HM compared to the Uyghur population,and the Uyghur population may anatomically more susceptible to primary angle closure glaucoma than the Han population.
基金supported by the National Natural Science Foundation of China(No.32271611)Functional traits of plant communities at different elevation gradients in the Taibai Mountain of Qinling Mountains financed by the Ministry of Science and Technology of China(No.2016YFC0500202)245 Qinling National Forest Ecosystem Research Station in 2022 financed by Ministry of Education of China.
文摘Root anatomical traits play an important role in understanding the link between root physiological function and ecological process. To determine how plants change root anatomical traits to adapt to distinct environments, we measured four key root anatomical traits-stele diameter(SD), cortex thickness(CT), root diameter(RD), and the stele to root diameter ratio(SDRD)-of first-order roots of 82species collected from different vegetation zones along a 2000 m altitudinal gradient on the northern slope of Taibai Mountain. Compared with other altitudes, plants located in temperate birch and fir forests had thinner SD, CT, RD, and SDRD. We found that elevational variation in root anatomical traits could largely be explained by phylogenetic taxonomy(clade). In addition, changes in SD were driven by soil bulk density, whereas variations in CT and RD were influenced by soil available nitrogen. When phylogenetic factors were removed from our analysis, allometric relationships between RD and root anatomical traits(SD and CT) were observed across different altitudes. Our study reveals the influence of phylogeny and environment on the elevational variation in root anatomical traits and further supports the allometric relationship between root anatomical traits(SD and CT) and RD. These findings enhance our understanding of the evolutionary and adaptive mechanisms of root anatomical structures, providing a basis for predicting how root anatomical traits respond to global changes.
基金supported by grants from the National Nat-ural Science Foundation of China(82173129)the Innova-tive and Entrepreneurial Talent Doctor of Jiangsu Province,China(JSSCBS20221872)。
文摘Background:Dorsal approach is the potentially effective strategy for minimally invasive liver resection.This study aimed to compare the outcomes between robot-assisted and laparoscopic hemihepatectomy through dorsal approach.Methods:We compared the patients who underwent robot-assisted hemihepatectomy(Rob-HH)and who had laparoscopic hemihepatectomy(Lap-HH)through dorsal approach between January 2020 and December 2022.A 1:1 propensity score-matching(PSM)analysis was performed to minimize bias and confounding factors.Results:Ninety-six patients were included,41 with Rob-HH and 55 with Lap-HH.Among them,58 underwent left hemihepatectomy(LHH)and 38 underwent right hemihepatectomy(RHH).Compared with LapHH group,patients with Rob-HH had less estimated blood loss(median:100.0 vs.300.0 m L,P=0.016),lower blood transfusion rates(4.9%vs.29.1%,P=0.003)and postoperative complication rates(26.8%vs.54.5%,P=0.016).These significant differences consistently existed after PSM and in the LHH subgroups.Furthermore,robot-assisted LHH was associated with decreased Pringle duration(45 vs.60 min,P=0.047).RHH subgroup analysis showed that compared with Lap-RHH,Rob-RHH was associated with less estimated blood loss(200.0 vs.400.0 m L,P=0.013).No significant differences were found in other perioperative outcomes among pre-and post-PSM cohorts,such as Pringle duration,operative time,and hospital stay.Conclusions:The dorsal approach was a safe and feasible strategy for hemi-hepatectomy with favorable outcomes under robot-assisted system in reducing intraoperative blood loss,transfusion,and postoperative complications.
基金Supported by the Health Commission of Fuyang City,Anhui,China,No.FY2023-45Fuyang Municipal Science and Technology Bureau,Anhui,China,No.FK20245505+1 种基金Anhui Provincial Health Commission,No.AHWJ2023Baa20164Bengbu Medical University,No.2023byzd215.
