This paper addresses the design of a biomimetic fish robot actuated by piezoeeramic actuators and the effect of artificial caudal fins on the fish robot＇s performance. The limited bending displacement produced by a l...This paper addresses the design of a biomimetic fish robot actuated by piezoeeramic actuators and the effect of artificial caudal fins on the fish robot＇s performance. The limited bending displacement produced by a lightweight piezocomposite actuator was amplified and transformed into a large tail beat motion by means of a linkage system. Caudal fins that mimic the shape of a mackerel fin were fabricated for the purpose of examining the effect of caudal fm characteristics on thrust production at an operating frequency range. The thickness distribution of a real mackerel＇s fin was measured and used to design artificial caudal fins. The thrust performance of the biomimetic fish robot propelled by fins of various thicknesses was examined in terms of the Strouhal number, the Froude number, the Reynolds number, and the power consumption. For the same fm area and aspect ratio, an artificial caudal fin with a distributed thickness shows the best forward speed and the least power consumption.展开更多
AIM:To study our novel caudal approach laparoscopic posterior-sectionectomy with parenchymal transection prior to mobilization under laparoscopy-specific view.METHODS:Points of the procedure are:(1) Patients are put i...AIM:To study our novel caudal approach laparoscopic posterior-sectionectomy with parenchymal transection prior to mobilization under laparoscopy-specific view.METHODS:Points of the procedure are:(1) Patients are put in left lateral position and posterior sector is not mobilized;(2) Glissonian pedicle of the sector is encircled and clamped extra-hepatically and divided afterward during the transection;(3) Dissection of inferior vena cava(IVC) anterior wall behind the liver is started from caudal.Simultaneously,liver transection is performed to search right hepatic vein(RHV) from caudal;(4) Liver transection proceeds to the bifurcation of the vessels from caudal to cranial,exposing the surfaces of IVC and RHV.Since the remnant liver sinks down,the cutting surface is well-opend;and(5) After the completion of transection,dissection of the resected liver from retroperitoneum is easily performed using the gravity.This approach was performed for a 63 years old woman with liver metastasis close to RHV.RESULTS:RHV exposure is required for R0 resection of the lesion.Although the cutting plane is horizontal in supine position and the gravity obstructs the exposure in the small subphrenic space,the use of specific characteristics of laparoscopic hepatectomy,such as the good vision for the dorsal part of the liver and IVC and facilitated dissection using the gravity with the patient positioning,made the complete RHV exposure during the liver transection easy to perform.The operation time was 341 min and operative blood loss was 1356 mL.Her postoperative hospital stay was uneventfull and she is well without any signs of recurrences 14 mo after surgery.CONCLUSION:The new procedure is feasible and useful for the patients with tumors close to RHV and the need of the exposure of RHV.展开更多
Parkinson’s disease(PD)is the second most common and fastest-growing neurodegenerative disorder.In recent years,it has been recognized that neurotransmitters other than dopamine and neuronal systems outside the basal...Parkinson’s disease(PD)is the second most common and fastest-growing neurodegenerative disorder.In recent years,it has been recognized that neurotransmitters other than dopamine and neuronal systems outside the basal ganglia are also related to PD pathogenesis.However,little is known about whether and how the caudal zona incerta(ZIc)regulates parkinsonian motor symptoms.Here,we showed that specific glutamatergic but not GABAergic ZIc^(VgluT2) neurons regulated these symptoms.ZIc^(VgluT2) neuronal activation induced time-locked parkinsonian motor symptoms.In mouse models of PD,the ZIc^(VgluT2) neurons were hyperactive and inhibition of their activity ameliorated the motor deficits.ZIc^(VgluT2) neurons monosynaptically projected to the substantia nigra pars reticulata.Incerta-nigral circuit activation induced parkinsonian motor symptoms.Together,our findings provide a direct link between the ZIc,its glutamatergic neurons,and parkinsonian motor symptoms for the first time,help to better understand the mechanisms of PD,and supply a new important potential therapeutic target for PD.展开更多
Very little is known about the role of melatonin in the trigeminal system, including the function of melatonin receptor 1. In the present study, adult rats were injected with formaldehyde into the right vibrissae pad ...Very little is known about the role of melatonin in the trigeminal system, including the function of melatonin receptor 1. In the present study, adult rats were injected with formaldehyde into the right vibrissae pad to establish a model of orofacial inflammatory pain. The distribution of melatonin re- ceptor 1 and nicotinamide adenine dinucleotide phosphate diaphorase in the caudal spinal trigeminal nucleus and trigeminal ganglion was determined with immunohistochemistry and histo- chemistry. The results show that there are significant differences in melatonin receptor 1 expression and nicotinamide adenine dinucleotide phosphate diaphorase expression in the trigeminal ganglia and caudal spinal nucleus during the early stage of orofacial inflammatory pain. Our findings sug- gest that when melatonin receptor 1 expression in the caudal spinal nucleus is significantly reduced, melatonin＇s regulatory effect on pain is attenuated.展开更多
In the traditional flow-resistance-differential (FRD) type valve-less piezoelectric pump, the generated outflow and pressure are discontinuous because of the inherent periodicity and fluctuation of the pump. To overco...In the traditional flow-resistance-differential (FRD) type valve-less piezoelectric pump, the generated outflow and pressure are discontinuous because of the inherent periodicity and fluctuation of the pump. To overcome these drawbacks, utilizing the bending vibration of piezoelectric bimorph to drive fluid was conducted. However, our investigation on the current status of this piezoelectric bimorph pump shows that larger driving force and vibration amplitude are required for fluid pumping; the pumping can be realized through the centrifugal force; and the mechanism of fluid pumping is no longer further studied. Based on these cases, the paper designed a piezoelectric-stack pump with variable-cross-section oscillating (VCSO) vibrator by imitating the swing of the caudal-fin of tuna, and the pump is neither the rotating type nor the volumetric type according to the taxonomy. The interaction between the oscillating vibrator and the fluid parcel is firstly analyzed from the viewpoint of momentum conservation, and the analytical expression of pump flow rate is obtained. Then the modal and harmonic response analyses on the vibrator immerged in water are carried out. From the analyses the first two orders resonance frequencies are 832 Hz and 1 939 Hz, respectively, and the peak value of the tip amplitude is 0.6 mm. Laser Doppler vibrometer is used to measure both the frequency and vibration amplitude, and the determined first two orders resonance frequencies are 617 Hz and 1 356 Hz, respectively. The measured tip amplitude reaches to the peak value of 0.3 mm. At last, experimental measurement for the flow rates with different driving frequencies is conducted. The results show that the flow rate can reach 560 mL/min at 1 370 Hz when the pump runs under the backpressure of 30 mm water column. And the flow rate is as much as 560% of that of experiment results carried out by researchers from Brazil. The proposed pump innovates in both theory and taxonomy; in addition, the pump overcomes the drawbacks such as large flow fluctuation and low flow rate in the traditional FRD type pumps, which will help to broaden the application of the valve-less piezoelectric pump.展开更多
