BACKGROUND Inferior mesenteric arteriovenous fistula(IMAVF)is an uncommon circulatory malformation with few reported instances.It entails a direct arteriovenous communication within the inferior mesenteric vascular sy...BACKGROUND Inferior mesenteric arteriovenous fistula(IMAVF)is an uncommon circulatory malformation with few reported instances.It entails a direct arteriovenous communication within the inferior mesenteric vascular system,producing abnormal hemodynamic flow that may result in gastrointestinal hypoperfusion,elevated portal venous pressure,and secondary cardiac dysfunction.Diagnosis often experiences delays because of nonspecific symptoms.Imaging modalities,such as multi-detector computed tomography(MDCT)and angiography,prove essential for accurate diagnosis and treatment planning.CASE SUMMARY Over a 10-year period,only two cases of IMAVF were encountered.The initial case involved a 56-year-old male without notable prior medical conditions who experienced intermittent lower abdominal discomfort,diarrhea,and hematochezia over several months.Ischemic colitis with an IMAVF was revealed through colonoscopy and MDCT angiography.Due to the size of the IMAVF,Hartmann’s procedure was performed instead of an endovascular intervention.Recovery proceeded uneventfully,and the colostomy was reversed one year later,with no recurrence observed on follow-up imaging.The subsequent case involved a 76-year-old female with repeated left-sided pyelonephritis and colonic diverticular disease,who manifested with abdominal discomfort and hematochezia.In contrast to previous computed tomography scans,MDCT and angiography revealed a newly developed IMAVF.Given her unstable vital signs,emergency laparoscopic total colectomy with ileorectal anastomosis and temporary ileostomy was conducted.Recovery occurred without complications,and the ileostomy was successfully reversed 2 months later,with no recurrence noted.CONCLUSION These cases emphasize the need to evaluate for vascular abnormalities in individuals presenting with ischemic colitis and unexplained gastrointestinal bleeding.The second case demonstrates that recurrent intra-abdominal inflammation may contribute to the development of IMAVF.展开更多
BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under laparoscopy.Dissecting the third hepatic hilum before parenchymal transection often lead...BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under laparoscopy.Dissecting the third hepatic hilum before parenchymal transection often leads to significant liver mobilization,tumor compression,and bleeding from the short hepatic veins(SHVs).This study introduces a novel technique utilizing the ventral avascular area of the inferior vena cava(IVC),allowing SHVs to be addressed after parenchymal transection,thereby reducing surgical complexity and improving outcomes in in situ LLR.AIM To introduce and evaluate a novel LLR technique using the ventral avascular area of the IVC and compare its short-term outcomes with conventional methods.METHODS The clinical cohort data of patients with pathologically confirmed hepatocellular carcinoma or intrahepatic cholangiocarcinoma who underwent conventional LLR and novel LLR between July 2021 and July 2023 at the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.In novel LLR,we initially separated the caudate lobe from the IVC using dissecting forceps along the ventral avascular area of the IVC.Then,we transected the parenchyma of the left and right caudate lobes from the caudal side to the cephalic side using the avascular area as a marker.Subsequently,we addressed the SHVs and finally dissected the root of the right hepatic vein or left hepatic vein.The short-term postoperative outcomes and oncological results of the two approaches were evaluated and compared.RESULTS A total of 256 patients were included,with 150(58.59%)undergoing conventional LLR and 106(41.41%)undergoing novel LLR.The novel technique resulted in significantly larger tumor resections(6.47±2.96 cm vs 4.01±2.33 cm,P<0.001),shorter operative times(199.57±60.37 minutes vs 262.33±83.90 minutes,P<0.001),less intraoperative blood loss(206.92±37.09 mL vs 363.34±131.27 mL,P<0.001),and greater resection volume(345.11±31.40 mL vs 264.38±31.98 mL,P<0.001)compared to conventional LLR.CONCLUSION This novel technique enhances liver resection outcomes by reducing intraoperative complications such as bleeding and tumor compression.It facilitates a safer,in situ removal of complex liver tumors,even in challenging anatomical locations.Compared to conventional methods,this technique offers significant advantages,including reduced operative time,blood loss,and improved overall surgical efficiency.展开更多
BACKGROUND Inferior intra-articular patella dislocation is rare and comprises horizontal(type 1)and the more common vertical(type 2)dislocations in young and elderly patients respectively.In this case report,we descri...BACKGROUND Inferior intra-articular patella dislocation is rare and comprises horizontal(type 1)and the more common vertical(type 2)dislocations in young and elderly patients respectively.In this case report,we describe a case of an elderly patient who pre sented with a type 2 dislocation after a fall.The mechanisms of inferior patella dislocation,their classification,key imaging features and treatment options are discussed.CASE SUMMARY A 75-year-old woman presented with a right knee fixed flexion deformity after a fall.Preoperative imaging confirmed a vertical intra-articular patella dislocation with a femoral trochlear osteochondral defect and lax though grossly intact patella tendon.Closed reduction was performed under general anaesthesia.Knee arthroscopy confirmed the presence of a femoral trochlear osteochondral defect whose edges were subsequently smoothed and there was debridement of scant debris with thorough irrigation of the joint.Postoperative imaging demonstrated anatomical alignment,however,there was a new nondisplaced medial femoral trochlear.The patient however was able to mobilise well in a range of motion brace set at 0-30 degrees and was discharged 1-day post operatively.CONCLUSION Inferior patella dislocation is rare and this article highlights its types and imaging features which determine the most appropriate management.展开更多