文摘BACKGROUND Sigmoid colon cancer faces challenges due to anatomical diversity,including variable inferior mesenteric artery(IMA)branching and tumor localization complexities,which increase intraoperative risks.AIM To comprehensively evaluate the impact of three-dimensional(3D)visualization technology on enhancing surgical precision and safety,as well as optimizing perioperative outcomes in laparoscopic sigmoid cancer resection.METHODS A prospective cohort of 106 patients(January 2023 to December 2024)undergoing laparoscopic sigmoid cancer resection was divided into the 3D(n=55)group and the control(n=51)group.The 3D group underwent preoperative enhanced computed tomography reconstruction(3D Slicer 5.2.2&Mimics 19.0).3D reconstruction visualization navigation intraoperatively guided the following key steps:Tumor location,Toldt’s space dissection,IMA ligation level selection,regional lymph node dissection,and marginal artery preservation.Outcomes included operative parameters,lymph node yield,and recovery metrics.RESULTS The 3D group demonstrated a significantly shorter operative time(172.91±20.69 minutes vs 190.29±32.29 minutes;P=0.002),reduced blood loss(31.5±11.8 mL vs 44.1±23.4 mL,P=0.001),earlier postoperative flatus(2.23±0.54 days vs 2.53±0.61 days;P=0.013),shorter hospital length of stay(13.47±1.74 days vs 16.20±7.71 days;P=0.013),shorter postoperative length of stay(8.6±2.6 days vs 10.5±4.9 days;P=0.014),and earlier postoperative exhaust time(2.23±0.54 days vs 2.53±0.61 days;P=0.013).Furthermore,the 3D group exhibited a higher mean number of lymph nodes harvested(16.91±5.74 vs 14.45±5.66;P=0.030).CONCLUSION The 3D visualization technology effectively addresses sigmoid colon anatomical complexity through surgical navigation,improving procedural safety and efficiency.
文摘BACKGROUND Ectopic gallbladder,occurring in 0.1%to 0.7%of the population,is rarely found in the left liver lobe without situs inversus totalis.Functional gallbladder disorder(FGBD),characterized by biliary pain without stones or sludge,affects 8%of men and 21%of women.No prior cases of concomitant FGBD and left-sided gallbladder have been reported,posing diagnostic and surgical challenges.CASE SUMMARY A 73-year-old woman with a 20-year history of epigastric pain was diagnosed with a left-sided gallbladder and FGBD based on imaging findings and impaired gallbladder contraction.Laparoscopic cholecystectomy was performed and confirmed the ectopic gallbladder adherent to the left liver lobe.Postoperative pathology revealed no abnormalities,and the patient achieved complete symptom resolution at three-month follow-up.CONCLUSION This is the first reported case of FGBD with a left-sided gallbladder.Preoperative imaging,such as magnetic resonance cholangiopancreatography or computed tomography,is crucial for identifying anatomical variations of the gallbladder.Laparoscopic cholecystectomy is feasible but requires careful planning to avoid complications.
文摘Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventional M-mode(MM)offers high-resolution imaging but requires precise alignment,which can be diffi cult in ICU patients.[3-5]Anatomical M-mode(AMM)allows flexible line adjustment,enabling accurate DE measurements despite poor acoustic windows.[6]However,comparative data between MM and AMM are limited.This retrospective study evaluated the concordance between MM and AMM for assessing right DE.
基金supported by the National Natural Science Foundation of China(Number:32060645)The Joint Special Project(Key Project)of Yunnan Province Local Undergraduate University(202101BA070001-036)+2 种基金The Joint Special Project(Surface Project)of Yunnan Province Local Undergraduate University(202101BA070001-172)the Science Research Fund Project for Education Department of Yunnan Province(Numbers:2023Y0876,2023Y0860,2023J0828)the Basic Research Special Project for Science and Technology Department of Yunnan Provincial(Number:202301AU070137).