AIM:To characterize the regeneration-associated stem cell-related phenotype of hepatocyte-derived growth factor receptor(HGFR)-expressing cells in active ulcerative colitis(UC).METHODS:On the whole 38 peripheral blood...AIM:To characterize the regeneration-associated stem cell-related phenotype of hepatocyte-derived growth factor receptor(HGFR)-expressing cells in active ulcerative colitis(UC).METHODS:On the whole 38 peripheral blood samples and 38 colonic biopsy samples from 18 patients with histologically proven active UC and 20 healthy control subjects were collected.After preparing tissue microarrays and blood smears HGFR,caudal type homeobox 2(CDX2),prominin-1(CD133) and Musashi-1conventional and double fluorescent immunolabelings were performed.Immunostained samples were digitalized using high-resolution Mirax Desk instrument,and analyzed with the Mirax TMA Module software.For semiquantitative counting of immunopositive lamina propria(LP) cells 5 fields of view were counted at magnification x 200 in each sample core,then mean ± SD were determined.In case of peripheral blood smears,30 fields of view with 100 μm diameter were evaluated in every sample and the number of immunopositive cells(mean ± SD) was determined.Using 337 nm UVA Laser MicroDissection system at least 5000 subepithelial cells from the lamina propria were collected.Gene expression analysis of HGFR,CDX2,CD133,leucine-rich repeat-containing G-protein coupled receptor 5(Lgr5),Musashi-1 and cytokeratin20(CK20) were performed in both laser-microdisscted samples and blood samples by using real time reverse transcription polymerase chain reaction(RT-PCR).RESULTS:By performing conventional and double fluorescent immunolabelings confirmed by RT-PCR,higher number of HGFR(blood:6.7 ± 1.22 vs 38.5 ±3.18;LP:2.25 ± 0.85 vs 9.22 ± 0.65;P < 0.05),CDX2(blood:0 vs 0.94 ± 0.64;LP:0.75 ± 0.55 vs 2.11± 0.75;P < 0.05),CD133(blood:1.1 ± 0.72 vs 8.3± 1.08;LP:11.1 ± 0.85 vs 26.28 ± 1.71;P < 0.05)and Musashi-1(blood and LP:0 vs scattered) positive cells were detected in blood and lamina propria of UC samples as compared to controls.HGFR/CDX2(blood:0 vs 1± 0.59;LP:0.8 ± 0.69 vs 2.06 ± 0.72,P < 0.05)and Musashi-1/CDX2(blood and LP:0 vs scattered) coexpressions were found in blood and lamina propria of UC samples.HGFR/CD133 and CD133/CDX2 coexpressions appeared only in UC lamina propria samples.CDX2,Lgr5 and Musashi-1 expressions in UC blood samples were not accompanied by CK20 mRNA expression.CONCLUSION:In active UC,a portion of circulating HGFR-expressing cells are committed to the epithelial lineage,and may participate in mucosal regeneration by undergoing mesenchymal-to-epithelial transition.展开更多
Objective:Caudal block provides satisfactory postoperative pain relief in lower abdominal operations.This pilot study explores its safety and effect on postoperative pain control in patients who underwent robot-assist...Objective:Caudal block provides satisfactory postoperative pain relief in lower abdominal operations.This pilot study explores its safety and effect on postoperative pain control in patients who underwent robot-assisted laparoscopic radical prostatectomy(RARP).Methods:From 2013 to 2014,40 consecutive patients were randomized into two groups d one received caudal block using ropivacaine immediately after operation,the other received standard analgesia.Primary outcome measure was pain score based on 11-point Likert scale(0e10)recorded at recovery room,and at 6,12,24,48,and 72 h after operation.All analgesic requirements,opioid-related adverse events and time to passage of flatus were examined.Results:Mean age of the two groups was similar(60.4 vs.62.3 years,p Z 0.33),as was American Society of Anaesthesiologists(ASA)class,body mass index(BMI)and operation times.No significant difference in median pain scores was reported in recovery room(2 vs.3,p Z 0.34),and at 6 h(2 vs.2,p Z 0.94),12 h(0 vs.0,p Z 0.62),24 h(1 vs.0,p Z 0.58),48 h(1 vs.0,p Z 0.36)and 72 h(0 vs.0,p Z 0.78)postoperatively between control and caudal block groups,respectively.There was a higher mean opioid usage in the caudal block group which was not statistically significant.Although this was statistically insignificant while no significant difference in mean paracetamol usage was observed postoperatively.Median time to passage of flatus was similar(2.0 vs.2.0 days,p Z 0.97).There was one case of superficial wound infection and no opioid-related adverse events observed.Hospital stay was similar in both groups(2.5 vs.2.5 days,p Z 0.96).展开更多
The viscous flow field around two-dimensional flapping （ heaving and pitching） foils was numerically computed. The structural characteristics of caudal vortices were investigated and the contour curves at different ...The viscous flow field around two-dimensional flapping （ heaving and pitching） foils was numerically computed. The structural characteristics of caudal vortices were investigated and the contour curves at different phase angles were obtained. The relationships between the structural characteristics of the vortices and the force acting on the foil and between the widths of the caudal vortex street and of the caudal flow field were analyzed. A method to determine the shedding frequency of the vortices was proposed.展开更多
In the tails of dromaeosaurid dinosaurs and rhamphorhynchid pterosaurs, elongate osteological rods extend anteriorly from the chevrons and the prezygapophyses. These caudal rods are positioned in parallel and are stac...In the tails of dromaeosaurid dinosaurs and rhamphorhynchid pterosaurs, elongate osteological rods extend anteriorly from the chevrons and the prezygapophyses. These caudal rods are positioned in parallel and are stacked dorsoventrally. The fully articulated and three-dimensionally preserved caudal series of some dromaeosaurid specimens show that individually these caudal rods were flexible, not rigid as previously thought. However, examination of the arrangement of the caudal rods in cross-section indicates that the combined effect of multiple caudal rods did provide substantial rigidity in the dorsoventral, but not in the lateral, plane. The results of digital muscle reconstructions confirm that dromaeosaurids and rhamphorhynchids also shared greatly reduced caudofemoral muscles in the anterior tail region. The striking similarities between the tails of dromaeosaurids and rhamphorhynchids suggest that both evolved under similar behavioral and biomechanical pressures. Combined with recent discoveries of primitive deinonychosaurs that phylogenetically bracket the evolution of dromaeosaurid caudal rods between two arboreal gliding/flying forms, these results are evidence that the unique caudal morphologies of dromaeosaurids and rhamphorhynchids were both adaptations for an aerial lifestyle.展开更多
BACKGROUND Laparoscopic hepatectomy is a proven safe and technically feasible approach for liver tumor resection,but laparoscopic anatomical SVIII resection(LASVIIIR)remains rarely reported due to poor accessibility,d...BACKGROUND Laparoscopic hepatectomy is a proven safe and technically feasible approach for liver tumor resection,but laparoscopic anatomical SVIII resection(LASVIIIR)remains rarely reported due to poor accessibility,difficult exposure,and the deep-lying Glissonean pedicle.This study examined the safety,feasibility,and perio-perative outcomes of LASVIIIR via a middle hepatic fissure approach at our in-stitution.AIM To investigate the safety,feasibility,and perioperative outcomes of LASVIIIR via a middle hepatic fissure approach at our institution.METHODS From November 2017 to December 2022,all patients with a liver tumor who underwent LASVIIIR were enrolled.The perioperative outcomes and postope-rative complications were evaluated.RESULTS Thirty-four patients underwent LASVIIIR via a middle hepatic fissure approach from the side or cranio side and were included.The mean operation time was 164±54 minutes,and the intra-operative blood loss was 100 mL(range:20-1000 mL).The mean operative times were,respectively,152±50 minutes and 222±29 minutes(P=0.001)for the caudal side and cranial side approaches.In addition,the median blood loss volumes were 100 mL(range:20-300 mL)and 250 mL(range:20-1000 mL),respectively,for the caudal and cranial sides(P=0.064).Three patients treated using the cranial side approach experienced bile leakage,while 1 patient treated using the caudal side approach had subphrenic collection and underwent percutaneous drainage to successfully recover.There were no differences regarding postoperative hospital stays for the caudal and cranial side approaches[9(7-26)days vs 8(8-19)days](P=0.226).CONCLUSION LASVIIIR resection remains a challenging operation,but the middle hepatic fissure approach is a reasonable and easy-to-implement technique.展开更多
