Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 20...Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.展开更多
Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and t...Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.展开更多
This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadi...This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.展开更多
Background:An increasing number of patients with Fontan circulation are reaching adulthood;however,long-term outcomes remain limited by Fontan failure,which is characterized by elevated central venous pressure(CVP)and...Background:An increasing number of patients with Fontan circulation are reaching adulthood;however,long-term outcomes remain limited by Fontan failure,which is characterized by elevated central venous pressure(CVP)and reduced cardiac output.Red blood cell distribution width(RDW),a readily available hematological parameter,is a known prognostic marker of heart failure.However,its relationship with invasive hemodynamics in adolescent and adult Fontan patients has not been fully examined.Objectives:To clarify the association between RDW and invasive hemodynamic indices in adolescent and adult Fontan patients and assess the utility of RDW as a noninvasive circulatory marker.Methods:This single-center retrospective study included consecutive Fontan patients aged≥16 years who underwent routine cardiac catheterization≥5 years after surgery,between June 2014 and July 2025.Laboratory data and catheter-derived hemodynamics were also analyzed.The primary endpoint was the correlation between RDW and CVP,and the secondary endpoint was the correlation between RDW and central venous oxygen saturation(ScvO_(2)).Results:Forty patients(median age:22 years)were analyzed.The median RDW was 13.3%,and the median CVP was 11.0 mmHg.RDW correlated positively with CVP(ρ=0.57,p<0.001)and negatively with ScvO_(2)(ρ=-0.66,p<0.001)and the cardiac index(ρ=-0.34,p=0.03).Patients with elevated RDW(>14.5%)had higher CVP(14.5 vs.10.5 mmHg,p<0.001)and lower ScvO_(2)(63.8%vs.76.1%,p<0.001),compared with those with normal RDW.Multivariable analysis identified RDW as an independent predictor of ScvO_(2)(p<0.001).Conclusions:In adolescents and adults after the Fontan procedure,RDW was significantly associated with elevated CVP and reduced ScvO_(2)and independently predicted impaired oxygen delivery.RDW is inexpensive,widely accessible,and may serve as a practical noninvasive biomarker for the early detection of Fontan failure and the optimization of invasive testing and interventions during long-term follow-up.展开更多
Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur si...Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur simultaneously.Closed-globe injuries can damage one or more ocular structures.展开更多
BACKGROUND In open heart surgery requiring cardiopulmonary bypass(CPB),ventricular fibrillation(VF)is common,but refractory recurrent VF is uncommon but perilous.CASE SUMMARY This article reports a 58-year-old male pa...BACKGROUND In open heart surgery requiring cardiopulmonary bypass(CPB),ventricular fibrillation(VF)is common,but refractory recurrent VF is uncommon but perilous.CASE SUMMARY This article reports a 58-year-old male patient with an ascending aortic aneurysm who presented for a Bentall procedure and subsequently experienced multiple occurrences of unexplained VF after weaning from CPB.The recurrent episodes of VF in this case were felt to be related to coronary insufficiency after reconstruction of the aortic root.Coronary artery bypass grafting(CABG)of the proximal right coronary artery and the left anterior descending artery successfully resolved VF.Finally,this patient was safely transferred to the postoperative intensive care unit,and was discharged successfully after subsequent supportive treatment.CONCLUSION In aortic root replacement,coronary insufficiency is a potential cause of VF episodes and should be considered in the differential diagnosis.CABG is the sole effective treatment for VF caused by coronary insufficiency.展开更多
The transverse incision with longitudinal ligation(TILL)procedure is a new method for treating circumferential prolapsed hemorrhoids.A study by Song et al found TILL to be better than the traditional Milligan-Morgan h...The transverse incision with longitudinal ligation(TILL)procedure is a new method for treating circumferential prolapsed hemorrhoids.A study by Song et al found TILL to be better than the traditional Milligan-Morgan hemorrhoidectomy for short-term results,showing less pain,quicker healing,and lower risk of anal stenosis.TILL reduces tissue tension and controls blood supply,allowing effective removal of diseased tissue while maintaining anal function and structure.However,the study's limitations,including its retrospective,single-center design,small sample size,and short follow-up,restrict the findings'generalizability and ability to assess long-term outcomes like recurrence.Larger,multicenter trials are needed for a thorough evaluation and wider clinical adoption of TILL.展开更多
Background:The management of high complex anal fistulas has posed a significant challenge for surgeons.In this study,we presented a novel surgical procedure for managing high complex anal fistulas that combines core-o...Background:The management of high complex anal fistulas has posed a significant challenge for surgeons.In this study,we presented a novel surgical procedure for managing high complex anal fistulas that combines core-out fistulectomy with suture repair of the external anal sphincter defect and endorectal advancement flap.Methods:A cohort of patients with high complex anal fistulas undergoing core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap between December 2020 and December 2021 was reviewed retrospectively.Results:The median age of the patients was 43(range:25-53)years.All patients had high transsphincteric fistulas.Two of the five cases involved recurrent anal fistulas.During the median follow-up period of 23(range:23-34)months,no recurrence events were observed in the cohort.Furthermore,it was noted that no patients developed anal incontinence after the operation.Conclusion:Core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap is an effective procedure for the treatment of high complex anal fistulas.展开更多