Inferior grains exhibit delayed developmental processes and reduced metabolic activities compared to superior grains,leading to unstable rice yield and quality.While significant advancements have been achieved in eluc...Inferior grains exhibit delayed developmental processes and reduced metabolic activities compared to superior grains,leading to unstable rice yield and quality.While significant advancements have been achieved in elucidating the physiology of endosperm filling in inferior grains,the role of the embryo remains underexplored and warrants comprehensive investigation.Two Wuyujing 3 mutants,DW024(relatively synchronous;syn-DW024)and DW179(significantly asynchronous;asyn-DW179),with different grain-filling patterns were used in this study.Samples of superior and inferior grains were collected at intervals from 5 to 60 d after fertilization and subsequently dissected into subsamples of the embryo and endosperm.Histochemical staining,biochemical analysis,and RNA sequencing(RNA-seq)were combined to systematically compare developmental and physiological traits between superior and inferior grains.Combining hierarchical clustering of mRNA datasets revealed three developmental phases of the endosperm and embryo:morphogenesis,endosperm filling/embryo enlargement,and maturation.In both syn-DW024 and asyn-DW179,the duration of the endosperm/embryo morphogenesis phase was identical in superior and inferior grains.The inferior grains of asyn-DW179 exhibited a 10-day prolongation in the endosperm filling phase and a 20-day extension in the embryo enlargement phase compared to the superior grains.The endosperm of inferior grains exhibited higher contents of sugars and free amino acids,along with slower accumulation of storage compounds,which was associated with the down-regulation of genes for starch synthesis and ABA signaling.In addition,transporters for nutrient exchanges between endosperm and embryo were down-regulated,suggesting a potential role of the embryo in adjusting the endosperm filling process.Collectively,our results reveal that the prolonged phases of endosperm filling and embryo enlargement may underlie the impaired development of inferior grains,offering a new perspective for breeding or cultivating rice with uniform grain quality.展开更多
BACKGROUND Inferior mesenteric arteriovenous fistula(IMAVF)is an extremely rare condition characterized by abnormal communication between the inferior mesenteric artery and vein.IMAVF often mimics ischemic bowel disea...BACKGROUND Inferior mesenteric arteriovenous fistula(IMAVF)is an extremely rare condition characterized by abnormal communication between the inferior mesenteric artery and vein.IMAVF often mimics ischemic bowel disease and ulcerative colitis(UC),leading to diagnostic challenges and treatment failures.CASE SUMMARY Three consecutive cases presented with non-specific symptoms including perianal pain and bloody diarrhea were reported.Initial diagnosis included acute severe UC and ischemic colitis.Pathology suggested ischemic changes,and with further contrast-enhanced computed tomography together with digital subtraction angiography which confirmed the diagnosis of IMAVF.All three cases were treated by vascular embolization,and symptoms improved rapidly following treatment.CONCLUSION We presented the largest single center IMAVF series with detailed clinical characteristics,facilitating early diagnosis for similar cases in the future.展开更多
BACKGROUND Kidney transplantation is increasingly more common due to the ongoing shortage of deceased donors.However,anatomical challenges,such as a short renal artery,can complicate surgical procedures and increase c...BACKGROUND Kidney transplantation is increasingly more common due to the ongoing shortage of deceased donors.However,anatomical challenges,such as a short renal artery,can complicate surgical procedures and increase complication risk,including thrombosis and anastomotic stenosis.To address these issues and optimize graft outcomes,innovative surgical techniques are essential.CASE SUMMARY We present a case of kidney transplantation complicated by a short donor renal artery.To address the discrepancy between arterial length and diameter mismatch,the recipient’s inferior epigastric artery was used as a cuff interposition for arterial reconstruction.Following standard laparoscopic donor nephrectomy,vascular reconstruction was performed on the back table.The use of the inferior epigastric artery as a cuff allowed for successful elongation and size matching of the donor renal artery,enabling a tension-free anastomosis to the recipient’s external iliac artery.Postoperative Doppler ultrasound and angiography confirmed excellent graft perfusion.The patient experienced an uneventful recovery with immediate graft function and maintained stable renal function at 6 months post-transplant.To our knowledge,this is the first reported use of the inferior epigastric artery as a cuff interposition in renal artery reconstruction,offering a novel and effective technique for managing short renal arteries in kidney transplantation.CONCLUSION Interposition of the epigastric artery offers an innovative technique for managing short donor renal arteries,reducing the risk of early thrombosis and long-term complications as size mismatch and intimal hyperplasia.展开更多
BACKGROUND Inferior vena cava(IVC)leiomyosarcomas are rare and aggressive tumors.Complete cure depends on achieving R0 resection,which often requires circumferential resection and reconstruction.Synthetic grafts have ...BACKGROUND Inferior vena cava(IVC)leiomyosarcomas are rare and aggressive tumors.Complete cure depends on achieving R0 resection,which often requires circumferential resection and reconstruction.Synthetic grafts have traditionally been used when venous continuity must be restored.However,the use of cadaveric IVC grafts for reconstruction has not been widely reported.CASE SUMMARY Herein,we present the case of a 64-year-old woman diagnosed with an intrahepatic IVC leiomyosarcoma with local invasion.The patient responded favorably to chemotherapy and subsequently underwent an en bloc right hepatectomy,retrohepatic IVC resection,and reconstruction with an interpositional cadaveric IVC graft.Serial imaging follow-ups until 2 years after the operation showed persistent patency of the graft and no graft-related complications.CONCLUSION Cadaveric IVC grafts are an alternative to synthetic grafts for reconstruction,with acceptable outcomes.Larger,long-term studies are necessary to validate these findings.展开更多
Case Letter Severe trauma has high morbidity and mortality rates,being the leading cause of death in young adults.Among all traumas,tra ffi c injuries are particularly lethal.^([1-2]) The injury severity score(ISS) ca...Case Letter Severe trauma has high morbidity and mortality rates,being the leading cause of death in young adults.Among all traumas,tra ffi c injuries are particularly lethal.^([1-2]) The injury severity score(ISS) can be used to assess trauma severity,with ISS of<9,9–15,16–24,and≥25 indicating minor,moderate,severe,and critical trauma,respectively.The ISS is correlated with mortality,morbidity,and hospitalization duration after injury.^([3-4]) Here,we report one patient who was admitted to our emergency intensive care unit(EICU) due to traumatic liver rupture and traumatic myocardial infarction complicated with inferior vena cava(IVC) thrombosis.展开更多