<span style="font-family:Verdana;"><strong>Introduction:</strong></span><span style="font-family:Verdana;">Regional anaesthesia combined with general anaesthesia reduc...<span style="font-family:Verdana;"><strong>Introduction:</strong></span><span style="font-family:Verdana;">Regional anaesthesia combined with general anaesthesia reduces </span><span style="font-family:;" "=""><span style="font-family:Verdana;">stress response to surgery, duration of ventilation, intensive care unit (ICU) </span><span style="font-family:Verdana;">stay and promotes early recovery. Studies on thoracic epidural, caudal analgesi</span><span style="font-family:Verdana;">a along wit</span><span style="font-family:Verdana;">h general anaesthesia (GA) in paediatric </span><span style="font-family:Verdana;">cardiac surgery are limited he</span><span style="font-family:Verdana;">nce we aimed to compare efficacy and safety of caudal, thoracic epid</span><span style="font-family:Verdana;">ural and intravenous analgesia in paediatric cardiac surgery. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This study was conducted in the Department of Anaesthesiology in a tertiary care teaching hospital in southern India from February 2019 to December 2019. 90 children were randomised into group A, group B, group C. Children in group A received caudal analgesia along with GA. Group B children received thoracic epidural along with GA. Group C patients received intravenous analgesia along with GA. Rescue analgesia 1 mcg/kg fentanyl given in all 3 groups if p</span><span style="font-family:Verdana;">ai</span><span style="font-family:Verdana;">n score is more than 4. Primary outcome assessed was post-o</span><span style="font-family:Verdana;">p pain sco</span><span style="font-family:Verdana;">res. Secondary outcome assessed was duration of ventilation, duration of intensive care unit stay. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> All patients were comparable in terms of age, sex, </span><span style="font-family:Verdana;">weight, mean RACHS score, baseline heart rate and blood pressure. Pain sco</span><span style="font-family:Verdana;">res </span><span style="font-family:Verdana;">were significantly lower in thoracic epidural group compared to other two grou</span><span style="font-family:Verdana;"> ps. Duration of ventilation was lower in thoracic epidural group (91.17</span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 43.85) minutes and caudal (199.6 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 723.59) minutes compared to intravenous analgesia groups (436.37 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 705.51) minutes. Duration of ICU stay was significantly low in thoracic epidural group (2.73 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 0.69) days compared to caudal (3.7 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 2.8) and intravenous analgesia groups (4.33 </span><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;"> 0.920). We didn’t have </span><span><span style="font-family:Verdana;">any complications like hematoma, transient or permanent neurological sequelae in regional anesthesia groups. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Regional anaesthesia along with </span></span><span style="font-family:Verdana;">general anaesthesia was more effective in pain relief than intravenous analgesia with general anaesthesia in paediatric cardiac surgery.</span></span></span>展开更多
Zebrafish hematopoietic stem and progenitor cells（HSPCs） originate from the hemogenic endothelium of the ventral wall of the dorsal aorta（DA） through the endothelial-to-hematopoietic transition（EHT） from approxi...Zebrafish hematopoietic stem and progenitor cells（HSPCs） originate from the hemogenic endothelium of the ventral wall of the dorsal aorta（DA） through the endothelial-to-hematopoietic transition（EHT） from approximately 30 to 60 hours post fertilization（hpf）. However, whether other artery sites can generate HSPCs de novo remains unclear. In this study, using live imaging and lineage tracing, we found that the caudal dorsal artery（CDA） in the caudal hematopoietic tissue directly gave rise to HSPCs through EHT.This process initiated from approximately 60 hpf and terminated at approximately 156 hpf. Compared with that in the DA, fewer EHT events were observed in the CDA. The EHT events in the DA and CDA were similarly regulated by Runx1 but differentially influenced by blood flow（i.e., the EHT frequency in CDA was affected to a lesser extent when circulation was compromised in the tnnt2a～（-/-）mutant）. Therefore,the whole artery, including both DA and CDA, was endowed with the ability to produce HSPCs during a much longer time period. Coincidently, the lineage tracing results indicated that adult hematopoietic cells originated from the embryonic endothelium, and those produced later preferentially colonized the adult thymus. Collectively, our study revealed that the CDA serves as an additional source of hematopoiesis, and it shows similar but not identical properties with the DA.展开更多
A simplified model of the thrust force is proposed based on a caudal fin oscillation of an underwater bionic robot. The caudal fin oscillation is generalized by cen- tral pattern generators （CPGs）. In this model, th...A simplified model of the thrust force is proposed based on a caudal fin oscillation of an underwater bionic robot. The caudal fin oscillation is generalized by cen- tral pattern generators （CPGs）. In this model, the drag coefficient and lift coefficient are the two critical parameters which are obtained by the digital particle image velocimetry （DPIV） and the force transducer experiment. Numerical simulation and physical experi- ments have been performed to verify this dynamic model.展开更多
The initial mechanical damage of a spinal cord injury(SCI)triggers a progressive secondary injury cascade,which is a complicated process integrating multiple systems and cells.It is crucial to explore the molecular an...The initial mechanical damage of a spinal cord injury(SCI)triggers a progressive secondary injury cascade,which is a complicated process integrating multiple systems and cells.It is crucial to explore the molecular and biological process alterations that occur after SCI for therapy development.The differences between the rostral and caudal regions around an SCI lesion have received little attention.Here,we analyzed the differentially expressed genes between rostral and caudal sites after injury to determine the biological processes in these two segments after SCI.We identified a set of differentially expressed genes,including Col3a1,Col1a1,Dcn,Fn1,Kcnk3,and Nrg1,between rostral and caudal regions at different time points following SCI.Functional enrichment analysis indicated that these genes were involved in response to mechanical stimulus,blood vessel development,and brain development.We then chose Col3a1,Col1a1,Dcn,Fn1,Kcnk3,and Nrg1 for quantitative real-time PCR and Fn1 for immunostaining validation.Our results indicate alterations in different biological events enriched in the rostral and caudal lesion areas,providing new insights into the pathology of SCI.展开更多
Fresh semen has a very limited life span after it leaves the gonad. The relative research shows that the epididymal plasma provides a special environment to spermatozoa for survival. In this study, the osmolarity and ...Fresh semen has a very limited life span after it leaves the gonad. The relative research shows that the epididymal plasma provides a special environment to spermatozoa for survival. In this study, the osmolarity and protein concentration of caput and caudal bull epididymis were analyzed. Bovine caudal epididymal sperm were incubated in different protein and sorbitol combinations of CEP-2 diluents at 4 ℃ for 120 h and sperm viability was assessed. Under this condition, sperm viability was greater than 60% after 5 d. The osmolarity of caput and caudal epididymis were （287.0 ± 13.7） and （310.8 ± 17.0 ） mOsm, respectively. The protein concentration of caput and caudal epididymis were （ 37.43 ± 12.55 ） and （50.58±11.08） mg/mg, respectively. This may have an application in the animal production industry.展开更多
Introduction: The caudal anesthesia is used by many authors for postoperative analgesia. The purpose of this study was to report our experience in the practice of caudal block as post operative analgesia method in amb...Introduction: The caudal anesthesia is used by many authors for postoperative analgesia. The purpose of this study was to report our experience in the practice of caudal block as post operative analgesia method in ambulatory surgery in a context of limited technical equipment. Patients and Method: Over a period of 5 months, a prospective study was conducted on 39 children aged 3 to 5 years weighing on average 15.12 kg. Children classified ASA I and II were selected. After premedication with midazolam (0.3 mg/kg) by intra rectal route, the inhalation induction was made with sevoflurane 8%, conveyed by fresh gas (50% O2 and 50% air). The caudal block was obtained with the levobupivacaine 0.25% at a dose of 1 ml/kg. The hemodynamic parameters (systolic and diastolic blood pressure, heart rates) and respiratory parameters (respiratory frequency) pre-, per- and post-operative were measured. Post-operative pain was assessed with the Objective Pain Scale (OPS). The date of first use of analgesia was noted. The adverse effects of caudal block (meningitis, respiratory disorders, acute urinary retention, cardiac disorders) have been assessed. Results: The average duration of the procedure was 55.2 minutes. The use of analgesia was made 4 hours after skin closure, when the OPS Broadmann score was greater than 3. An agitation was observed in 6 children. Haemodynamic parameters have not significantly varied from the pre- to the post-operative. No infectious complications or intolerance to local anesthetics were observed. Allthe children were able to drink 4 hours after the end of the intervention and issued their first urine later than 3 hours after surgery. Conclusion: This type of anesthesia has been found very suitable for ambulatory surgery of the child, and is always helpful. It assured a post operative analgesia of good quality, and a reduction in consumption of morphine intraoperatively.展开更多