In this study,we searched for dispersed repeats(DRs)in the rice(Oryza sativa)genome using the iterative procedure(IP)method.The results revealed that the O.sativa genome contained 79 DR families,comprising 992739 DNA ...In this study,we searched for dispersed repeats(DRs)in the rice(Oryza sativa)genome using the iterative procedure(IP)method.The results revealed that the O.sativa genome contained 79 DR families,comprising 992739 DNA repeats,of which 496762 and 495977 were identified on the forward and reverse DNA strands,respectively.The detected DRs were,on average,374 bp in length and occupied 66.4%of the O.sativa genome.Totally 61%of DRs,identified by the IP method,overlapped with previously annotated dispersed repeats(ADRs)detected using the Extensive De Novo TE Annotator(EDTA)pipeline.展开更多
BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with signifi...BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.展开更多
BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development...BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development worldwide.Traditionally,cell apoptosis is identified using morphological,biochemical,and cell cycle experiments,which is time consuming,and experimental materials are not from the same group,and it is very hard to ensure the identity and veracity of results of former and latter experiments.AIM To establish a selective,instant,and practical protocol to identify cell apoptosis induced by natural products.METHODS A one transient cell processing procedure(OTCPP)was used to detect human colorectal cancer LoVo cell apoptosis after treatment with Pinus massoniana bark extract(PMBE)at the morphological,biochemical,and cell cycle levels.The methods used included treatment with DNA gel electrophoresis,fluorescence microscopy,and flow cytometry.RESULTS In PMBE-treated LoVo cells,we observed a DNA ladder on gel electrophoresis and fluorescence microscopy revealed"nuclear shrinkage,chromatin condensation or fragmentation".In addition,flow cytometry showed an"obvious apoptosis curve".Thus OTCPP achieved synchronous detection of the morphology,biochemistry,cell cycle,and the DNA content of the cells.CONCLUSION OTCPP can quickly identify apoptosis and measure the apoptosis rate,thereby unifying qualitative and quantitative analysis.展开更多
Practical jurisprudence is a completely new proposition in legal education and research.The introduction of the concept of“practical jurisprudence”in the teaching of the Civil Procedure Law of the People’s Republic...Practical jurisprudence is a completely new proposition in legal education and research.The introduction of the concept of“practical jurisprudence”in the teaching of the Civil Procedure Law of the People’s Republic of China(the“Civil Procedure Law”)is a major innovation in terms of values and methodology.Practical jurisprudence focuses more on practical issues,Chinese characteristics,and major needs,while strengthening the practical nature of the Civil Procedure Law.China’s traditional education system for juris masters(for non-law graduates)(“non-law JMs”)emphasizes the development of foundational legal theoretical knowledge.However,it has not fully achieved its goal of cultivating interdisciplinary and practical legal professionals.Therefore,the traditional education system for the Civil Procedure Law needs reconstruction and supplementation through the practical jurisprudence teaching system in the following areas:(a)System composition:The focus should be on the eight tertiary subsystems under the two secondary subsystems—“the knowledge teaching system and the practical teaching system”of practical jurisprudence in the Civil Procedure Law,as well as the management of their interrelationships.(b)Credit structure:The proportion of credits for“practical teaching and training”should be increased.(c)Practical ability requirements:Legal professionals should be cultivated according to the standards for juris masters(for law graduates)as stipulated by the Law of the People’s Republic of China on Academic Degrees.(d)Practice evaluation:“Formalization of the evaluations,”“homogeneity of the evaluators,”and“reliance on written formats”should be avoided.展开更多
BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes an...BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.展开更多
Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing...Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing its role as a primary treatment with excellent long-term outcomes and minimal adverse events.The evolution of POEM underscores the need for precision in myotomy techniques and the importance of interdisciplinary collaboration,especially regar-ding anesthetic considerations.Despite significant advances,challenges remain in standardizing safety protocols and managing complications.As POEM appli-cations expand,precision endoscopy continues to enhance therapeutic outcomes,promising a transformative impact on gastrointestinal motility disorder manage-ment.展开更多
基金Construction of Standardized Protective Nursing Plan for Hydrofluoric Acid Operation in Stomatology and Re search on Injury Prevention Effect(Project No.:FZ2025101)。
文摘Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.
