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
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
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
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
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
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 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
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
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
[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
The growth and development of staminate inflorescence and anatomic structure of male chestnut flower were observed. Results showed that staminate in-florescence on the base of branch formed first, then upward successi...The growth and development of staminate inflorescence and anatomic structure of male chestnut flower were observed. Results showed that staminate in-florescence on the base of branch formed first, then upward successively. About 50 days were needed from the formation of staminate inflorescence on the base of branch to ful y develop the staminate inflorescence on the top of the branch. On the same staminate inflorescence, male flower clusters of the base formed first, then upward successively. About 20 days were needed from the formation of stami-nate inflorescence on the base of the male flower cluster to ful y develop the stami-nate inflorescence on the top of the branch. 5-7 male flowers forming a cluster, the flower number in a cluster was odd number usual y, and there was one on the top and each two paral el y arranged downward. The flower on the top came into bloom first, and then downward successively. The flowers paral el y arranged came into bloom at the same time. Sporangium of male flower of chestnut was monolocular. There were a large number of pol en grains in the sporangium. There were large differences between the development process of different sporangium in one male flower. Chestnut had larger quantity of male flowers and pol en and long period of pol ination compared with female flower. It is remained to be further studied whether it was necessary for anemophilous pol ination.展开更多
[Objective] This study was conducted to compare leaf anatomical structure of Malus sieversii and M. robusta under different salt concentration levels to determine their tolerance to salt and thus to provide rootstock ...[Objective] This study was conducted to compare leaf anatomical structure of Malus sieversii and M. robusta under different salt concentration levels to determine their tolerance to salt and thus to provide rootstock materials for apple production in salinized soil in Southern Xinjiang. [Method] The experiment was conducted with M. sieversii and M. robusta as test materials. Salt stress was simulated using 8 g/L of NaCI solution, and Hoagland nutrient solution was used instead of NaCI solution as control group （CK）. Samples were collected on the 20^th d of treatment, sliced through paraffin processing. The prepared paraffin sections of M. sieversii and M. robusta were then observed under a light microscope for anatomical structures of leaf, upper epidermis, lower epidermis, palisade tissue and spongy tissue. [Result] Compared with the control, the leaf, upper epidermis, lower epidermis and spongy tissue of M. sieversii and M. robusta under salt stress were thickened at different degrees, while the thickness of the palisade tissue was decreased. Moreover, high salt concentration caused severer damage to the cell structure of M. sieversii than to that of M. robusta, as M. robusta cells maintained better structural integrity. [Conclusion] M. robusta has higher adaptability to salt stress than M. sieversii.展开更多
BACKGROUND The long-term survival of patients with solitary hepatocellular carcinoma(HCC)following anatomical resection(AR)vs non-anatomical resection(NAR)is still controversial.It is necessary to investigate which ap...BACKGROUND The long-term survival of patients with solitary hepatocellular carcinoma(HCC)following anatomical resection(AR)vs non-anatomical resection(NAR)is still controversial.It is necessary to investigate which approach is better for patients with solitary HCC.AIM To compare perioperative and long-term survival outcomes of AR and NAR for solitary HCC.METHODS We performed a comprehensive literature search of PubMed,Medline(Ovid),Embase(Ovid),and Cochrane Library.Participants of any age and sex,who underwent liver resection,were considered following the following criteria:(1)Studies reporting AR vs NAR liver resection;(2)Studies focused on primary HCC with a solitary tumor;(3)Studies reporting the long-term survival outcomes(>5 years);and(4)Studies including patients without history of preoperative treatment.The main results were overall survival(OS)and disease-free survival(DFS).Perioperative outcomes were also compared.RESULTS A total of 14 studies,published between 2001 and 2020,were included in our meta-analysis,including 9444 patients who were mainly from China,Japan,and Korea.AR was performed on 4260(44.8%)patients.The synthetic results showed that the 5-year OS[odds ratio(OR):1.19;P<0.001]and DFS(OR:1.26;P<0.001)were significantly better in the AR group than in the NAR group.AR was associated with longer operating time[mean difference(MD):47.08;P<0.001],more blood loss(MD:169.29;P=0.001),and wider surgical margin(MD=1.35;P=0.04)compared to NAR.There was no obvious difference in blood transfusion ratio(OR:1.16;P=0.65)or postoperative complications(OR:1.24,P=0.18).CONCLUSION AR is superior to NAR in terms of long-term outcomes.Thus,AR can be recommended as a reasonable surgical option in patients with solitary HCC.展开更多