Objective:Caudal epidural analgesia has become very common analgesic technique in paediatric surgery.Adding tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects.The aim...Objective:Caudal epidural analgesia has become very common analgesic technique in paediatric surgery.Adding tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects.The aim of the study was to investigate the different effects of caudal bupivacaine versus bupivacaine with thamadol for postoperative analgesia in paediatric cancer patients.Methods:A prospective randomized controlled trial was conducted over 40 paediatric cancer patients who were recruited from Children Cancer Hospital of Egypt(57357 Hospital).Patients were randomized into 2 groups:bupivacaine group(group B,20 patients) to receive single shot caudal block of 1 mL/kg 0.1875% bupivacaine;tramadol group(group T,20 patients) prepared as group B with the addition of 1 mg/kg caudal tramadol.Results:The mean duration of analgesia was significantly longer among group T than group B [(24 ± 13.7) hours versus(7 ± 3.7) hours respectively with P = 0.001].Group T showed a significantly lower mean FLACC score than group B(2.2 ± 0.9 versus 3.6 ± 0.6 with P = 0.002).The difference in FLACC score was comparable on arrival,and after 2 and 4 hours.At 8 and 12 hours the group B recorded significantly higher scores(P = 0.002 and 0.0001 respectively).There were no significant differences between the groups as regards sedation score [the median in both groups was 1(0-1) with P value = o.8].No one developed facial flush or pruritis.Conclusion:Caudal injection of low dose tramadol 1 mg/kg with bupivacaine 0.1875% is proved to be effective,long standing technique for postoperative analgesia in major paediatric cancer surgery and almost devoid of side effect.展开更多
<b>Background and Aims:</b> Low back pain (LBP) is considered one of the most common health conditions in the world right now, and it affects many individuals throughout different stages of their lives. Ch...<b>Background and Aims:</b> Low back pain (LBP) is considered one of the most common health conditions in the world right now, and it affects many individuals throughout different stages of their lives. Chronic LBP (CLBP) was estimated to be between 5% and 10%, defined as LBP that lasts for 12 weeks. The most common causes of CLBP with radiculopathy are lumbar disc prolapse (LDP) and degenerative facet osteoarthropathy (DFO);the aim of this study is to investigate the efficacy of ultrasound (US) guided, fluoroscopy (FL) guided, Caudal Epidural Steroid Injection (CESI), lumbar epidural steroid injections (LESI), and blinding lumbosacral steroid injections (LSPSI) in patients with CLBP with radiculopathy. <b>Patients and Methods:</b> This is a randomized prospective study that was conducted at the department of rheumatology at Al Azhar University Hospital in Egypt between November 2020 and August 2021. A total of 100 patients with refractory CLBP with radiculopathy were enrolled in the study. Consequently, they were divided into 2 groups: the first consisted of fifty patients with CLBP and radiculopathy caused by LDP, as determined by lumbosacral magnetic resonance imaging (MRI), and the second group consisted of fifty patients with refractory low back pain and radiculopathy caused by DFO, as determined by lumbosacral plain x-rays and lumbosacral MRI. The following procedures were performed: US-guided CESI, FL-guided CESI, FL-guided LESI, US-guided LESI, and blinding LSPSI. <b>Results:</b> In the LDP group, there is a statistically significant difference between considered spinal nerve roots as regards Visual Analogue Scale (VAS) (at 2 months). Likewise, a statistically significant difference was found between blinding LSPSI and US-Guided LESI with respect to VAS (baseline) and VAS (2 months) (P-value = 0.018 and 0.003, respectively). Statistically significant differences were reported in VAS (2 months) for both FL-guided LESI and FL-guided CESI groups. Considering the VAS of studied spinal nerve roots in the DFO group, there is a statistically significant difference between the examined spinal nerve roots with respect to Oswestry Disability Index (ODI) (2 months). Similarly, there is a statistically significant difference in VAS (2 months) between US-guided LESI and para-spinal roots and FL-guided LESI and para-spinal roots (P-value = 0.038 and 0.021, respectively). Additionally, there is a statistically significant difference between the US-guided CESI, FL-guided CESI, FL-guided LESI, and spinal nerve roots with respect to ODI (at 2 months). (P-value = 0.033, 0.025 and 0.005, respectively). <b>Conclusion:</b> US is excellent in guiding CESI and LESI and should be the preferred alternative when FL is not provided, with a similar treatment outcome compared to FL-CESI and LESI.展开更多
Purpose: Circumcision is one of the most common surgeries performed in the pediatric population. Multiple regional analgesic techniques, including caudal (CB) and penile block (PB), have championed as offering optimal...Purpose: Circumcision is one of the most common surgeries performed in the pediatric population. Multiple regional analgesic techniques, including caudal (CB) and penile block (PB), have championed as offering optimal analgesia for circumcision in the post-neonatal pediatric population without clear consensus. This meta-analysis sought to investigate CB and PB’s analgesic efficacy and the impact on postoperative analgesic requirements in pediatric circumcisions. Methods: A comprehensive literature search of PubMed, Google Scholar, and Cochrane Library (1966-2016) was completed to identify all published randomized control trials (RCTs). Keywords searched included “circumcision”, “caudal block”, “penile block”, and “analgesia”. Inclusion criteria were limited to the comparison of PB versus CB in children less than 18 years of age and its efficacy towards circumcision. The efficacy, time to first additive analgesia, time to first micturition, duration of prolonged motor blockade, incidence of vomiting, and length of stay were analyzed. Results: 9 RCTs involving 574 children (N = 287 in CB and PB) were included. No differences in analgesic efficacy (relative risk (RR) = 0.983, 95% confidence interval (CI) = 0.95 to 1.02;p = 0.328) or time to first additive analgesia were observed (standardized difference in mean (SDM) = 0.438, 95% CI = -0.04 to 0.92;p = 0.073). Time to first micturition (SDM = 0.680, 95% CI = 0.40 to 0.96;p p = 0.007) were significantly prolonged in patients receiving CB. No differences were observed between groups in regards to the incidence of vomiting (RR = 1.56, 95% CI = 0.91 to 2.67;p = 0.107) and length of stay (SDM = 0.741, 95% CI = -0.05 to 1.53;p = 0.066). Conclusion: CB and PB offer similar analgesic success rates for pediatric patients (age 18 months to 16 years) undergoing circumcision. CB is associated with a trend towards longer duration of analgesia, but is associated with prolonged urinary retention and delayed ambulation. CB use is recommended in non-ambulatory children, whereas PB is recommended in ambulatory children.展开更多
文摘This paper addresses the design of a biomimetic fish robot actuated by piezoeeramic actuators and the effect of artificial caudal fins on the fish robot＇s performance. The limited bending displacement produced by a lightweight piezocomposite actuator was amplified and transformed into a large tail beat motion by means of a linkage system. Caudal fins that mimic the shape of a mackerel fin were fabricated for the purpose of examining the effect of caudal fm characteristics on thrust production at an operating frequency range. The thickness distribution of a real mackerel＇s fin was measured and used to design artificial caudal fins. The thrust performance of the biomimetic fish robot propelled by fins of various thicknesses was examined in terms of the Strouhal number, the Froude number, the Reynolds number, and the power consumption. For the same fm area and aspect ratio, an artificial caudal fin with a distributed thickness shows the best forward speed and the least power consumption.