文摘Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.
基金supported by funding from the Medical Research Funding of Guangdong(No.A2022499 to QGX)the National Natural Science Foundation of China(No.82301796 to PL)the Guangdong Province Regional Joint Fund-Youth Fund Project of China(No.2022A1515111201 to PL).
文摘This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.
文摘Background:An increasing number of patients with Fontan circulation are reaching adulthood;however,long-term outcomes remain limited by Fontan failure,which is characterized by elevated central venous pressure(CVP)and reduced cardiac output.Red blood cell distribution width(RDW),a readily available hematological parameter,is a known prognostic marker of heart failure.However,its relationship with invasive hemodynamics in adolescent and adult Fontan patients has not been fully examined.Objectives:To clarify the association between RDW and invasive hemodynamic indices in adolescent and adult Fontan patients and assess the utility of RDW as a noninvasive circulatory marker.Methods:This single-center retrospective study included consecutive Fontan patients aged≥16 years who underwent routine cardiac catheterization≥5 years after surgery,between June 2014 and July 2025.Laboratory data and catheter-derived hemodynamics were also analyzed.The primary endpoint was the correlation between RDW and CVP,and the secondary endpoint was the correlation between RDW and central venous oxygen saturation(ScvO_(2)).Results:Forty patients(median age:22 years)were analyzed.The median RDW was 13.3%,and the median CVP was 11.0 mmHg.RDW correlated positively with CVP(ρ=0.57,p<0.001)and negatively with ScvO_(2)(ρ=-0.66,p<0.001)and the cardiac index(ρ=-0.34,p=0.03).Patients with elevated RDW(>14.5%)had higher CVP(14.5 vs.10.5 mmHg,p<0.001)and lower ScvO_(2)(63.8%vs.76.1%,p<0.001),compared with those with normal RDW.Multivariable analysis identified RDW as an independent predictor of ScvO_(2)(p<0.001).Conclusions:In adolescents and adults after the Fontan procedure,RDW was significantly associated with elevated CVP and reduced ScvO_(2)and independently predicted impaired oxygen delivery.RDW is inexpensive,widely accessible,and may serve as a practical noninvasive biomarker for the early detection of Fontan failure and the optimization of invasive testing and interventions during long-term follow-up.
文摘Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur simultaneously.Closed-globe injuries can damage one or more ocular structures.
文摘BACKGROUND In open heart surgery requiring cardiopulmonary bypass(CPB),ventricular fibrillation(VF)is common,but refractory recurrent VF is uncommon but perilous.CASE SUMMARY This article reports a 58-year-old male patient with an ascending aortic aneurysm who presented for a Bentall procedure and subsequently experienced multiple occurrences of unexplained VF after weaning from CPB.The recurrent episodes of VF in this case were felt to be related to coronary insufficiency after reconstruction of the aortic root.Coronary artery bypass grafting(CABG)of the proximal right coronary artery and the left anterior descending artery successfully resolved VF.Finally,this patient was safely transferred to the postoperative intensive care unit,and was discharged successfully after subsequent supportive treatment.CONCLUSION In aortic root replacement,coronary insufficiency is a potential cause of VF episodes and should be considered in the differential diagnosis.CABG is the sole effective treatment for VF caused by coronary insufficiency.
文摘The transverse incision with longitudinal ligation(TILL)procedure is a new method for treating circumferential prolapsed hemorrhoids.A study by Song et al found TILL to be better than the traditional Milligan-Morgan hemorrhoidectomy for short-term results,showing less pain,quicker healing,and lower risk of anal stenosis.TILL reduces tissue tension and controls blood supply,allowing effective removal of diseased tissue while maintaining anal function and structure.However,the study's limitations,including its retrospective,single-center design,small sample size,and short follow-up,restrict the findings'generalizability and ability to assess long-term outcomes like recurrence.Larger,multicenter trials are needed for a thorough evaluation and wider clinical adoption of TILL.
基金supported by the Guangzhou Clinical High-Tech Project,Guangdong Province[grant number 2023P-GX09]The Sixth Affiliated Hospital,Sun Yat-sen University Clinical Research 1010 Program[grant number 1010PY(2020)-18]+1 种基金The Natural Science Foundation of Guangdong Province for Distinguished Young Scholars[grant number 2022B1515020003]National Key Clinical Discipline,Guangdong Provincial Clinical Research Center for Digestive Diseases[grant number 2020B1111170004].