BACKGROUND Acute pulmonary thromboembolism is a complication of venous thrombosis.Extracorporeal membrane oxygenation(ECMO),an effective rescue measure for rapid hemodynamic recovery,can be used in patients for whom t...BACKGROUND Acute pulmonary thromboembolism is a complication of venous thrombosis.Extracorporeal membrane oxygenation(ECMO),an effective rescue measure for rapid hemodynamic recovery,can be used in patients for whom thrombolysis therapy has failed.CASE SUMMARY This case report describes an extreme rescue process for a patient with a preset inferior vena cava(IVC)filter in a relatively economically underdeveloped area with an insufficient supply of consumables.In an emergency,veno-arterial ECMO was successfully initiated by intubation through the IVC filter to the right atrial opening without displacement of the filter during the entire process.CONCLUSION This study demonstrates that in resource-limited settings,femoral vein cannulation for veno-arterial ECMO is a feasible and safe option for patients with preimplanted IVC filters.展开更多
Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside a...Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.展开更多
BACKGROUND Diagnosing posterior inferior cerebellar artery dissection(PICAD)using radio-logical images is challenging.Massive cerebellar infarctions resulting from spon-taneous,isolated PICAD are rare,and the associat...BACKGROUND Diagnosing posterior inferior cerebellar artery dissection(PICAD)using radio-logical images is challenging.Massive cerebellar infarctions resulting from spon-taneous,isolated PICAD are rare,and the associated clinical,imaging,and treat-ment options remain unclear.CASE SUMMARY A 39-year-old man was admitted for dizziness and unstable gait for two days.Ph-ysical examination revealed decreased right-limb muscle strength and right-sided ataxia.Brain magnetic resonance imaging(MRI)showed a massive acute right cerebellar infarction,but other modalities,including head and neck computed tomographic angiography(CTA)and magnetic resonance angiography(MRA),showed no obvious abnormalities.High-resolution vessel wall MRI(HR-VW-MRI)revealed right PICAD.The patient was diagnosed with massive cerebellar infarction caused by PICAD and active conservative treatment was initiated.The initial PICAD lesion disappeared 1.5 months after discharge,after which the patient experienced only slight weakness in his right limb for three months.CONCLUSION Since MRA and CTA may fail to identify PICAD,HR-VW-MRI is key in diagnosis and follow-up evaluation.Aggressive medication may be effective and safe for treating PICAD.展开更多
The development of innovative surgical techniques has been a constant and fundamental aspect in liver transplantation(LT)to address chronic organ shortage.Domino liver transplantation(DLT),initially performed by Furta...The development of innovative surgical techniques has been a constant and fundamental aspect in liver transplantation(LT)to address chronic organ shortage.Domino liver transplantation(DLT),initially performed by Furtado et al.in Lisbon in 1995,is an innovative technique in which a liver from a patient with a metabolic disorder is transplanted into a recipient with end-stage liver disease[1].展开更多
OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicent...OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.展开更多
In order to study the effect of weak noise on the sound signal extraction of mouse (Mus musculus Km) inferior collicular (IC) neurons from environments,we examined the changes in frequency tuning curves (FTCs) of 32 n...In order to study the effect of weak noise on the sound signal extraction of mouse (Mus musculus Km) inferior collicular (IC) neurons from environments,we examined the changes in frequency tuning curves (FTCs) of 32 neurons induced by a weak noise relative to 5 dB below minimum threshold of tone (reMT-5 dB) under free field stimulation conditions.The results were as follows:① There were three types of variations in FTCs,sharpened (34.4%),broadened (18.8%),and unaffected (46.9%),nevertheless,only the alteration of sharpened FTCs was statistically different.② Sharpness of frequency tuning induced by a reMT-5 dB noise was very strong.Q 10 and Q 30 of FTCs were increased by (34.42±17.04)% (P=0.026,n=11) and (46.34±22.88)% (P=0.009,n=7).③ The changes of inverse-slopes (ISs,kHz/dB) between high (IS high) and low (IS low) limbs of FTCs were dissymmetry.The IS high of FTCs decreased markedly (P=0.046,n=7),however,there was little change (P=0.947,n=7) in IS low.Our data revealed for the first time that the weak noise could sharpen frequency tuning and increase the sensitivity on the high frequency of sound signal in IC neurons of mouse.展开更多
AIM:To compare the changes in excyclotorsion after inferior oblique(IO)recession in patients with primary and secondary inferior oblique overaction(IOOA).METHODS:We retrospectively analyzed the data obtained from pati...AIM:To compare the changes in excyclotorsion after inferior oblique(IO)recession in patients with primary and secondary inferior oblique overaction(IOOA).METHODS:We retrospectively analyzed the data obtained from patients with IOOA who underwent graded IO recession.The patients were followed up for at least 3 mo after surgery.Fundus photographs were taken preand postoperatively,and the sum of the angles of torsion in both eyes was used to analyze changes in excyclotorsion.Patients were divided into two groups:those diagnosed with primary IOOA were enrolled in the 1’IOOA group,and those diagnosed with secondary IOOA caused by superior oblique palsy(SOP)were enrolled in the 2’IOOA group.Excyclotorsion before and after surgery were compared between the two groups.RESULTS:A total of 78 patients were enrolled in this study:34 eyes in the 1’IOOA group and 44 eyes in the 2’IOOA group.In the 78 patients,torsional angle significantly decreased from 15.31°±7.40°to 12.11°±6.53°after IO recession(P<0.001).Mean preoperative torsional angle was larger in the 2’IOOA group than in the 1’IOOA group(P=0.03).In both groups,excyclotorsion significantly decreased after IO recession(P=0.001 and P<0.001,respectively);however,there was no significant difference in the amounts of changes in excyclotorsion between the two groups.CONCLUSION:Excyclotorsion is significantly larger in secondary IOOA than in primary IOOA,and a significant decrease in the torsional angle occurs after IO recession in both types of IOOA.展开更多
AIM:To investigate the effectiveness of a modified inferior oblique muscle belly transposition for treatment of V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction.METHODS:Thirteen ca...AIM:To investigate the effectiveness of a modified inferior oblique muscle belly transposition for treatment of V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction.METHODS:Thirteen cases(23 affected eyes)of V-pattern exotropia with inferior oblique muscle overaction(+or++)who underwent the modified inferior oblique muscle belly transposition procedure were retrospectively reviewed.The amount of V-pattern,grade of inferior oblique overaction,degree of vertical strabismus,abnormal head posture,and the fovea-disc angle were evaluated before and after surgery.RESULTS:The V-pattern was corrected in all cases,and the amount of V-pattern reduced by 17.85±5.13 prism diopter(PD)on average(t=16.07,P<0.001).The surgical cure rate for mild to moderate inferior oblique muscle overaction was 87.0%(20/23).The degree of the foveadisc angle has a mean reduction of 5.45°±2.87°(t=3.95,P=0.003)after surgery.The mean vertical deviation in 5 cases with a small-angle hypertropia(5.23±3.06 PD)in the primary position reduced by 3.15±1.86 PD(t=6.10,P<0.001).No serious complications were observed.CONCLUSION:The modified inferior oblique muscle belly transposition procedure can effectively treat mild to moderate inferior oblique overaction and relieve the V-pattern,which is safe and easy to perform.展开更多