文摘AIM:To study our novel caudal approach laparoscopic posterior-sectionectomy with parenchymal transection prior to mobilization under laparoscopy-specific view.METHODS:Points of the procedure are:(1) Patients are put in left lateral position and posterior sector is not mobilized;(2) Glissonian pedicle of the sector is encircled and clamped extra-hepatically and divided afterward during the transection;(3) Dissection of inferior vena cava(IVC) anterior wall behind the liver is started from caudal.Simultaneously,liver transection is performed to search right hepatic vein(RHV) from caudal;(4) Liver transection proceeds to the bifurcation of the vessels from caudal to cranial,exposing the surfaces of IVC and RHV.Since the remnant liver sinks down,the cutting surface is well-opend;and(5) After the completion of transection,dissection of the resected liver from retroperitoneum is easily performed using the gravity.This approach was performed for a 63 years old woman with liver metastasis close to RHV.RESULTS:RHV exposure is required for R0 resection of the lesion.Although the cutting plane is horizontal in supine position and the gravity obstructs the exposure in the small subphrenic space,the use of specific characteristics of laparoscopic hepatectomy,such as the good vision for the dorsal part of the liver and IVC and facilitated dissection using the gravity with the patient positioning,made the complete RHV exposure during the liver transection easy to perform.The operation time was 341 min and operative blood loss was 1356 mL.Her postoperative hospital stay was uneventfull and she is well without any signs of recurrences 14 mo after surgery.CONCLUSION:The new procedure is feasible and useful for the patients with tumors close to RHV and the need of the exposure of RHV.
基金This work was supported by Key Research and Development Program of Guangdong Province(2019B030335001)the Natural Science Foundation of China(31871070,82090031)+4 种基金Key R&D Program of Zhejiang Province(2020C03009)Science and Technology Program of Guangdong(2018B030334001)Funds for Creative Research Groups of China from the National Natural Science Foundation of China(81521062)Non-Profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2019PT310023)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-057).
文摘Parkinson’s disease(PD)is the second most common and fastest-growing neurodegenerative disorder.In recent years,it has been recognized that neurotransmitters other than dopamine and neuronal systems outside the basal ganglia are also related to PD pathogenesis.However,little is known about whether and how the caudal zona incerta(ZIc)regulates parkinsonian motor symptoms.Here,we showed that specific glutamatergic but not GABAergic ZIc^(VgluT2) neurons regulated these symptoms.ZIc^(VgluT2) neuronal activation induced time-locked parkinsonian motor symptoms.In mouse models of PD,the ZIc^(VgluT2) neurons were hyperactive and inhibition of their activity ameliorated the motor deficits.ZIc^(VgluT2) neurons monosynaptically projected to the substantia nigra pars reticulata.Incerta-nigral circuit activation induced parkinsonian motor symptoms.Together,our findings provide a direct link between the ZIc,its glutamatergic neurons,and parkinsonian motor symptoms for the first time,help to better understand the mechanisms of PD,and supply a new important potential therapeutic target for PD.
基金supported by the National Natural Science Foundation of China,No.81271166,81371107the Natural Science Foundation of Guangdong Province in China,No.10451008901006145
文摘Very little is known about the role of melatonin in the trigeminal system, including the function of melatonin receptor 1. In the present study, adult rats were injected with formaldehyde into the right vibrissae pad to establish a model of orofacial inflammatory pain. The distribution of melatonin re- ceptor 1 and nicotinamide adenine dinucleotide phosphate diaphorase in the caudal spinal trigeminal nucleus and trigeminal ganglion was determined with immunohistochemistry and histo- chemistry. The results show that there are significant differences in melatonin receptor 1 expression and nicotinamide adenine dinucleotide phosphate diaphorase expression in the trigeminal ganglia and caudal spinal nucleus during the early stage of orofacial inflammatory pain. Our findings sug- gest that when melatonin receptor 1 expression in the caudal spinal nucleus is significantly reduced, melatonin＇s regulatory effect on pain is attenuated.
基金supported by National Natural Science Foundation of China (Grant No. 50775109, Grant No. 51075201)Important Project of National Natural Science Foundation of China (Grant No. 50735002)Open Foundation for National Key laboratory of the Numerical Manufacturing Equipment and Technology of China (Grant No. DMETKF2009002)
文摘In the traditional flow-resistance-differential (FRD) type valve-less piezoelectric pump, the generated outflow and pressure are discontinuous because of the inherent periodicity and fluctuation of the pump. To overcome these drawbacks, utilizing the bending vibration of piezoelectric bimorph to drive fluid was conducted. However, our investigation on the current status of this piezoelectric bimorph pump shows that larger driving force and vibration amplitude are required for fluid pumping; the pumping can be realized through the centrifugal force; and the mechanism of fluid pumping is no longer further studied. Based on these cases, the paper designed a piezoelectric-stack pump with variable-cross-section oscillating (VCSO) vibrator by imitating the swing of the caudal-fin of tuna, and the pump is neither the rotating type nor the volumetric type according to the taxonomy. The interaction between the oscillating vibrator and the fluid parcel is firstly analyzed from the viewpoint of momentum conservation, and the analytical expression of pump flow rate is obtained. Then the modal and harmonic response analyses on the vibrator immerged in water are carried out. From the analyses the first two orders resonance frequencies are 832 Hz and 1 939 Hz, respectively, and the peak value of the tip amplitude is 0.6 mm. Laser Doppler vibrometer is used to measure both the frequency and vibration amplitude, and the determined first two orders resonance frequencies are 617 Hz and 1 356 Hz, respectively. The measured tip amplitude reaches to the peak value of 0.3 mm. At last, experimental measurement for the flow rates with different driving frequencies is conducted. The results show that the flow rate can reach 560 mL/min at 1 370 Hz when the pump runs under the backpressure of 30 mm water column. And the flow rate is as much as 560% of that of experiment results carried out by researchers from Brazil. The proposed pump innovates in both theory and taxonomy; in addition, the pump overcomes the drawbacks such as large flow fluctuation and low flow rate in the traditional FRD type pumps, which will help to broaden the application of the valve-less piezoelectric pump.