文摘Background:The management of high complex anal fistulas has posed a significant challenge for surgeons.In this study,we presented a novel surgical procedure for managing high complex anal fistulas that combines core-out fistulectomy with suture repair of the external anal sphincter defect and endorectal advancement flap.Methods:A cohort of patients with high complex anal fistulas undergoing core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap between December 2020 and December 2021 was reviewed retrospectively.Results:The median age of the patients was 43(range:25-53)years.All patients had high transsphincteric fistulas.Two of the five cases involved recurrent anal fistulas.During the median follow-up period of 23(range:23-34)months,no recurrence events were observed in the cohort.Furthermore,it was noted that no patients developed anal incontinence after the operation.Conclusion:Core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap is an effective procedure for the treatment of high complex anal fistulas.
基金supported by the Russian Science Foundation,Russia(Grant No.24-24-00031).
文摘In this study,we searched for dispersed repeats(DRs)in the rice(Oryza sativa)genome using the iterative procedure(IP)method.The results revealed that the O.sativa genome contained 79 DR families,comprising 992739 DNA repeats,of which 496762 and 495977 were identified on the forward and reverse DNA strands,respectively.The detected DRs were,on average,374 bp in length and occupied 66.4%of the O.sativa genome.Totally 61%of DRs,identified by the IP method,overlapped with previously annotated dispersed repeats(ADRs)detected using the Extensive De Novo TE Annotator(EDTA)pipeline.
基金Supported by Scientific Research Fund of China-Japan Friendship Hospital,No.2019-1-QN-53.
文摘BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.
基金Supported by 2023 Key R&D Projects of Tongji University,No.150029607160-24323Industrial Key Program Foundation of Guangdong Province:R&D of Natural Novel Anticancer Drugs,No.2004B10401033。
文摘BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development worldwide.Traditionally,cell apoptosis is identified using morphological,biochemical,and cell cycle experiments,which is time consuming,and experimental materials are not from the same group,and it is very hard to ensure the identity and veracity of results of former and latter experiments.AIM To establish a selective,instant,and practical protocol to identify cell apoptosis induced by natural products.METHODS A one transient cell processing procedure(OTCPP)was used to detect human colorectal cancer LoVo cell apoptosis after treatment with Pinus massoniana bark extract(PMBE)at the morphological,biochemical,and cell cycle levels.The methods used included treatment with DNA gel electrophoresis,fluorescence microscopy,and flow cytometry.RESULTS In PMBE-treated LoVo cells,we observed a DNA ladder on gel electrophoresis and fluorescence microscopy revealed"nuclear shrinkage,chromatin condensation or fragmentation".In addition,flow cytometry showed an"obvious apoptosis curve".Thus OTCPP achieved synchronous detection of the morphology,biochemistry,cell cycle,and the DNA content of the cells.CONCLUSION OTCPP can quickly identify apoptosis and measure the apoptosis rate,thereby unifying qualitative and quantitative analysis.
文摘Practical jurisprudence is a completely new proposition in legal education and research.The introduction of the concept of“practical jurisprudence”in the teaching of the Civil Procedure Law of the People’s Republic of China(the“Civil Procedure Law”)is a major innovation in terms of values and methodology.Practical jurisprudence focuses more on practical issues,Chinese characteristics,and major needs,while strengthening the practical nature of the Civil Procedure Law.China’s traditional education system for juris masters(for non-law graduates)(“non-law JMs”)emphasizes the development of foundational legal theoretical knowledge.However,it has not fully achieved its goal of cultivating interdisciplinary and practical legal professionals.Therefore,the traditional education system for the Civil Procedure Law needs reconstruction and supplementation through the practical jurisprudence teaching system in the following areas:(a)System composition:The focus should be on the eight tertiary subsystems under the two secondary subsystems—“the knowledge teaching system and the practical teaching system”of practical jurisprudence in the Civil Procedure Law,as well as the management of their interrelationships.(b)Credit structure:The proportion of credits for“practical teaching and training”should be increased.(c)Practical ability requirements:Legal professionals should be cultivated according to the standards for juris masters(for law graduates)as stipulated by the Law of the People’s Republic of China on Academic Degrees.(d)Practice evaluation:“Formalization of the evaluations,”“homogeneity of the evaluators,”and“reliance on written formats”should be avoided.
基金Supported by the Beijing Tsinghua Changgung Hospital Fund,China,No.12023C01005.
文摘BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.
文摘Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing its role as a primary treatment with excellent long-term outcomes and minimal adverse events.The evolution of POEM underscores the need for precision in myotomy techniques and the importance of interdisciplinary collaboration,especially regar-ding anesthetic considerations.Despite significant advances,challenges remain in standardizing safety protocols and managing complications.As POEM appli-cations expand,precision endoscopy continues to enhance therapeutic outcomes,promising a transformative impact on gastrointestinal motility disorder manage-ment.
