Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and...Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and stable view, articulated instruments, and reduction of physiologic tremors leading to superior dexterity and ergonomics. Therefore, robotic platforms could potentially address limitations of laparoscopic rectal surgery. It was aimed at reviewing current literature on short-term clinical and oncological(pathological) outcomes after robotic rectal cancer surgery in comparison with laparoscopic surgery. A systematic review was performed for the period 2002 to 2014. A total of 1776 patients with rectal cancer underwent minimally invasive robotic treatment in 32 studies. After robotic and laparoscopic approach to oncologic rectal surgery, respectively, mean operating time varied from 192-385 min, and from 158-297 min; mean estimated blood loss was between 33 and 283 mL, and between 127 and 300 mL; mean length of stay varied from 4-10 d; and from 6-15 d. Conversion after robotic rectal surgery varied from 0% to 9.4%, and from 0 to 22% after laparoscopy. There was no difference between robotic(0%-41.3%) and laparoscopic(5.5%-29.3%) surgery regarding morbidity and anastomotic complications(respectively, 0%-13.5%, and 0%-11.1%). Regarding immediate oncologic outcomes, respectively among robotic and laparoscopic cases, positive circumferential margins varied from 0% to 7.5%, and from 0% to 8.8%; the mean number of retrieved lymph nodes was between 10 and 20, and between 11 and 21; and the mean distal resection margin was from 0.8 to 4.7 cm, and from 1.9 to 4.5 cm. Robotic rectal cancer surgery is being undertaken by experienced surgeons. However, the quality of the assembled evidence does not support definite conclusions about most studies variables. Robotic rectal cancer surgery is associated to increased costs and operating time. It also seems to be associated to reduced conversion rates. Other short-term outcomes are comparable to conventional laparoscopy techniques, if not better. Ultimately, pathological data evaluation suggests that oncologic safety may be preserved after robotic total mesorectal excision. However, further studies are required to evaluate oncologic safety and functional results.展开更多
药物性肝损伤(DILI)因果关系评估量表的优化改进一直是临床上关注的一个热点问题。新近Hayashi等[1]在Hepatology发表了《用于DILI诊断的改良电子版RUCAM量表(A revised electronic version of RUCAM for the diagnosis of DILI)》一文...药物性肝损伤(DILI)因果关系评估量表的优化改进一直是临床上关注的一个热点问题。新近Hayashi等[1]在Hepatology发表了《用于DILI诊断的改良电子版RUCAM量表(A revised electronic version of RUCAM for the diagnosis of DILI)》一文,并将这种新的量表正式命名为“改良电子化因果关系评估量表(revised electronic causality assessment method,RECAM)”,我们已在本刊第7期对其进行了介绍。RECAM发布后,RUCAM量表的主要设计者Danan和Teschke致信Hepatology编辑部,认为RECAM的设计理念和依据存在多方面的明显缺陷。我们欢迎这样的学术争鸣,这将有助于DILI临床诊断量表的进一步合理化改进和完善,提高临床对DILI诊断量表的认知度和利用度,推动DILI诊断的规范化、标准化、同质化,提高不同研究之间的可比性。现将该信全文翻译刊载如下。展开更多
A monolithic integrated two-section distributed feedback(TS-DFB)semiconductor laser for high-speed direct modulation is proposed and analyzed theoretically.The grating structure of the TS-DFB laser is designed by the ...A monolithic integrated two-section distributed feedback(TS-DFB)semiconductor laser for high-speed direct modulation is proposed and analyzed theoretically.The grating structure of the TS-DFB laser is designed by the reconstructionequivalent-chirp(REC)technique,which can reduce the manufacturing cost and difficulty,and achieve high wavelength controlling accuracy.The detuned loading effect and the photon-photon resonance(PPR)effect are utilized to enhance the modulation bandwidth of the TS-DFB laser,exceeding 37 GHz,while that of the conventional one-section DFB laser is only 16 GHz.When the bit rate of the non-return-to-zero(NRZ)signal reaches 55 Gb/s,a clear eye diagram with large opening can still be obtained.These results show that the proposed method can enhance the modulation bandwidth of DFB laser significantly.展开更多
RECS1(responsive to centrifugal force and shear stress gene 1)是一血液剪切力应答蛋白.RECS1基因敲除的小鼠年老时易患主动脉囊性中层坏死并表现有大动脉扩张症,暗示RECS1可能参与调控血管的发育重塑.免疫组化分析发现,RECS1基因敲...RECS1(responsive to centrifugal force and shear stress gene 1)是一血液剪切力应答蛋白.RECS1基因敲除的小鼠年老时易患主动脉囊性中层坏死并表现有大动脉扩张症,暗示RECS1可能参与调控血管的发育重塑.免疫组化分析发现,RECS1基因敲除(RECS1 knockout,RECS1 KO)的小鼠主动脉基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)的表达水平明显提高,但RECS1的结构与功能及相关作用机理仍不清楚.研究发现,RECS1是肿瘤坏死因子受体2(tumor neucrosisfactor receptor 2,TNFR2)的结合蛋白质.报告基因检测实验表明,RECS1能特异地抑制TNFR2特异的激动性抗体或过量表达TNFR2诱导的核转录因子-κB(nuclear factor-κB,NF-κB)活化.NPLY模体缺失突变的RECS1不能结合TNFR2,并丧失对TNFR2介导NF-κB活化的抑制能力.稳定表达RECS1的MEFS细胞中,TNFR2特异的激动性抗体诱导的IκB(inhibitor of NF-κB)降解和NF-κB靶基因白介素-6(interleukin-6,IL-6)的表达均受到明显抑制.该研究揭示了RECS1通过与TNFR2的相互作用,负调控TNFR2介导肿瘤坏死因子信号传递的新功能及RECS1参与血管发育重塑调控的可能机制.展开更多