<strong>Aim: </strong>To compare the type of stress distribution pattern occurring with anatomic and non-anatomic tooth forms beneath a complete denture in both maxillary and mandibular arch. <strong>...<strong>Aim: </strong>To compare the type of stress distribution pattern occurring with anatomic and non-anatomic tooth forms beneath a complete denture in both maxillary and mandibular arch. <strong>Methodology: </strong>A photoelastic model of the edentulous maxillary and mandibular ridge was prepared meticulously to simulate the human mandible and maxilla. Two sets of acrylic teeth with anatomic and non-anatomic occlusal forms were used to fabricate upper and lower dentures. A vertical static load of 100 N was applied through the mandibular model to the maxillary model. After load application on the dentures the photoelastic model as well as the upper and lower complete dentures were sectioned in the midline. The sectioned photoelastic model was viewed through a polariscope to observe the fringe pattern indicating varying amounts of stress distribution. In this study, a two-dimensional photoelastic stress analysis technique was utilized. <strong>Results:</strong> Force per unit area was observed more in anatomic teeth than the non-anatomic counterpart. Hence anatomic tooth forms may increase the possibility of bone resorption rate over a period of time. However, in non-anatomic lower teeth, a decrease in value was observed from posterior to anterior region. <strong>Conclusion: </strong>Stress of greater magnitude was observed with cuspal teeth whereas non-anatomic (0<span style="white-space:nowrap;">°</span>) showed slightly less magnitude of stress. Depending upon the clinical situation the clinician needs to choose the type of occlusal tooth forms for edentulous patients.展开更多
Anatomical and chemical characteristics of stems affect lodging in wheat(Triticum aestivum L.) cultivars. Traits associated with lodging resistance, such as plant height, stem strength, culm wall thickness, pith diame...Anatomical and chemical characteristics of stems affect lodging in wheat(Triticum aestivum L.) cultivars. Traits associated with lodging resistance, such as plant height, stem strength, culm wall thickness, pith diameter, and stem diameter, were extensively investigated in earlier studies. However, the solid stem trait was rarely considered. In this study, we measured a range of anatomical and chemical characteristics on solid and hollow stemmed wheat cultivars. Significant correlations were detected between resistance to lodging and several anatomical features, including width of mechanical tissue, weight of low internodes, and width of stem walls. Morphological features that gave the best indication of improved lodging resistance were increased stem width, width of mechanical tissue layer, and stem density. Multiple linear regression analysis showed that 99% of the variation in lodging resistance could be explained by the width of the mechanical tissue layer, suggesting that solid stemmed wheat has several anatomical features for increasing resistance to lodging. In addition, microsatellite markers GWM247 and GWM340 were linked to a single solid stem QTL on chromosome 3BL in a population derived from the cross Xinongshixin(solid stem)/Line 3159(hollow stem). These markers should be valuable in breeding wheat for solid stem.展开更多
Hepatocellular carcinoma(HCC) is the sixth most common type of cancer and the third most frequent cause of cancer-related death. Advances in preoperative assessment of HCC(e.g., imaging studies and liver function test...Hepatocellular carcinoma(HCC) is the sixth most common type of cancer and the third most frequent cause of cancer-related death. Advances in preoperative assessment of HCC(e.g., imaging studies and liver function tests), surgical techniques, and postoperative care have improved the surgical outcomes and survival of patients who undergo hepatic resection for HCC. However, in the last 20 years, the long-term survival after hepatectomy has remained unsatisfactory owing to the high rates of local recurrence and multicentric occurrence. Anatomical liver resection(AR) was introduced in the 1980 s. Although several studies have revealed tangible benefits of AR for HCC, these benefits are still debated. Because most HCCs occur in patients with liver cirrhosis and poor hepatic function, there are many factors that affect survival, including the surgical method. Nevertheless, many studies have documented the perioperative and long-term benefits of AR in various conditions. In this article, we review the results of several recently published, well-designed comparative studies of AR, to investigate whether AR provides real benefits on survival outcomes. We also discuss the potential pitfalls associated with this approach.展开更多
Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the propor...Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the proportion of cases at each site and the related features.In this study,we explored the location,distribution and other features of colorectal cancers at each anatomic site in Chinese patients.Methods:We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018;the reports covered a total of 2,097,347 hospitalizations.Incident cases were chosen as the study population,and their epidemiological features were further analyzed.Results:A total of 20,739 colorectal cancer patients were identified.Rectum was the most common location(48.3%)of the cancer,whereas the proportions of patients with distal and proximal colon cancer were 24.5%and18.6%,respectively.Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites(each P<0.001).The highest proportion of emergency admissions,the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer(each P<0.001).The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy,cholecystolithiasis and/or gallbladder polyps and appendectomy(P=0.009,P<0.001 and P<0.001,respectively).The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension(P<0.001,respectively).Conclusions:The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer.Different epidemiological features were also found based on anatomic sites.Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.展开更多
BACKGROUND The long-term effect of anatomic resection(AR)is better than that of nonanatomic resection(NAR).At present,there is no study on microvascular invasion(MVI)and liver resection types.AIM To explore whether AR...BACKGROUND The long-term effect of anatomic resection(AR)is better than that of nonanatomic resection(NAR).At present,there is no study on microvascular invasion(MVI)and liver resection types.AIM To explore whether AR improves long-term survival in patients with hepatocellular carcinoma(HCC)by removing the peritumoral MVI.METHODS A total of 217 patients diagnosed with HCC were enrolled in the study.The surgical margin was routinely measured.According to the stratification of different tumor diameters,patients were divided into the following groups:≤2 cm group,2-5 cm group,and>5 cm group.RESULTS In the 2-5 cm diameter group,the overall survival(OS)of MVI positive patients was significantly better than that of MVI negative patients(P=0.031).For the MVI positive patients,there was a statistically significant difference between AR and NAR(P=0.027).AR leads to a wider surgical margin than NAR(2.0±2.3 cm vs 0.7±0.5 cm,P<0.001).In the groups with tumor diameters<2 cm,both AR and NAR can obtain a wide surgical margin,and the surgical margins of AR are wider than that of NAR(3.5±5.8 cm vs 1.6±0.5 cm,P=0.048).In the groups with tumor diameters>5 cm,both AR and NAR fail to obtain wide surgical margin(0.6±1.0 cm vs 0.7±0.4 cm,P=0.491).CONCLUSION For patients with a tumor diameter of 2-5 cm,AR can achieve the removal of peritumoral MVI by obtaining a wide incision margin,reduce postoperative recurrence,and improve prognosis.展开更多
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].
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.
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 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.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 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 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.
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.
基金Supported by the Major Project of the Natural Science Foundation of Hubei Province(2010CBB03901)the Key Project of the Industry-University-Research Cooperation Program of the Education Department of Hubei Province(C2010060)+3 种基金the Demonstration Project of the Forestry Scientific and Technical Extension of the Central Finance in 2011(2011BH0032)the Open Fund Project of the Key Laboratory of Economic Forest Germplasm Improvement Resources Comprehensive Utilization of Hubei Province(2013000503)the Industry-University-Research Cooperation Program of Huanggang Normal University(2012025703)the Postdoctoral Fund of Jiangsu Province(1402115C)~~
文摘The growth and development of staminate inflorescence and anatomic structure of male chestnut flower were observed. Results showed that staminate in-florescence on the base of branch formed first, then upward successively. About 50 days were needed from the formation of staminate inflorescence on the base of branch to ful y develop the staminate inflorescence on the top of the branch. On the same staminate inflorescence, male flower clusters of the base formed first, then upward successively. About 20 days were needed from the formation of stami-nate inflorescence on the base of the male flower cluster to ful y develop the stami-nate inflorescence on the top of the branch. 5-7 male flowers forming a cluster, the flower number in a cluster was odd number usual y, and there was one on the top and each two paral el y arranged downward. The flower on the top came into bloom first, and then downward successively. The flowers paral el y arranged came into bloom at the same time. Sporangium of male flower of chestnut was monolocular. There were a large number of pol en grains in the sporangium. There were large differences between the development process of different sporangium in one male flower. Chestnut had larger quantity of male flowers and pol en and long period of pol ination compared with female flower. It is remained to be further studied whether it was necessary for anemophilous pol ination.