Objective To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.Methods The patients confirmed to the enrolled criteria were randomly divid...Objective To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.Methods The patients confirmed to the enrolled criteria were randomly divided into an observation group（n=31） and a control group（n=30）.In the observation group,electroacupuncture was applied to Sìbái（四白 ST 2）,Xiàguān（下关 ST 7）,Hégǔ（合谷 LI 4） and Zhīgōu（支沟 TE 6） on the left side for the anesthesia and the routine local anesthesia was done on the right side.In the control group,the routine local anesthesia was adopted on both sides.The feelings of pain,circulatory index and operation effect were observed and compared between the two groups.Results During radiofrequency ablation,the pain grades of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group（all P〈0.05）.In the observation group,the pain grade on the left side was lower than that on the right side（P〈0.05）,and the systolic blood pressure and the heart rate were lower than those in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side,respectively（all P〈0.05）.There was no significant difference in operation effect between the two groups.Conclusion Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for hypertrophic inferior turbinate,and would be helpful to prevent cyclic fluctuation during the operation at the same time.展开更多
AIM To investigate the vascular anatomy of inferior mesenteric artery(IMA) in laparoscopic radical resection with the preservation of left colic artery(LCA) for rectal cancer. METHODS A total of 110 patients with rect...AIM To investigate the vascular anatomy of inferior mesenteric artery(IMA) in laparoscopic radical resection with the preservation of left colic artery(LCA) for rectal cancer. METHODS A total of 110 patients with rectal cancer who underwent laparoscopic surgical resection with preservation of the LCA were retrospectively reviewed. A 3 D vascular reconstruction was performed before each surgical procedure to assess the branches of the IMA. During surgery, the relationship among the IMA, LCA, sigmoid artery(SA) andsuperior rectal artery(SRA) was evaluated, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between inferior mesenteric vein(IMV) and LCA was also evaluated.RESULTS Three vascular types were identified in this study. In type A, LCA arose independently from IMA(46.4%, n = 51); in type B, LCA and SA branched from a common trunk of the IMA(23.6%, n = 26); and in type C, LCA, SA, and SRA branched at the same location(30.0%, n = 33). The difference in the length from the origin of IMA to LCA was not statistically significant among the three types. LCA was located under the IMV in 61 cases and above the IMV in 49 cases. CONCLUSION The vascular anatomy of the IMA and IMV is essential for laparoscopic radical resection with preservation of the LCA for rectal cancer. To recognize different branches of the IMA is necessary for the resection of lymph nodes and dissection of vessels.展开更多
The changes in activities of key enzymes involved in sucrose-to-starch conversion and concentrations of hormones in superior and inferior spikelets of super rice were investigated and their association with grain fill...The changes in activities of key enzymes involved in sucrose-to-starch conversion and concentrations of hormones in superior and inferior spikelets of super rice were investigated and their association with grain filling was analyzed.Four super rice cultivars,Liangyoupeijiu,IIyou 084,Huaidao 9 and Wujing 15,and two high-yielding and elite check cultivars,Shanyou 63 and Yangfujing 8,were used.The activities of sucrose synthase （SuSase）,adenosine diphosphoglucose pyrophosphorylase （AGPase）,starch synthase （StSase） and starch branching enzyme （SBE）,and the concentrations of zeatin ＋ zeatin riboside （Z ＋ ZR）,indole-3-acetic acid （IAA） and abscisic acid （ABA） in superior and inferior spikelets were determined during the grain filling period and their relationships with grain filling rate were analyzed.Maximum grain filling rate,the time reaching the maximum grain-filling rate,mean grain filling rate and brown rice weight for superior spikelets showed a slight difference between the super and check rice cultivars,but were significantly lower in the super rice than in the check rice for inferior spikelets.Changes of enzyme activities and hormone concentrations in grains exhibited single peak curves during the grain filling period.The peak values and the mean activities of SuSase,AGPase,StSase and SBE were lower in inferior spikelets than in superior ones,as well as the peak values and the mean concentrations of Z ＋ ZR and IAA.However,the peak value and the mean concentration of ABA were significantly higher in inferior spikelets than in superior ones and greater in the super rice than in the check rice.The grain filling rate was positively and significantly correlated with the activities of SuSase,AGPase and StSase and the concentrations of Z ＋ ZR and IAA.The results suggested that the low activities of SuSase,AGPase and StSase and the low concentrations of Z ＋ ZR and IAA might be important physiological reasons for the slow grain filling rate and light grain weight of inferior spikelets in super rice.展开更多
BACKGROUND: Hepatic resection is the main treatment modality for hepatic tumors. Advances in diagnostic technique, preoperative preparation, surgical technique, and postoperative management increased the success rate....BACKGROUND: Hepatic resection is the main treatment modality for hepatic tumors. Advances in diagnostic technique, preoperative preparation, surgical technique, and postoperative management increased the success rate. The present study aimed to evaluate hepatectomy and resection of inferior vena cava tumor thrombus (IVCTT) in patients with hepatocellular carcinoma, and the relationship between IVCTT classification and selection of surgical technique. METHODS: We retrospectively reviewed 13 patients with hepatocellular carcinoma who had undergone hepatectomy with IVCTT resection between May 1997 and August 2009. Age, gender, diagnosis, findings of physical examination, results of preoperative laboratory investigations, radiological examination, criteria for resection, postoperative pathological results, incisions, operative technique, intraoperative transfusion, drains, and intraoperative and postoperative complications were evaluated for all patients. RESULTS: Type Ⅰ IVCTT (10 patients) was posterior to the liver and below the diaphragm; type Ⅱ IVCTT (2 patients) was above the diaphragm but still outside the atrium; and type Ⅲ IVCTT (1 patient) was above the diaphragm and in the right atrium. Type Ⅰ was treated by radical hepatectomy and removal of IVCTT with total hepatic vascular exclusion. Type Ⅱ was treated by radical hepatectomy and removal of IVCTT by incision of the diaphragm. Type Ⅲ was treated by hepatectomy and resection of the thrombus from the right atrium under cardiopulmonary bypass. There were no surgical complications and one patient has been survived for 4 years with cancer-free status. The median survival time was 18.2 months, and the 1-and 2-year survival rates were 53.8% and 15.4%, respectively. CONCLUSION: Surgical treatment is safe and feasible for treatment of IVCTT in patients with hepatocellular carcinoma, and surgical resectability can be judged according to the classification of tumor thrombus.展开更多