文摘Soil salinization is a major abiotic stress that hampers plant development and significantly reduces agricultural productivity,posing a serious challenge to global food security.Akebia trifoliata(Thunb.)Koidz,a species within the genus Akebia Decne.,is valued for its use in food,traditionalmedicine,oil production,and as an ornamental plant.Curcumin,widely recognized for its pharmacological properties including anti-cancer,anti-neuroinflammatory,and anti-fibrotic effects,has recently drawn interest for its potential roles in plant stress responses.However,its impact on plant tolerance to saline-alkali stress remains poorly understood.In this study,the effects of curcumin on saline-alkali resistance in A.trifoliata were examined by subjecting plants to a saline-alkali solution containing 150 mmol/L sodium ions(a mixture of Na_(2)SO_(4),Na_(2)CO_(3),and NaHCO_(3)).Curcumin treatment under these stress conditions leads to anatomical improvements in leaf structure.Furthermore,A.trifoliatamaintained a favorable Na^(+)/K^(+)ratio through increased potassium uptake and reduced sodium accumulation.Biochemical analysis revealed elevated levels of proline,soluble sugars,and soluble proteins,along with improved activities of antioxidant enzymes such as superoxide dismutase(SOD),catalase(CAT),and peroxidase(POD).Similarly,the concentrations of hydrogen peroxide(H_(2)O_(2))and malondialdehyde(MDA)were significantly reduced.Transcriptome analysis under saline-alkali stress conditions showed that curcumin influenced seven keymetabolic pathways annotated in the Kyoto Encyclopedia of Genes and Genomes(KEGG)database,with differentially expressed unigenes primarily enriched in transcription factor families such as MYB,AP2/ERF,NAC,bHLH,and C2C2.Moreover,eight differentially expressed genes(DEGs)associated with plant hormone signal transduction were linked to the auxin and brassinosteroid pathways,critical for cell elongation and plant growth.These findings indicate that curcumin increases saline-alkali stress tolerance in A.trifoliata by modulating physiological,biochemical,and transcriptional responses,ultimately supporting improved growth under adverse conditions.
文摘BACKGROUND Periampullary diverticulum(PAD)is a common anatomical variant,but its association with post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)remains controversial.While PAD may alter ampullary anatomy,increasing technical difficulty during ERCP,existing studies report inconsistent findings on its role in PEP pathogenesis.We hypothesize that PAD presence,particularly type B,shows a significant association with PEP development and may interact with procedural factors like pancreatic duct guidewire insertion.AIM To examine the association between PAD(including subtypes A/B)and PEP incidence after ERCP for choledocholithiasis.METHODS We conducted a retrospective cohort study of 615 patients undergoing ERCP at two tertiary hospitals from 2023 to 2025.Participants were stratified into PAD(n=183;subtype A=125,subtype B=58)and non-PAD(n=432)groups.The primary outcome was PEP incidence.Multivariable logistic regression adjusted for age,sex,hypertension,diabetes,gallbladder surgery,and guidewire insertion.Statistical significance was set at P<0.05(two-tailed).RESULTS PAD prevalence was 29.8%(183/615).PEP occurrence was more frequent in PAD patients[15.3%(28/183)]than in non-PAD patients[4.2%(18/432)],odds ratio(OR)=3.86,95%confidence interval:2.03-7.35,P<0.001.Type B PAD showed a stronger association with PEP than type A(OR=14.16,95%confidence interval:5.84-34.34,P<0.001).Guidewire pancreatic duct entry was linked to higher PEP odds in PAD patients(adjusted OR=5.02,P<0.05).Hypertension also demonstrated an association with PEP in the PAD subgroup(P=0.012).CONCLUSION PAD,particularly type B,is independently associated with PEP after ERCP.Patients with these features,especially those with hypertension or pancreatic duct instrumentation,may benefit from enhanced monitoring and prophylaxis.
文摘BACKGROUND Certain implant combinations change leg length and offset in primary total hip arthroplasty(THA).Poor restoration of leg biomechanics is a frequently cited reason for patient dissatisfaction following primary THA.A pure high-offset stem should provide direct lateralization without affecting femoral length when compared to a standard stem.However,clinical experience with preoperative planning software based on computed tomography-based three-dimensionalmodels reveals that using pure high-offset stems in THA may cause a difference between expected(no change in femoral length)and actual(small increase)in postoperative femoral length.AIM To elucidate the causes of these femoral length discrepancies using preoperative planning software.METHODS Preoperative templating for 43 robotic-assisted THAs,optimizing acetabular size and orientation,center of rotation,stem size and offset,and prosthetic head diameter were obtained.The preoperative planning software was used to calculate differences between preoperative and postoperative femoral length for standard and pure high-offset stems,unique to each patient.RESULTS Whilst the increase in femoral length between standard and high-offset stems was not significant(P=0.93),35 femurs(81.4%)experienced a 1-mm increase,and 3(7.0%)experienced a 2-mm increase in femoral length while using high-offset stem compared to the standard stem.The incidence of femoral length increase was lower for patients with shorter femurs(18/22;81.8%)compared to patients with longer femurs(20/21;95.2%).CONCLUSION When pure high-offset stems were used in preoperative planning software,we demonstrated an unexpected increase in leg length between 1-2-mm in 88.4%of patients.This unexpected increase in femoral length is due to a function of the preoperative planning software’s planned stem alignment with the anatomical axis,and not an inherent fault in the stem design.With expanding accessibility of robotic-assisted THA platforms,all potential sources of postoperative leg length discrepancy should be identified during preoperative templating and necessary alterations to the surgical plan should be made to accommodate this unexpected difference when using a pure high-offset stem.