文摘[Objective] This study was conducted to compare leaf anatomical structure of Malus sieversii and M. robusta under different salt concentration levels to determine their tolerance to salt and thus to provide rootstock materials for apple production in salinized soil in Southern Xinjiang. [Method] The experiment was conducted with M. sieversii and M. robusta as test materials. Salt stress was simulated using 8 g/L of NaCI solution, and Hoagland nutrient solution was used instead of NaCI solution as control group （CK）. Samples were collected on the 20^th d of treatment, sliced through paraffin processing. The prepared paraffin sections of M. sieversii and M. robusta were then observed under a light microscope for anatomical structures of leaf, upper epidermis, lower epidermis, palisade tissue and spongy tissue. [Result] Compared with the control, the leaf, upper epidermis, lower epidermis and spongy tissue of M. sieversii and M. robusta under salt stress were thickened at different degrees, while the thickness of the palisade tissue was decreased. Moreover, high salt concentration caused severer damage to the cell structure of M. sieversii than to that of M. robusta, as M. robusta cells maintained better structural integrity. [Conclusion] M. robusta has higher adaptability to salt stress than M. sieversii.
基金Supported by National Key Technologies RD Program,No.2018YFC1106803National Natural Science Foundation of China,No.81872004,No.81770615,and No.81672882Science and Technology Support Program of Sichuan Province,No.2019YFQ0001 and No.2017SZ0003。
文摘BACKGROUND The long-term survival of patients with solitary hepatocellular carcinoma(HCC)following anatomical resection(AR)vs non-anatomical resection(NAR)is still controversial.It is necessary to investigate which approach is better for patients with solitary HCC.AIM To compare perioperative and long-term survival outcomes of AR and NAR for solitary HCC.METHODS We performed a comprehensive literature search of PubMed,Medline(Ovid),Embase(Ovid),and Cochrane Library.Participants of any age and sex,who underwent liver resection,were considered following the following criteria:(1)Studies reporting AR vs NAR liver resection;(2)Studies focused on primary HCC with a solitary tumor;(3)Studies reporting the long-term survival outcomes(>5 years);and(4)Studies including patients without history of preoperative treatment.The main results were overall survival(OS)and disease-free survival(DFS).Perioperative outcomes were also compared.RESULTS A total of 14 studies,published between 2001 and 2020,were included in our meta-analysis,including 9444 patients who were mainly from China,Japan,and Korea.AR was performed on 4260(44.8%)patients.The synthetic results showed that the 5-year OS[odds ratio(OR):1.19;P<0.001]and DFS(OR:1.26;P<0.001)were significantly better in the AR group than in the NAR group.AR was associated with longer operating time[mean difference(MD):47.08;P<0.001],more blood loss(MD:169.29;P=0.001),and wider surgical margin(MD=1.35;P=0.04)compared to NAR.There was no obvious difference in blood transfusion ratio(OR:1.16;P=0.65)or postoperative complications(OR:1.24,P=0.18).CONCLUSION AR is superior to NAR in terms of long-term outcomes.Thus,AR can be recommended as a reasonable surgical option in patients with solitary HCC.
文摘<strong>Aim: </strong>To compare the type of stress distribution pattern occurring with anatomic and non-anatomic tooth forms beneath a complete denture in both maxillary and mandibular arch. <strong>Methodology: </strong>A photoelastic model of the edentulous maxillary and mandibular ridge was prepared meticulously to simulate the human mandible and maxilla. Two sets of acrylic teeth with anatomic and non-anatomic occlusal forms were used to fabricate upper and lower dentures. A vertical static load of 100 N was applied through the mandibular model to the maxillary model. After load application on the dentures the photoelastic model as well as the upper and lower complete dentures were sectioned in the midline. The sectioned photoelastic model was viewed through a polariscope to observe the fringe pattern indicating varying amounts of stress distribution. In this study, a two-dimensional photoelastic stress analysis technique was utilized. <strong>Results:</strong> Force per unit area was observed more in anatomic teeth than the non-anatomic counterpart. Hence anatomic tooth forms may increase the possibility of bone resorption rate over a period of time. However, in non-anatomic lower teeth, a decrease in value was observed from posterior to anterior region. <strong>Conclusion: </strong>Stress of greater magnitude was observed with cuspal teeth whereas non-anatomic (0<span style="white-space:nowrap;">°</span>) showed slightly less magnitude of stress. Depending upon the clinical situation the clinician needs to choose the type of occlusal tooth forms for edentulous patients.