基金Cell Analysis Laboratory, 2nd Department of Internal Medicine, and the 1st Department of Pathology and Experimental Oncology, Semmelweis University for their technical support
文摘AIM:To characterize the regeneration-associated stem cell-related phenotype of hepatocyte-derived growth factor receptor(HGFR)-expressing cells in active ulcerative colitis(UC).METHODS:On the whole 38 peripheral blood samples and 38 colonic biopsy samples from 18 patients with histologically proven active UC and 20 healthy control subjects were collected.After preparing tissue microarrays and blood smears HGFR,caudal type homeobox 2(CDX2),prominin-1(CD133) and Musashi-1conventional and double fluorescent immunolabelings were performed.Immunostained samples were digitalized using high-resolution Mirax Desk instrument,and analyzed with the Mirax TMA Module software.For semiquantitative counting of immunopositive lamina propria(LP) cells 5 fields of view were counted at magnification x 200 in each sample core,then mean ± SD were determined.In case of peripheral blood smears,30 fields of view with 100 μm diameter were evaluated in every sample and the number of immunopositive cells(mean ± SD) was determined.Using 337 nm UVA Laser MicroDissection system at least 5000 subepithelial cells from the lamina propria were collected.Gene expression analysis of HGFR,CDX2,CD133,leucine-rich repeat-containing G-protein coupled receptor 5(Lgr5),Musashi-1 and cytokeratin20(CK20) were performed in both laser-microdisscted samples and blood samples by using real time reverse transcription polymerase chain reaction(RT-PCR).RESULTS:By performing conventional and double fluorescent immunolabelings confirmed by RT-PCR,higher number of HGFR(blood:6.7 ± 1.22 vs 38.5 ±3.18;LP:2.25 ± 0.85 vs 9.22 ± 0.65;P < 0.05),CDX2(blood:0 vs 0.94 ± 0.64;LP:0.75 ± 0.55 vs 2.11± 0.75;P < 0.05),CD133(blood:1.1 ± 0.72 vs 8.3± 1.08;LP:11.1 ± 0.85 vs 26.28 ± 1.71;P < 0.05)and Musashi-1(blood and LP:0 vs scattered) positive cells were detected in blood and lamina propria of UC samples as compared to controls.HGFR/CDX2(blood:0 vs 1± 0.59;LP:0.8 ± 0.69 vs 2.06 ± 0.72,P < 0.05)and Musashi-1/CDX2(blood and LP:0 vs scattered) coexpressions were found in blood and lamina propria of UC samples.HGFR/CD133 and CD133/CDX2 coexpressions appeared only in UC lamina propria samples.CDX2,Lgr5 and Musashi-1 expressions in UC blood samples were not accompanied by CK20 mRNA expression.CONCLUSION:In active UC,a portion of circulating HGFR-expressing cells are committed to the epithelial lineage,and may participate in mucosal regeneration by undergoing mesenchymal-to-epithelial transition.
文摘Objective:Caudal block provides satisfactory postoperative pain relief in lower abdominal operations.This pilot study explores its safety and effect on postoperative pain control in patients who underwent robot-assisted laparoscopic radical prostatectomy(RARP).Methods:From 2013 to 2014,40 consecutive patients were randomized into two groups d one received caudal block using ropivacaine immediately after operation,the other received standard analgesia.Primary outcome measure was pain score based on 11-point Likert scale(0e10)recorded at recovery room,and at 6,12,24,48,and 72 h after operation.All analgesic requirements,opioid-related adverse events and time to passage of flatus were examined.Results:Mean age of the two groups was similar(60.4 vs.62.3 years,p Z 0.33),as was American Society of Anaesthesiologists(ASA)class,body mass index(BMI)and operation times.No significant difference in median pain scores was reported in recovery room(2 vs.3,p Z 0.34),and at 6 h(2 vs.2,p Z 0.94),12 h(0 vs.0,p Z 0.62),24 h(1 vs.0,p Z 0.58),48 h(1 vs.0,p Z 0.36)and 72 h(0 vs.0,p Z 0.78)postoperatively between control and caudal block groups,respectively.There was a higher mean opioid usage in the caudal block group which was not statistically significant.Although this was statistically insignificant while no significant difference in mean paracetamol usage was observed postoperatively.Median time to passage of flatus was similar(2.0 vs.2.0 days,p Z 0.97).There was one case of superficial wound infection and no opioid-related adverse events observed.Hospital stay was similar in both groups(2.5 vs.2.5 days,p Z 0.96).
文摘The viscous flow field around two-dimensional flapping （ heaving and pitching） foils was numerically computed. The structural characteristics of caudal vortices were investigated and the contour curves at different phase angles were obtained. The relationships between the structural characteristics of the vortices and the force acting on the foil and between the widths of the caudal vortex street and of the caudal flow field were analyzed. A method to determine the shedding frequency of the vortices was proposed.
基金the financial support of the Dinosaur Research Institute and the University of Alberta China Institute
文摘In the tails of dromaeosaurid dinosaurs and rhamphorhynchid pterosaurs, elongate osteological rods extend anteriorly from the chevrons and the prezygapophyses. These caudal rods are positioned in parallel and are stacked dorsoventrally. The fully articulated and three-dimensionally preserved caudal series of some dromaeosaurid specimens show that individually these caudal rods were flexible, not rigid as previously thought. However, examination of the arrangement of the caudal rods in cross-section indicates that the combined effect of multiple caudal rods did provide substantial rigidity in the dorsoventral, but not in the lateral, plane. The results of digital muscle reconstructions confirm that dromaeosaurids and rhamphorhynchids also shared greatly reduced caudofemoral muscles in the anterior tail region. The striking similarities between the tails of dromaeosaurids and rhamphorhynchids suggest that both evolved under similar behavioral and biomechanical pressures. Combined with recent discoveries of primitive deinonychosaurs that phylogenetically bracket the evolution of dromaeosaurid caudal rods between two arboreal gliding/flying forms, these results are evidence that the unique caudal morphologies of dromaeosaurids and rhamphorhynchids were both adaptations for an aerial lifestyle.
基金Supported by Guangdong Provincial Science and Technology Plan Project,No.2022A0505050065Guangdong Natural Science Foundation,No.2022A1515011632.
文摘BACKGROUND Laparoscopic hepatectomy is a proven safe and technically feasible approach for liver tumor resection,but laparoscopic anatomical SVIII resection(LASVIIIR)remains rarely reported due to poor accessibility,difficult exposure,and the deep-lying Glissonean pedicle.This study examined the safety,feasibility,and perio-perative outcomes of LASVIIIR via a middle hepatic fissure approach at our in-stitution.AIM To investigate the safety,feasibility,and perioperative outcomes of LASVIIIR via a middle hepatic fissure approach at our institution.METHODS From November 2017 to December 2022,all patients with a liver tumor who underwent LASVIIIR were enrolled.The perioperative outcomes and postope-rative complications were evaluated.RESULTS Thirty-four patients underwent LASVIIIR via a middle hepatic fissure approach from the side or cranio side and were included.The mean operation time was 164±54 minutes,and the intra-operative blood loss was 100 mL(range:20-1000 mL).The mean operative times were,respectively,152±50 minutes and 222±29 minutes(P=0.001)for the caudal side and cranial side approaches.In addition,the median blood loss volumes were 100 mL(range:20-300 mL)and 250 mL(range:20-1000 mL),respectively,for the caudal and cranial sides(P=0.064).Three patients treated using the cranial side approach experienced bile leakage,while 1 patient treated using the caudal side approach had subphrenic collection and underwent percutaneous drainage to successfully recover.There were no differences regarding postoperative hospital stays for the caudal and cranial side approaches[9(7-26)days vs 8(8-19)days](P=0.226).CONCLUSION LASVIIIR resection remains a challenging operation,but the middle hepatic fissure approach is a reasonable and easy-to-implement technique.