文摘BACKGROUND Inferior mesenteric arteriovenous fistula(IMAVF)is an uncommon circulatory malformation with few reported instances.It entails a direct arteriovenous communication within the inferior mesenteric vascular system,producing abnormal hemodynamic flow that may result in gastrointestinal hypoperfusion,elevated portal venous pressure,and secondary cardiac dysfunction.Diagnosis often experiences delays because of nonspecific symptoms.Imaging modalities,such as multi-detector computed tomography(MDCT)and angiography,prove essential for accurate diagnosis and treatment planning.CASE SUMMARY Over a 10-year period,only two cases of IMAVF were encountered.The initial case involved a 56-year-old male without notable prior medical conditions who experienced intermittent lower abdominal discomfort,diarrhea,and hematochezia over several months.Ischemic colitis with an IMAVF was revealed through colonoscopy and MDCT angiography.Due to the size of the IMAVF,Hartmann’s procedure was performed instead of an endovascular intervention.Recovery proceeded uneventfully,and the colostomy was reversed one year later,with no recurrence observed on follow-up imaging.The subsequent case involved a 76-year-old female with repeated left-sided pyelonephritis and colonic diverticular disease,who manifested with abdominal discomfort and hematochezia.In contrast to previous computed tomography scans,MDCT and angiography revealed a newly developed IMAVF.Given her unstable vital signs,emergency laparoscopic total colectomy with ileorectal anastomosis and temporary ileostomy was conducted.Recovery occurred without complications,and the ileostomy was successfully reversed 2 months later,with no recurrence noted.CONCLUSION These cases emphasize the need to evaluate for vascular abnormalities in individuals presenting with ischemic colitis and unexplained gastrointestinal bleeding.The second case demonstrates that recurrent intra-abdominal inflammation may contribute to the development of IMAVF.
基金Supported by the General Project of the Natural Science Foundation of Chongqing,No.cstc2021jcyj-msxmX0604.
文摘BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under laparoscopy.Dissecting the third hepatic hilum before parenchymal transection often leads to significant liver mobilization,tumor compression,and bleeding from the short hepatic veins(SHVs).This study introduces a novel technique utilizing the ventral avascular area of the inferior vena cava(IVC),allowing SHVs to be addressed after parenchymal transection,thereby reducing surgical complexity and improving outcomes in in situ LLR.AIM To introduce and evaluate a novel LLR technique using the ventral avascular area of the IVC and compare its short-term outcomes with conventional methods.METHODS The clinical cohort data of patients with pathologically confirmed hepatocellular carcinoma or intrahepatic cholangiocarcinoma who underwent conventional LLR and novel LLR between July 2021 and July 2023 at the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.In novel LLR,we initially separated the caudate lobe from the IVC using dissecting forceps along the ventral avascular area of the IVC.Then,we transected the parenchyma of the left and right caudate lobes from the caudal side to the cephalic side using the avascular area as a marker.Subsequently,we addressed the SHVs and finally dissected the root of the right hepatic vein or left hepatic vein.The short-term postoperative outcomes and oncological results of the two approaches were evaluated and compared.RESULTS A total of 256 patients were included,with 150(58.59%)undergoing conventional LLR and 106(41.41%)undergoing novel LLR.The novel technique resulted in significantly larger tumor resections(6.47±2.96 cm vs 4.01±2.33 cm,P<0.001),shorter operative times(199.57±60.37 minutes vs 262.33±83.90 minutes,P<0.001),less intraoperative blood loss(206.92±37.09 mL vs 363.34±131.27 mL,P<0.001),and greater resection volume(345.11±31.40 mL vs 264.38±31.98 mL,P<0.001)compared to conventional LLR.CONCLUSION This novel technique enhances liver resection outcomes by reducing intraoperative complications such as bleeding and tumor compression.It facilitates a safer,in situ removal of complex liver tumors,even in challenging anatomical locations.Compared to conventional methods,this technique offers significant advantages,including reduced operative time,blood loss,and improved overall surgical efficiency.
文摘BACKGROUND Inferior intra-articular patella dislocation is rare and comprises horizontal(type 1)and the more common vertical(type 2)dislocations in young and elderly patients respectively.In this case report,we describe a case of an elderly patient who pre sented with a type 2 dislocation after a fall.The mechanisms of inferior patella dislocation,their classification,key imaging features and treatment options are discussed.CASE SUMMARY A 75-year-old woman presented with a right knee fixed flexion deformity after a fall.Preoperative imaging confirmed a vertical intra-articular patella dislocation with a femoral trochlear osteochondral defect and lax though grossly intact patella tendon.Closed reduction was performed under general anaesthesia.Knee arthroscopy confirmed the presence of a femoral trochlear osteochondral defect whose edges were subsequently smoothed and there was debridement of scant debris with thorough irrigation of the joint.Postoperative imaging demonstrated anatomical alignment,however,there was a new nondisplaced medial femoral trochlear.The patient however was able to mobilise well in a range of motion brace set at 0-30 degrees and was discharged 1-day post operatively.CONCLUSION Inferior patella dislocation is rare and this article highlights its types and imaging features which determine the most appropriate management.
基金supported by the National Key Research and Development Program of China(2022YFD2300700)the National Natural Science Foundation of China(32201894)+1 种基金Hainan Provincial Natural Science Foundation of China(323QN193)Rothamsted Research receives strategic funding from the Biotechnological and Biological Sciences Research Council of the UK.Matthew J.Paul acknowledges funding from the Delivering Sustainable Wheat(BB/X011003/1)Strategic Program.