基金supported by the National Basic Research Program of China (2011CB100302)the Knowledge Innovation Program of CAS (KSCX2-EW-N-02)
文摘Anatomical and chemical characteristics of stems affect lodging in wheat(Triticum aestivum L.) cultivars. Traits associated with lodging resistance, such as plant height, stem strength, culm wall thickness, pith diameter, and stem diameter, were extensively investigated in earlier studies. However, the solid stem trait was rarely considered. In this study, we measured a range of anatomical and chemical characteristics on solid and hollow stemmed wheat cultivars. Significant correlations were detected between resistance to lodging and several anatomical features, including width of mechanical tissue, weight of low internodes, and width of stem walls. Morphological features that gave the best indication of improved lodging resistance were increased stem width, width of mechanical tissue layer, and stem density. Multiple linear regression analysis showed that 99% of the variation in lodging resistance could be explained by the width of the mechanical tissue layer, suggesting that solid stemmed wheat has several anatomical features for increasing resistance to lodging. In addition, microsatellite markers GWM247 and GWM340 were linked to a single solid stem QTL on chromosome 3BL in a population derived from the cross Xinongshixin(solid stem)/Line 3159(hollow stem). These markers should be valuable in breeding wheat for solid stem.
文摘Hepatocellular carcinoma(HCC) is the sixth most common type of cancer and the third most frequent cause of cancer-related death. Advances in preoperative assessment of HCC(e.g., imaging studies and liver function tests), surgical techniques, and postoperative care have improved the surgical outcomes and survival of patients who undergo hepatic resection for HCC. However, in the last 20 years, the long-term survival after hepatectomy has remained unsatisfactory owing to the high rates of local recurrence and multicentric occurrence. Anatomical liver resection(AR) was introduced in the 1980 s. Although several studies have revealed tangible benefits of AR for HCC, these benefits are still debated. Because most HCCs occur in patients with liver cirrhosis and poor hepatic function, there are many factors that affect survival, including the surgical method. Nevertheless, many studies have documented the perioperative and long-term benefits of AR in various conditions. In this article, we review the results of several recently published, well-designed comparative studies of AR, to investigate whether AR provides real benefits on survival outcomes. We also discuss the potential pitfalls associated with this approach.
基金supported by grants from the National Natural Science Foundation of China(No.81972702 and No.91959110)national multidisciplinary cooperative diagnosis and treatment capacity building project for major diseases:comprehensive diagnosis and treatment of gastrointestinal tumors,National Health and Family Planning Commission Foundation of China(No.2020YB57)“Clinical Medicine+X”Foundation of Peking University(No.PKU2021LCXQ001)。
文摘Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the proportion of cases at each site and the related features.In this study,we explored the location,distribution and other features of colorectal cancers at each anatomic site in Chinese patients.Methods:We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018;the reports covered a total of 2,097,347 hospitalizations.Incident cases were chosen as the study population,and their epidemiological features were further analyzed.Results:A total of 20,739 colorectal cancer patients were identified.Rectum was the most common location(48.3%)of the cancer,whereas the proportions of patients with distal and proximal colon cancer were 24.5%and18.6%,respectively.Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites(each P<0.001).The highest proportion of emergency admissions,the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer(each P<0.001).The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy,cholecystolithiasis and/or gallbladder polyps and appendectomy(P=0.009,P<0.001 and P<0.001,respectively).The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension(P<0.001,respectively).Conclusions:The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer.Different epidemiological features were also found based on anatomic sites.Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.
基金The National Key Research and Development Program of China,No.2016YFC0106004.
文摘BACKGROUND The long-term effect of anatomic resection(AR)is better than that of nonanatomic resection(NAR).At present,there is no study on microvascular invasion(MVI)and liver resection types.AIM To explore whether AR improves long-term survival in patients with hepatocellular carcinoma(HCC)by removing the peritumoral MVI.METHODS A total of 217 patients diagnosed with HCC were enrolled in the study.The surgical margin was routinely measured.According to the stratification of different tumor diameters,patients were divided into the following groups:≤2 cm group,2-5 cm group,and>5 cm group.RESULTS In the 2-5 cm diameter group,the overall survival(OS)of MVI positive patients was significantly better than that of MVI negative patients(P=0.031).For the MVI positive patients,there was a statistically significant difference between AR and NAR(P=0.027).AR leads to a wider surgical margin than NAR(2.0±2.3 cm vs 0.7±0.5 cm,P<0.001).In the groups with tumor diameters<2 cm,both AR and NAR can obtain a wide surgical margin,and the surgical margins of AR are wider than that of NAR(3.5±5.8 cm vs 1.6±0.5 cm,P=0.048).In the groups with tumor diameters>5 cm,both AR and NAR fail to obtain wide surgical margin(0.6±1.0 cm vs 0.7±0.4 cm,P=0.491).CONCLUSION For patients with a tumor diameter of 2-5 cm,AR can achieve the removal of peritumoral MVI by obtaining a wide incision margin,reduce postoperative recurrence,and improve prognosis.