AIM:To investigate the distribution and expressionof C-type natriuretic peptide(CNP)/natriuretic peptide receptor B(NPR-B) in the rectum of a rodent depression model and the interventional effect of Xiaoyaosan(XYS).ME...AIM:To investigate the distribution and expressionof C-type natriuretic peptide(CNP)/natriuretic peptide receptor B(NPR-B) in the rectum of a rodent depression model and the interventional effect of Xiaoyaosan(XYS).METHODS:Male rats(n = 45) of clean grade(200 ± 20 g) were divided into five groups after one week of adaptive feeding:primary control,depression model,low dose XYS,middle dose XYS,and high dose XYS.The animal experiment continued for 3 wk.Primary controls were fed normally ad libitum.The rats of all other groups were raised in solitary and exposed to classic chronic mild unpredictable stimulation each day.XYS groups were perfused intragastrically with low dose,middle dose,and high dose XYS one hour before stimulation.Primary control and depression model groups were perfused intragastrically with normal saline under similar conditions as the XYS groups.Three weeks later,all rats were sacrificed,and the expression levels of CNP and NPR-B in rectum tissues were analyzed by immunohistochemistry,real-time polymerase chain reaction,and Western blotting.RESULTS:CNP and NPR-B were both expressed in the rectum tissues of all rats.However,the expression levels of CNP and NPR-B at both gene and protein levels in the depression model group were significantly higher when compared to the primary control group(n = 9; P < 0.01).XYS intervention markedly inhibited the expression levels of CNP and NPR-B in depressed rats.The expression levels of CNP and NPR-B in the high dose XYS group did not significantly differ from the expression levels in the primary control group.Additionally,the high and middle dose XYS groups(but not the low dose group) significantly exhibited lower CNP and NPR-B expression levels in the rectum tissues of the respectively treated rats compared to the untreated depression model cohort(n = 9; P < 0.01).CONCLUSION:The CNP/NPR-B pathway is upregulated in the rectum of depressed rats and may be one mechanism for depression-associated digestive disorders.XYS antagonizes this pathway at least partially.展开更多
文摘Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and stable view, articulated instruments, and reduction of physiologic tremors leading to superior dexterity and ergonomics. Therefore, robotic platforms could potentially address limitations of laparoscopic rectal surgery. It was aimed at reviewing current literature on short-term clinical and oncological(pathological) outcomes after robotic rectal cancer surgery in comparison with laparoscopic surgery. A systematic review was performed for the period 2002 to 2014. A total of 1776 patients with rectal cancer underwent minimally invasive robotic treatment in 32 studies. After robotic and laparoscopic approach to oncologic rectal surgery, respectively, mean operating time varied from 192-385 min, and from 158-297 min; mean estimated blood loss was between 33 and 283 mL, and between 127 and 300 mL; mean length of stay varied from 4-10 d; and from 6-15 d. Conversion after robotic rectal surgery varied from 0% to 9.4%, and from 0 to 22% after laparoscopy. There was no difference between robotic(0%-41.3%) and laparoscopic(5.5%-29.3%) surgery regarding morbidity and anastomotic complications(respectively, 0%-13.5%, and 0%-11.1%). Regarding immediate oncologic outcomes, respectively among robotic and laparoscopic cases, positive circumferential margins varied from 0% to 7.5%, and from 0% to 8.8%; the mean number of retrieved lymph nodes was between 10 and 20, and between 11 and 21; and the mean distal resection margin was from 0.8 to 4.7 cm, and from 1.9 to 4.5 cm. Robotic rectal cancer surgery is being undertaken by experienced surgeons. However, the quality of the assembled evidence does not support definite conclusions about most studies variables. Robotic rectal cancer surgery is associated to increased costs and operating time. It also seems to be associated to reduced conversion rates. Other short-term outcomes are comparable to conventional laparoscopy techniques, if not better. Ultimately, pathological data evaluation suggests that oncologic safety may be preserved after robotic total mesorectal excision. However, further studies are required to evaluate oncologic safety and functional results.