文摘Inferior grains exhibit delayed developmental processes and reduced metabolic activities compared to superior grains,leading to unstable rice yield and quality.While significant advancements have been achieved in elucidating the physiology of endosperm filling in inferior grains,the role of the embryo remains underexplored and warrants comprehensive investigation.Two Wuyujing 3 mutants,DW024(relatively synchronous;syn-DW024)and DW179(significantly asynchronous;asyn-DW179),with different grain-filling patterns were used in this study.Samples of superior and inferior grains were collected at intervals from 5 to 60 d after fertilization and subsequently dissected into subsamples of the embryo and endosperm.Histochemical staining,biochemical analysis,and RNA sequencing(RNA-seq)were combined to systematically compare developmental and physiological traits between superior and inferior grains.Combining hierarchical clustering of mRNA datasets revealed three developmental phases of the endosperm and embryo:morphogenesis,endosperm filling/embryo enlargement,and maturation.In both syn-DW024 and asyn-DW179,the duration of the endosperm/embryo morphogenesis phase was identical in superior and inferior grains.The inferior grains of asyn-DW179 exhibited a 10-day prolongation in the endosperm filling phase and a 20-day extension in the embryo enlargement phase compared to the superior grains.The endosperm of inferior grains exhibited higher contents of sugars and free amino acids,along with slower accumulation of storage compounds,which was associated with the down-regulation of genes for starch synthesis and ABA signaling.In addition,transporters for nutrient exchanges between endosperm and embryo were down-regulated,suggesting a potential role of the embryo in adjusting the endosperm filling process.Collectively,our results reveal that the prolonged phases of endosperm filling and embryo enlargement may underlie the impaired development of inferior grains,offering a new perspective for breeding or cultivating rice with uniform grain quality.
文摘BACKGROUND Inferior mesenteric arteriovenous fistula(IMAVF)is an extremely rare condition characterized by abnormal communication between the inferior mesenteric artery and vein.IMAVF often mimics ischemic bowel disease and ulcerative colitis(UC),leading to diagnostic challenges and treatment failures.CASE SUMMARY Three consecutive cases presented with non-specific symptoms including perianal pain and bloody diarrhea were reported.Initial diagnosis included acute severe UC and ischemic colitis.Pathology suggested ischemic changes,and with further contrast-enhanced computed tomography together with digital subtraction angiography which confirmed the diagnosis of IMAVF.All three cases were treated by vascular embolization,and symptoms improved rapidly following treatment.CONCLUSION We presented the largest single center IMAVF series with detailed clinical characteristics,facilitating early diagnosis for similar cases in the future.
文摘BACKGROUND Kidney transplantation is increasingly more common due to the ongoing shortage of deceased donors.However,anatomical challenges,such as a short renal artery,can complicate surgical procedures and increase complication risk,including thrombosis and anastomotic stenosis.To address these issues and optimize graft outcomes,innovative surgical techniques are essential.CASE SUMMARY We present a case of kidney transplantation complicated by a short donor renal artery.To address the discrepancy between arterial length and diameter mismatch,the recipient’s inferior epigastric artery was used as a cuff interposition for arterial reconstruction.Following standard laparoscopic donor nephrectomy,vascular reconstruction was performed on the back table.The use of the inferior epigastric artery as a cuff allowed for successful elongation and size matching of the donor renal artery,enabling a tension-free anastomosis to the recipient’s external iliac artery.Postoperative Doppler ultrasound and angiography confirmed excellent graft perfusion.The patient experienced an uneventful recovery with immediate graft function and maintained stable renal function at 6 months post-transplant.To our knowledge,this is the first reported use of the inferior epigastric artery as a cuff interposition in renal artery reconstruction,offering a novel and effective technique for managing short renal arteries in kidney transplantation.CONCLUSION Interposition of the epigastric artery offers an innovative technique for managing short donor renal arteries,reducing the risk of early thrombosis and long-term complications as size mismatch and intimal hyperplasia.
文摘BACKGROUND Inferior vena cava(IVC)leiomyosarcomas are rare and aggressive tumors.Complete cure depends on achieving R0 resection,which often requires circumferential resection and reconstruction.Synthetic grafts have traditionally been used when venous continuity must be restored.However,the use of cadaveric IVC grafts for reconstruction has not been widely reported.CASE SUMMARY Herein,we present the case of a 64-year-old woman diagnosed with an intrahepatic IVC leiomyosarcoma with local invasion.The patient responded favorably to chemotherapy and subsequently underwent an en bloc right hepatectomy,retrohepatic IVC resection,and reconstruction with an interpositional cadaveric IVC graft.Serial imaging follow-ups until 2 years after the operation showed persistent patency of the graft and no graft-related complications.CONCLUSION Cadaveric IVC grafts are an alternative to synthetic grafts for reconstruction,with acceptable outcomes.Larger,long-term studies are necessary to validate these findings.
文摘Case Letter Severe trauma has high morbidity and mortality rates,being the leading cause of death in young adults.Among all traumas,tra ffi c injuries are particularly lethal.^([1-2]) The injury severity score(ISS) can be used to assess trauma severity,with ISS of<9,9–15,16–24,and≥25 indicating minor,moderate,severe,and critical trauma,respectively.The ISS is correlated with mortality,morbidity,and hospitalization duration after injury.^([3-4]) Here,we report one patient who was admitted to our emergency intensive care unit(EICU) due to traumatic liver rupture and traumatic myocardial infarction complicated with inferior vena cava(IVC) thrombosis.
文摘BACKGROUND Acute pulmonary thromboembolism is a complication of venous thrombosis.Extracorporeal membrane oxygenation(ECMO),an effective rescue measure for rapid hemodynamic recovery,can be used in patients for whom thrombolysis therapy has failed.CASE SUMMARY This case report describes an extreme rescue process for a patient with a preset inferior vena cava(IVC)filter in a relatively economically underdeveloped area with an insufficient supply of consumables.In an emergency,veno-arterial ECMO was successfully initiated by intubation through the IVC filter to the right atrial opening without displacement of the filter during the entire process.CONCLUSION This study demonstrates that in resource-limited settings,femoral vein cannulation for veno-arterial ECMO is a feasible and safe option for patients with preimplanted IVC filters.
文摘Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.