文摘<span style="font-family:Verdana;"><strong>Introduction:</strong></span><span style="font-family:Verdana;">Regional anaesthesia combined with general anaesthesia reduces </span><span style="font-family:;" "=""><span style="font-family:Verdana;">stress response to surgery, duration of ventilation, intensive care unit (ICU) </span><span style="font-family:Verdana;">stay and promotes early recovery. Studies on thoracic epidural, caudal analgesi</span><span style="font-family:Verdana;">a along wit</span><span style="font-family:Verdana;">h general anaesthesia (GA) in paediatric </span><span style="font-family:Verdana;">cardiac surgery are limited he</span><span style="font-family:Verdana;">nce we aimed to compare efficacy and safety of caudal, thoracic epid</span><span style="font-family:Verdana;">ural and intravenous analgesia in paediatric cardiac surgery. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This study was conducted in the Department of Anaesthesiology in a tertiary care teaching hospital in southern India from February 2019 to December 2019. 90 children were randomised into group A, group B, group C. Children in group A received caudal analgesia along with GA. Group B children received thoracic epidural along with GA. Group C patients received intravenous analgesia along with GA. Rescue analgesia 1 mcg/kg fentanyl given in all 3 groups if p</span><span style="font-family:Verdana;">ai</span><span style="font-family:Verdana;">n score is more than 4. Primary outcome assessed was post-o</span><span style="font-family:Verdana;">p pain sco</span><span style="font-family:Verdana;">res. Secondary outcome assessed was duration of ventilation, duration of intensive care unit stay. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> All patients were comparable in terms of age, sex, </span><span style="font-family:Verdana;">weight, mean RACHS score, baseline heart rate and blood pressure. Pain sco</span><span style="font-family:Verdana;">res </span><span style="font-family:Verdana;">were significantly lower in thoracic epidural group compared to other two grou</span><span style="font-family:Verdana;"> ps. Duration of ventilation was lower in thoracic epidural group (91.17</span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 43.85) minutes and caudal (199.6 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 723.59) minutes compared to intravenous analgesia groups (436.37 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 705.51) minutes. Duration of ICU stay was significantly low in thoracic epidural group (2.73 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 0.69) days compared to caudal (3.7 </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 2.8) and intravenous analgesia groups (4.33 </span><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;"> 0.920). We didn’t have </span><span><span style="font-family:Verdana;">any complications like hematoma, transient or permanent neurological sequelae in regional anesthesia groups. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Regional anaesthesia along with </span></span><span style="font-family:Verdana;">general anaesthesia was more effective in pain relief than intravenous analgesia with general anaesthesia in paediatric cardiac surgery.</span></span></span>
基金supported by the National Natural Science Foundation of China (Nos.31571500,31771623 and 31771628)the National Key Basic Research Program of China (2015CB942802)+1 种基金the Fundamental Research Funds for the Central Universities (XDJK2017A015)the Guangdong Natural Science Fund for Distinguished Young Scholars (2017A030306024)
文摘Zebrafish hematopoietic stem and progenitor cells（HSPCs） originate from the hemogenic endothelium of the ventral wall of the dorsal aorta（DA） through the endothelial-to-hematopoietic transition（EHT） from approximately 30 to 60 hours post fertilization（hpf）. However, whether other artery sites can generate HSPCs de novo remains unclear. In this study, using live imaging and lineage tracing, we found that the caudal dorsal artery（CDA） in the caudal hematopoietic tissue directly gave rise to HSPCs through EHT.This process initiated from approximately 60 hpf and terminated at approximately 156 hpf. Compared with that in the DA, fewer EHT events were observed in the CDA. The EHT events in the DA and CDA were similarly regulated by Runx1 but differentially influenced by blood flow（i.e., the EHT frequency in CDA was affected to a lesser extent when circulation was compromised in the tnnt2a～（-/-）mutant）. Therefore,the whole artery, including both DA and CDA, was endowed with the ability to produce HSPCs during a much longer time period. Coincidently, the lineage tracing results indicated that adult hematopoietic cells originated from the embryonic endothelium, and those produced later preferentially colonized the adult thymus. Collectively, our study revealed that the CDA serves as an additional source of hematopoiesis, and it shows similar but not identical properties with the DA.
基金Project supported by the National Natural Science Foundation of China(Nos.61503008 and 51575005)the China Postdoctoral Science Foundation(No.2015M570013)
文摘A simplified model of the thrust force is proposed based on a caudal fin oscillation of an underwater bionic robot. The caudal fin oscillation is generalized by cen- tral pattern generators （CPGs）. In this model, the drag coefficient and lift coefficient are the two critical parameters which are obtained by the digital particle image velocimetry （DPIV） and the force transducer experiment. Numerical simulation and physical experi- ments have been performed to verify this dynamic model.
基金supported by Postgraduate Research&Practice Innovation Program of Jiangsu Province,No.KYCX-2065(to XMC).
文摘The initial mechanical damage of a spinal cord injury(SCI)triggers a progressive secondary injury cascade,which is a complicated process integrating multiple systems and cells.It is crucial to explore the molecular and biological process alterations that occur after SCI for therapy development.The differences between the rostral and caudal regions around an SCI lesion have received little attention.Here,we analyzed the differentially expressed genes between rostral and caudal sites after injury to determine the biological processes in these two segments after SCI.We identified a set of differentially expressed genes,including Col3a1,Col1a1,Dcn,Fn1,Kcnk3,and Nrg1,between rostral and caudal regions at different time points following SCI.Functional enrichment analysis indicated that these genes were involved in response to mechanical stimulus,blood vessel development,and brain development.We then chose Col3a1,Col1a1,Dcn,Fn1,Kcnk3,and Nrg1 for quantitative real-time PCR and Fn1 for immunostaining validation.Our results indicate alterations in different biological events enriched in the rostral and caudal lesion areas,providing new insights into the pathology of SCI.
文摘Fresh semen has a very limited life span after it leaves the gonad. The relative research shows that the epididymal plasma provides a special environment to spermatozoa for survival. In this study, the osmolarity and protein concentration of caput and caudal bull epididymis were analyzed. Bovine caudal epididymal sperm were incubated in different protein and sorbitol combinations of CEP-2 diluents at 4 ℃ for 120 h and sperm viability was assessed. Under this condition, sperm viability was greater than 60% after 5 d. The osmolarity of caput and caudal epididymis were （287.0 ± 13.7） and （310.8 ± 17.0 ） mOsm, respectively. The protein concentration of caput and caudal epididymis were （ 37.43 ± 12.55 ） and （50.58±11.08） mg/mg, respectively. This may have an application in the animal production industry.