文摘药物性肝损伤(DILI)因果关系评估量表的优化改进一直是临床上关注的一个热点问题。新近Hayashi等[1]在Hepatology发表了《用于DILI诊断的改良电子版RUCAM量表(A revised electronic version of RUCAM for the diagnosis of DILI)》一文,并将这种新的量表正式命名为“改良电子化因果关系评估量表(revised electronic causality assessment method,RECAM)”,我们已在本刊第7期对其进行了介绍。RECAM发布后,RUCAM量表的主要设计者Danan和Teschke致信Hepatology编辑部,认为RECAM的设计理念和依据存在多方面的明显缺陷。我们欢迎这样的学术争鸣,这将有助于DILI临床诊断量表的进一步合理化改进和完善,提高临床对DILI诊断量表的认知度和利用度,推动DILI诊断的规范化、标准化、同质化,提高不同研究之间的可比性。现将该信全文翻译刊载如下。
基金the National Key Research and Development Program of China(Grant No.2020YFB2205804)the National Natural Science Foundation of China(Grant Nos.61974165 and Grant 61975075)the National Natural Science Foundation of China for the Youth,China(Grant No.62004105)。
文摘A monolithic integrated two-section distributed feedback(TS-DFB)semiconductor laser for high-speed direct modulation is proposed and analyzed theoretically.The grating structure of the TS-DFB laser is designed by the reconstructionequivalent-chirp(REC)technique,which can reduce the manufacturing cost and difficulty,and achieve high wavelength controlling accuracy.The detuned loading effect and the photon-photon resonance(PPR)effect are utilized to enhance the modulation bandwidth of the TS-DFB laser,exceeding 37 GHz,while that of the conventional one-section DFB laser is only 16 GHz.When the bit rate of the non-return-to-zero(NRZ)signal reaches 55 Gb/s,a clear eye diagram with large opening can still be obtained.These results show that the proposed method can enhance the modulation bandwidth of DFB laser significantly.
文摘RECS1(responsive to centrifugal force and shear stress gene 1)是一血液剪切力应答蛋白.RECS1基因敲除的小鼠年老时易患主动脉囊性中层坏死并表现有大动脉扩张症,暗示RECS1可能参与调控血管的发育重塑.免疫组化分析发现,RECS1基因敲除(RECS1 knockout,RECS1 KO)的小鼠主动脉基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)的表达水平明显提高,但RECS1的结构与功能及相关作用机理仍不清楚.研究发现,RECS1是肿瘤坏死因子受体2(tumor neucrosisfactor receptor 2,TNFR2)的结合蛋白质.报告基因检测实验表明,RECS1能特异地抑制TNFR2特异的激动性抗体或过量表达TNFR2诱导的核转录因子-κB(nuclear factor-κB,NF-κB)活化.NPLY模体缺失突变的RECS1不能结合TNFR2,并丧失对TNFR2介导NF-κB活化的抑制能力.稳定表达RECS1的MEFS细胞中,TNFR2特异的激动性抗体诱导的IκB(inhibitor of NF-κB)降解和NF-κB靶基因白介素-6(interleukin-6,IL-6)的表达均受到明显抑制.该研究揭示了RECS1通过与TNFR2的相互作用,负调控TNFR2介导肿瘤坏死因子信号传递的新功能及RECS1参与血管发育重塑调控的可能机制.
基金Supported by National Natural Science Foundation of China,No.81273919Grants from the Natural Science Foundation of Liaoning Province,No.2012225020 and No.2013023002the National Basic Research Program of China(973 Program),No.2013CB531703
文摘AIM:To investigate the distribution and expressionof C-type natriuretic peptide(CNP)/natriuretic peptide receptor B(NPR-B) in the rectum of a rodent depression model and the interventional effect of Xiaoyaosan(XYS).METHODS:Male rats(n = 45) of clean grade(200 ± 20 g) were divided into five groups after one week of adaptive feeding:primary control,depression model,low dose XYS,middle dose XYS,and high dose XYS.The animal experiment continued for 3 wk.Primary controls were fed normally ad libitum.The rats of all other groups were raised in solitary and exposed to classic chronic mild unpredictable stimulation each day.XYS groups were perfused intragastrically with low dose,middle dose,and high dose XYS one hour before stimulation.Primary control and depression model groups were perfused intragastrically with normal saline under similar conditions as the XYS groups.Three weeks later,all rats were sacrificed,and the expression levels of CNP and NPR-B in rectum tissues were analyzed by immunohistochemistry,real-time polymerase chain reaction,and Western blotting.RESULTS:CNP and NPR-B were both expressed in the rectum tissues of all rats.However,the expression levels of CNP and NPR-B at both gene and protein levels in the depression model group were significantly higher when compared to the primary control group(n = 9; P < 0.01).XYS intervention markedly inhibited the expression levels of CNP and NPR-B in depressed rats.The expression levels of CNP and NPR-B in the high dose XYS group did not significantly differ from the expression levels in the primary control group.Additionally,the high and middle dose XYS groups(but not the low dose group) significantly exhibited lower CNP and NPR-B expression levels in the rectum tissues of the respectively treated rats compared to the untreated depression model cohort(n = 9; P < 0.01).CONCLUSION:The CNP/NPR-B pathway is upregulated in the rectum of depressed rats and may be one mechanism for depression-associated digestive disorders.XYS antagonizes this pathway at least partially.