基金Supported by Shenzhen Second People’s Hospital Clinical Research Fund of Shenzhen High-level Hospital Construction Project,No.20243357001.
文摘BACKGROUND Diagnosing posterior inferior cerebellar artery dissection(PICAD)using radio-logical images is challenging.Massive cerebellar infarctions resulting from spon-taneous,isolated PICAD are rare,and the associated clinical,imaging,and treat-ment options remain unclear.CASE SUMMARY A 39-year-old man was admitted for dizziness and unstable gait for two days.Ph-ysical examination revealed decreased right-limb muscle strength and right-sided ataxia.Brain magnetic resonance imaging(MRI)showed a massive acute right cerebellar infarction,but other modalities,including head and neck computed tomographic angiography(CTA)and magnetic resonance angiography(MRA),showed no obvious abnormalities.High-resolution vessel wall MRI(HR-VW-MRI)revealed right PICAD.The patient was diagnosed with massive cerebellar infarction caused by PICAD and active conservative treatment was initiated.The initial PICAD lesion disappeared 1.5 months after discharge,after which the patient experienced only slight weakness in his right limb for three months.CONCLUSION Since MRA and CTA may fail to identify PICAD,HR-VW-MRI is key in diagnosis and follow-up evaluation.Aggressive medication may be effective and safe for treating PICAD.
文摘The development of innovative surgical techniques has been a constant and fundamental aspect in liver transplantation(LT)to address chronic organ shortage.Domino liver transplantation(DLT),initially performed by Furtado et al.in Lisbon in 1995,is an innovative technique in which a liver from a patient with a metabolic disorder is transplanted into a recipient with end-stage liver disease[1].
基金supported by the National Key Research and Development Program of China(No.2022YFC3602500)Beijing High-level Public Health Technical Talents Construction Project(Discipline Leader-03-24)Beijing Hospitals Authority’s Ascent Plan(DFL20240601).
文摘OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.
文摘In order to study the effect of weak noise on the sound signal extraction of mouse (Mus musculus Km) inferior collicular (IC) neurons from environments,we examined the changes in frequency tuning curves (FTCs) of 32 neurons induced by a weak noise relative to 5 dB below minimum threshold of tone (reMT-5 dB) under free field stimulation conditions.The results were as follows:① There were three types of variations in FTCs,sharpened (34.4%),broadened (18.8%),and unaffected (46.9%),nevertheless,only the alteration of sharpened FTCs was statistically different.② Sharpness of frequency tuning induced by a reMT-5 dB noise was very strong.Q 10 and Q 30 of FTCs were increased by (34.42±17.04)% (P=0.026,n=11) and (46.34±22.88)% (P=0.009,n=7).③ The changes of inverse-slopes (ISs,kHz/dB) between high (IS high) and low (IS low) limbs of FTCs were dissymmetry.The IS high of FTCs decreased markedly (P=0.046,n=7),however,there was little change (P=0.947,n=7) in IS low.Our data revealed for the first time that the weak noise could sharpen frequency tuning and increase the sensitivity on the high frequency of sound signal in IC neurons of mouse.
文摘AIM:To compare the changes in excyclotorsion after inferior oblique(IO)recession in patients with primary and secondary inferior oblique overaction(IOOA).METHODS:We retrospectively analyzed the data obtained from patients with IOOA who underwent graded IO recession.The patients were followed up for at least 3 mo after surgery.Fundus photographs were taken preand postoperatively,and the sum of the angles of torsion in both eyes was used to analyze changes in excyclotorsion.Patients were divided into two groups:those diagnosed with primary IOOA were enrolled in the 1’IOOA group,and those diagnosed with secondary IOOA caused by superior oblique palsy(SOP)were enrolled in the 2’IOOA group.Excyclotorsion before and after surgery were compared between the two groups.RESULTS:A total of 78 patients were enrolled in this study:34 eyes in the 1’IOOA group and 44 eyes in the 2’IOOA group.In the 78 patients,torsional angle significantly decreased from 15.31°±7.40°to 12.11°±6.53°after IO recession(P<0.001).Mean preoperative torsional angle was larger in the 2’IOOA group than in the 1’IOOA group(P=0.03).In both groups,excyclotorsion significantly decreased after IO recession(P=0.001 and P<0.001,respectively);however,there was no significant difference in the amounts of changes in excyclotorsion between the two groups.CONCLUSION:Excyclotorsion is significantly larger in secondary IOOA than in primary IOOA,and a significant decrease in the torsional angle occurs after IO recession in both types of IOOA.
文摘AIM:To investigate the effectiveness of a modified inferior oblique muscle belly transposition for treatment of V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction.METHODS:Thirteen cases(23 affected eyes)of V-pattern exotropia with inferior oblique muscle overaction(+or++)who underwent the modified inferior oblique muscle belly transposition procedure were retrospectively reviewed.The amount of V-pattern,grade of inferior oblique overaction,degree of vertical strabismus,abnormal head posture,and the fovea-disc angle were evaluated before and after surgery.RESULTS:The V-pattern was corrected in all cases,and the amount of V-pattern reduced by 17.85±5.13 prism diopter(PD)on average(t=16.07,P<0.001).The surgical cure rate for mild to moderate inferior oblique muscle overaction was 87.0%(20/23).The degree of the foveadisc angle has a mean reduction of 5.45°±2.87°(t=3.95,P=0.003)after surgery.The mean vertical deviation in 5 cases with a small-angle hypertropia(5.23±3.06 PD)in the primary position reduced by 3.15±1.86 PD(t=6.10,P<0.001).No serious complications were observed.CONCLUSION:The modified inferior oblique muscle belly transposition procedure can effectively treat mild to moderate inferior oblique overaction and relieve the V-pattern,which is safe and easy to perform.
基金Supported by Foundation Project in Guang'anmen Hospital,China Academy of Chinese Medical Sciences:2006 S 195
文摘Objective To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.Methods The patients confirmed to the enrolled criteria were randomly divided into an observation group（n=31） and a control group（n=30）.In the observation group,electroacupuncture was applied to Sìbái（四白 ST 2）,Xiàguān（下关 ST 7）,Hégǔ（合谷 LI 4） and Zhīgōu（支沟 TE 6） on the left side for the anesthesia and the routine local anesthesia was done on the right side.In the control group,the routine local anesthesia was adopted on both sides.The feelings of pain,circulatory index and operation effect were observed and compared between the two groups.Results During radiofrequency ablation,the pain grades of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group（all P〈0.05）.In the observation group,the pain grade on the left side was lower than that on the right side（P〈0.05）,and the systolic blood pressure and the heart rate were lower than those in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side,respectively（all P〈0.05）.There was no significant difference in operation effect between the two groups.Conclusion Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for hypertrophic inferior turbinate,and would be helpful to prevent cyclic fluctuation during the operation at the same time.