文摘Introduction: The caudal anesthesia is used by many authors for postoperative analgesia. The purpose of this study was to report our experience in the practice of caudal block as post operative analgesia method in ambulatory surgery in a context of limited technical equipment. Patients and Method: Over a period of 5 months, a prospective study was conducted on 39 children aged 3 to 5 years weighing on average 15.12 kg. Children classified ASA I and II were selected. After premedication with midazolam (0.3 mg/kg) by intra rectal route, the inhalation induction was made with sevoflurane 8%, conveyed by fresh gas (50% O2 and 50% air). The caudal block was obtained with the levobupivacaine 0.25% at a dose of 1 ml/kg. The hemodynamic parameters (systolic and diastolic blood pressure, heart rates) and respiratory parameters (respiratory frequency) pre-, per- and post-operative were measured. Post-operative pain was assessed with the Objective Pain Scale (OPS). The date of first use of analgesia was noted. The adverse effects of caudal block (meningitis, respiratory disorders, acute urinary retention, cardiac disorders) have been assessed. Results: The average duration of the procedure was 55.2 minutes. The use of analgesia was made 4 hours after skin closure, when the OPS Broadmann score was greater than 3. An agitation was observed in 6 children. Haemodynamic parameters have not significantly varied from the pre- to the post-operative. No infectious complications or intolerance to local anesthetics were observed. Allthe children were able to drink 4 hours after the end of the intervention and issued their first urine later than 3 hours after surgery. Conclusion: This type of anesthesia has been found very suitable for ambulatory surgery of the child, and is always helpful. It assured a post operative analgesia of good quality, and a reduction in consumption of morphine intraoperatively.
文摘Objective:Caudal epidural analgesia has become very common analgesic technique in paediatric surgery.Adding tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects.The aim of the study was to investigate the different effects of caudal bupivacaine versus bupivacaine with thamadol for postoperative analgesia in paediatric cancer patients.Methods:A prospective randomized controlled trial was conducted over 40 paediatric cancer patients who were recruited from Children Cancer Hospital of Egypt(57357 Hospital).Patients were randomized into 2 groups:bupivacaine group(group B,20 patients) to receive single shot caudal block of 1 mL/kg 0.1875% bupivacaine;tramadol group(group T,20 patients) prepared as group B with the addition of 1 mg/kg caudal tramadol.Results:The mean duration of analgesia was significantly longer among group T than group B [(24 ± 13.7) hours versus(7 ± 3.7) hours respectively with P = 0.001].Group T showed a significantly lower mean FLACC score than group B(2.2 ± 0.9 versus 3.6 ± 0.6 with P = 0.002).The difference in FLACC score was comparable on arrival,and after 2 and 4 hours.At 8 and 12 hours the group B recorded significantly higher scores(P = 0.002 and 0.0001 respectively).There were no significant differences between the groups as regards sedation score [the median in both groups was 1(0-1) with P value = o.8].No one developed facial flush or pruritis.Conclusion:Caudal injection of low dose tramadol 1 mg/kg with bupivacaine 0.1875% is proved to be effective,long standing technique for postoperative analgesia in major paediatric cancer surgery and almost devoid of side effect.
文摘<b>Background and Aims:</b> Low back pain (LBP) is considered one of the most common health conditions in the world right now, and it affects many individuals throughout different stages of their lives. Chronic LBP (CLBP) was estimated to be between 5% and 10%, defined as LBP that lasts for 12 weeks. The most common causes of CLBP with radiculopathy are lumbar disc prolapse (LDP) and degenerative facet osteoarthropathy (DFO);the aim of this study is to investigate the efficacy of ultrasound (US) guided, fluoroscopy (FL) guided, Caudal Epidural Steroid Injection (CESI), lumbar epidural steroid injections (LESI), and blinding lumbosacral steroid injections (LSPSI) in patients with CLBP with radiculopathy. <b>Patients and Methods:</b> This is a randomized prospective study that was conducted at the department of rheumatology at Al Azhar University Hospital in Egypt between November 2020 and August 2021. A total of 100 patients with refractory CLBP with radiculopathy were enrolled in the study. Consequently, they were divided into 2 groups: the first consisted of fifty patients with CLBP and radiculopathy caused by LDP, as determined by lumbosacral magnetic resonance imaging (MRI), and the second group consisted of fifty patients with refractory low back pain and radiculopathy caused by DFO, as determined by lumbosacral plain x-rays and lumbosacral MRI. The following procedures were performed: US-guided CESI, FL-guided CESI, FL-guided LESI, US-guided LESI, and blinding LSPSI. <b>Results:</b> In the LDP group, there is a statistically significant difference between considered spinal nerve roots as regards Visual Analogue Scale (VAS) (at 2 months). Likewise, a statistically significant difference was found between blinding LSPSI and US-Guided LESI with respect to VAS (baseline) and VAS (2 months) (P-value = 0.018 and 0.003, respectively). Statistically significant differences were reported in VAS (2 months) for both FL-guided LESI and FL-guided CESI groups. Considering the VAS of studied spinal nerve roots in the DFO group, there is a statistically significant difference between the examined spinal nerve roots with respect to Oswestry Disability Index (ODI) (2 months). Similarly, there is a statistically significant difference in VAS (2 months) between US-guided LESI and para-spinal roots and FL-guided LESI and para-spinal roots (P-value = 0.038 and 0.021, respectively). Additionally, there is a statistically significant difference between the US-guided CESI, FL-guided CESI, FL-guided LESI, and spinal nerve roots with respect to ODI (at 2 months). (P-value = 0.033, 0.025 and 0.005, respectively). <b>Conclusion:</b> US is excellent in guiding CESI and LESI and should be the preferred alternative when FL is not provided, with a similar treatment outcome compared to FL-CESI and LESI.
文摘Purpose: Circumcision is one of the most common surgeries performed in the pediatric population. Multiple regional analgesic techniques, including caudal (CB) and penile block (PB), have championed as offering optimal analgesia for circumcision in the post-neonatal pediatric population without clear consensus. This meta-analysis sought to investigate CB and PB’s analgesic efficacy and the impact on postoperative analgesic requirements in pediatric circumcisions. Methods: A comprehensive literature search of PubMed, Google Scholar, and Cochrane Library (1966-2016) was completed to identify all published randomized control trials (RCTs). Keywords searched included “circumcision”, “caudal block”, “penile block”, and “analgesia”. Inclusion criteria were limited to the comparison of PB versus CB in children less than 18 years of age and its efficacy towards circumcision. The efficacy, time to first additive analgesia, time to first micturition, duration of prolonged motor blockade, incidence of vomiting, and length of stay were analyzed. Results: 9 RCTs involving 574 children (N = 287 in CB and PB) were included. No differences in analgesic efficacy (relative risk (RR) = 0.983, 95% confidence interval (CI) = 0.95 to 1.02;p = 0.328) or time to first additive analgesia were observed (standardized difference in mean (SDM) = 0.438, 95% CI = -0.04 to 0.92;p = 0.073). Time to first micturition (SDM = 0.680, 95% CI = 0.40 to 0.96;p p = 0.007) were significantly prolonged in patients receiving CB. No differences were observed between groups in regards to the incidence of vomiting (RR = 1.56, 95% CI = 0.91 to 2.67;p = 0.107) and length of stay (SDM = 0.741, 95% CI = -0.05 to 1.53;p = 0.066). Conclusion: CB and PB offer similar analgesic success rates for pediatric patients (age 18 months to 16 years) undergoing circumcision. CB is associated with a trend towards longer duration of analgesia, but is associated with prolonged urinary retention and delayed ambulation. CB use is recommended in non-ambulatory children, whereas PB is recommended in ambulatory children.