文摘Various approaches to laparoscopic anatomic liver resection have been described.In this paper,the authors present a technique that utilizes the ventral avascular areas above the inferior vena cava.While many liver surgeons partially adopt this elements of this method,few employ it to the full extent outlined here.Main-taining low central venous pressure during anesthesia is critical to this approach,as demonstrated by the operative images showing collapsed hepatic veins.This technique is particularly advantageous when the patient’s body mass index is low,the tumor is small(or large but deeply embedded within the liver parenchy-ma),and the overlying liver tissue is not excessively bulky or heavy.Nonetheless,following the conventional course along the Glissonean pedicle can be beneficial.The authors demonstrate notable skill in completing these procedures laparosco-pically.However,concerns over margin positivity and tumor recurrence remain,and follow up studies are needed to further validate the approach.
基金Supported by National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical segment VIII resection,a challenging procedure due to the complex liver anatomy and difficulty in accessing deep-seated lesions.Peng and colleagues’experience with caudal and cranial approaches in 34 patients underscores the feasibility of these techniques while sparking debates about the optimal approach.Their study’s strengths lie in technique standardization and comprehensive analysis,although its limitations highlight the need for further research.As minimally invasive liver surgery progresses,larger,prospective trials and integration of advanced technologies are essential for establishing best practices.
文摘Dear Editor,The importance of the medial entorhinal cortex(MEC)for memory and spatial navigation has been shown repeatedly in many species,including mice and humans[1,2].It is,therefore,not surprising that the connectivity of this structure has been studied extensively over the past century,mainly using a range of anterograde and retrograde anatomical tracers[3].
基金Supported by the National 863 Program:Gene Polymerization Tech-nology Study and New Variety Breeding of High-qualityMulti-resist-ance and High-yield Tomato(2007AA10Z178)+1 种基金Shanghai Agricul-ture Committee Key ProjectGermplasm Innovation of Tomato Re-sistance to Yellow Leaf Curl Virus(2007)~~
文摘[Objective] The aim was to study the effect of tomato yellow leaf curl virus （TYLCV） infection on leaf anatomical structure and protective enzyme system of tomato. [Method] The anatomical structure of infected and healthy leaves of tomato were observed and compared by using paraffin section method. The activity changes of SOD, POD and CAT in the infected leaves of tomato were determined. [ Result] The results revealed that there were some differences in anatomical structure between healthy and infected leaves. Some cells of infected leaves were damaged so that the leaves curled and became yellow, which affected the normal function of organs. Compared with control, enzyme activities in the tomato plants infected by TYLCV were enhanced at the early periods and higher than that in control, then started to decline at the middle and late periods but lower than that in control.[ Conclusion] After infection by TYLCV, the leaf anatomical structure of tomato was changed greatly and the protective enzyme system was damaged severely, and affected the normal physJological metabolic functions of tissues and organs in tomato in further.
基金Supported by the Scientific Research Innovation Fund for the Youth of Hunan Academy of Forestry(2013LQJ13)~~
文摘Plants usually suffer drought stress during their growth process. As the photosynthetic activity center of plants, the leaf is the most sensitive organ under drought stress. In order to support the research on drought resistance of higher plants, this study reviewed the adaptation response and damage performance of epidermal structure, palisade tissue and spongy tissue, thickness, veins and stomata of plant leaves under drought stress.