基金Supported by the National Natural Science Foundation of China,No.81471020Shandong Medical and Health Technology Development Project,No.2014WS0148+1 种基金Qilu Hospital of Shandong University Scientific Research Funding,No.2015QLMS32Shandong University Basic Scientific Research Funding(Qilu Hospital Clinical Research Project),No.2014QLKY21
文摘AIM To investigate the vascular anatomy of inferior mesenteric artery(IMA) in laparoscopic radical resection with the preservation of left colic artery(LCA) for rectal cancer. METHODS A total of 110 patients with rectal cancer who underwent laparoscopic surgical resection with preservation of the LCA were retrospectively reviewed. A 3 D vascular reconstruction was performed before each surgical procedure to assess the branches of the IMA. During surgery, the relationship among the IMA, LCA, sigmoid artery(SA) andsuperior rectal artery(SRA) was evaluated, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between inferior mesenteric vein(IMV) and LCA was also evaluated.RESULTS Three vascular types were identified in this study. In type A, LCA arose independently from IMA(46.4%, n = 51); in type B, LCA and SA branched from a common trunk of the IMA(23.6%, n = 26); and in type C, LCA, SA, and SRA branched at the same location(30.0%, n = 33). The difference in the length from the origin of IMA to LCA was not statistically significant among the three types. LCA was located under the IMV in 61 cases and above the IMV in 49 cases. CONCLUSION The vascular anatomy of the IMA and IMV is essential for laparoscopic radical resection with preservation of the LCA for rectal cancer. To recognize different branches of the IMA is necessary for the resection of lymph nodes and dissection of vessels.
基金supported by the grants from the National Natural Science Foundation of China(NSFC-IRRI Joint Research Project 31061140457)General Project (Grant Nos. 31071360 and 31271641)+2 种基金the National Basic Research Program (Grant No.2009CB118603)the National Key Technology Support Program of China (Grant Nos. 2011BAD16B14 and 2012BAD04B08)the Basic Scientific Research Special Operation Cost of the Central Research Institutions in 2011 (Grant No. 201103003)
文摘The changes in activities of key enzymes involved in sucrose-to-starch conversion and concentrations of hormones in superior and inferior spikelets of super rice were investigated and their association with grain filling was analyzed.Four super rice cultivars,Liangyoupeijiu,IIyou 084,Huaidao 9 and Wujing 15,and two high-yielding and elite check cultivars,Shanyou 63 and Yangfujing 8,were used.The activities of sucrose synthase （SuSase）,adenosine diphosphoglucose pyrophosphorylase （AGPase）,starch synthase （StSase） and starch branching enzyme （SBE）,and the concentrations of zeatin ＋ zeatin riboside （Z ＋ ZR）,indole-3-acetic acid （IAA） and abscisic acid （ABA） in superior and inferior spikelets were determined during the grain filling period and their relationships with grain filling rate were analyzed.Maximum grain filling rate,the time reaching the maximum grain-filling rate,mean grain filling rate and brown rice weight for superior spikelets showed a slight difference between the super and check rice cultivars,but were significantly lower in the super rice than in the check rice for inferior spikelets.Changes of enzyme activities and hormone concentrations in grains exhibited single peak curves during the grain filling period.The peak values and the mean activities of SuSase,AGPase,StSase and SBE were lower in inferior spikelets than in superior ones,as well as the peak values and the mean concentrations of Z ＋ ZR and IAA.However,the peak value and the mean concentration of ABA were significantly higher in inferior spikelets than in superior ones and greater in the super rice than in the check rice.The grain filling rate was positively and significantly correlated with the activities of SuSase,AGPase and StSase and the concentrations of Z ＋ ZR and IAA.The results suggested that the low activities of SuSase,AGPase and StSase and the low concentrations of Z ＋ ZR and IAA might be important physiological reasons for the slow grain filling rate and light grain weight of inferior spikelets in super rice.
基金supported by a grant from the Chinese Key Project for Infectious Diseases (2008ZX10002-025)
文摘BACKGROUND: Hepatic resection is the main treatment modality for hepatic tumors. Advances in diagnostic technique, preoperative preparation, surgical technique, and postoperative management increased the success rate. The present study aimed to evaluate hepatectomy and resection of inferior vena cava tumor thrombus (IVCTT) in patients with hepatocellular carcinoma, and the relationship between IVCTT classification and selection of surgical technique. METHODS: We retrospectively reviewed 13 patients with hepatocellular carcinoma who had undergone hepatectomy with IVCTT resection between May 1997 and August 2009. Age, gender, diagnosis, findings of physical examination, results of preoperative laboratory investigations, radiological examination, criteria for resection, postoperative pathological results, incisions, operative technique, intraoperative transfusion, drains, and intraoperative and postoperative complications were evaluated for all patients. RESULTS: Type Ⅰ IVCTT (10 patients) was posterior to the liver and below the diaphragm; type Ⅱ IVCTT (2 patients) was above the diaphragm but still outside the atrium; and type Ⅲ IVCTT (1 patient) was above the diaphragm and in the right atrium. Type Ⅰ was treated by radical hepatectomy and removal of IVCTT with total hepatic vascular exclusion. Type Ⅱ was treated by radical hepatectomy and removal of IVCTT by incision of the diaphragm. Type Ⅲ was treated by hepatectomy and resection of the thrombus from the right atrium under cardiopulmonary bypass. There were no surgical complications and one patient has been survived for 4 years with cancer-free status. The median survival time was 18.2 months, and the 1-and 2-year survival rates were 53.8% and 15.4%, respectively. CONCLUSION: Surgical treatment is safe and feasible for treatment of IVCTT in patients with hepatocellular carcinoma, and surgical resectability can be judged according to the classification of tumor thrombus.
