Ever since the Bush administration took office, the U. S. national security strategy has given rise to much controversy. Whether the U. S. national security strategy is of unilateralism or multilateralistm is a questi...Ever since the Bush administration took office, the U. S. national security strategy has given rise to much controversy. Whether the U. S. national security strategy is of unilateralism or multilateralistm is a question in dispute. Many people think it is a unilateralist strategy. According to their views, to achieve its own objective, the U. S. administration has rarely considered the interests and feelings of other coun-展开更多
BRICS and Global South must unite against unilateralism and coercion In the face of US President Donald Trump’s aggressive tariff policies and coercive tactics,the Global South is increasingly choosing resistance ove...BRICS and Global South must unite against unilateralism and coercion In the face of US President Donald Trump’s aggressive tariff policies and coercive tactics,the Global South is increasingly choosing resistance over submission.展开更多
The world is now undergoing profound changes unseen in a century,with unilateralism and protectionism gaining momentum.As the head of the Asia-Pacific Think Tank,I would like to discuss the mission and responsibilitie...The world is now undergoing profound changes unseen in a century,with unilateralism and protectionism gaining momentum.As the head of the Asia-Pacific Think Tank,I would like to discuss the mission and responsibilities of China and ASEAN under the tariff hegemony of the United States.展开更多
China-Africa cooperation sets a benchmark for equitable development in a multipolar world Despite rising unilateralism and protectionism in the West and increasing uncertainties in global trade,China-Africa economic a...China-Africa cooperation sets a benchmark for equitable development in a multipolar world Despite rising unilateralism and protectionism in the West and increasing uncertainties in global trade,China-Africa economic and trade cooperation remains on a fast track,backed by concrete actions towards common modernisation.This collaboration reinforces solidarity across the Global South and contributes to greater stability and confidence in the global multilateral trading system.展开更多
Lumbar interbody fusion is essential for treating degenerative lumbar diseases.The disadvantages of open surgery have led to the evolution of minimally invasive spine surgery,including endoscopic techniques such as un...Lumbar interbody fusion is essential for treating degenerative lumbar diseases.The disadvantages of open surgery have led to the evolution of minimally invasive spine surgery,including endoscopic techniques such as unilateral biportal endoscopy(UBE).Leveraging arthroscopic principles,UBE offers superior visualization and flexibility and expands from decompression to fusion(UBE fusion).However,achieving robust UBE fusion presents challenges,such as suboptimal arthrodesis rates and implant-related complications,requiring more than surgical skill alone.Optimizing UBE fusion critically depends on the effective integration of advanced biomaterials with the surgical technique.This minireview assessed recent advances in UBE,focusing on the development of novel biomaterials,such as functionalized porous,expandable,or double-cage designs,to improve bone regeneration outcomes.These advancements address challenges,like washout of bone graft material and biologics,and utilize growth factors,such as recombinant human bone morphogenetic proteins,while exploring pathway modulation to improve outcomes.We also evaluated clinical optimization strategies involving technical refinements,fluid and hemostasis control,key complication mitigation especially concerning dural tears and hematomas,and technologies such as navigation and robotics.While UBE shows promise particularly for early recovery,its long-term success hinges on these biotechnological advancements.High-quality evidence,especially from randomized controlled trials and longterm studies,is needed to validate integrated strategies and define the optimal role of UBE fusion.展开更多
Unilateral pulmonary artery agenesis(UPAA)is a rare congenital cardiovascular anomaly defined by the complete absence of one pulmonary artery,most often affecting the right side.[1]Although typically identified in chi...Unilateral pulmonary artery agenesis(UPAA)is a rare congenital cardiovascular anomaly defined by the complete absence of one pulmonary artery,most often affecting the right side.[1]Although typically identified in childhood due to symptomatic presentation,certain cases may remain undiagnosed until adulthood,particularly in asymptomatic patients or those with subtle clinical signs.展开更多
Coloboma is due to a defect in the closure of the colobomic cleft generally occurring between the 5th and 7th week of embryonic life. Coloboma can affect the adnexa and/or the eyeball. We report the iconography of two...Coloboma is due to a defect in the closure of the colobomic cleft generally occurring between the 5th and 7th week of embryonic life. Coloboma can affect the adnexa and/or the eyeball. We report the iconography of two cases of ocular colobomas and one case of eyelids coloboma at the IOTA CHU. Case 1: This was a 32-year-old patient who consulted for decreased visual acuity in the left eye. The clinical examination found visual acuity of 10/10 in the right eye and hand movement in the left eye. Biomicroscopic examination revealed an iris and chorioretinal coloboma encompassing the papilla. Case 2: This was a 3-year-old child. Who consulted for eyelid malformation since birth. On ophthalmological examination, there was a bilateral coloboma of the inner half of the upper eyelid, associated with an underlying symblepharon and left eye corneal dystrophy. Our course of action consisted of a release of the symblepharon followed by a blepharoplasty which allowed a good anatomical and functional restitution. Case 3: This was a 15-year-old patient who consulted for bilateral visual acuity loss measured by counting fingers at 1m in the right eye and counting fingers at 3m in the left eye. The biomicroscopic examination found a bilateral papillary coloboma associated with a bilateral progressive cataract, an old detachment of the left retina. The etiological assessment was unremarkable. Conclusion: Coloboma is a congenital condition that can affect all parts of the eye. We reported three cases of colobomas, one palpebral, one iris and chorioretinal, and finally, one papillary associated with other ocular pathologies.展开更多
In an era marked by rising protectionism and geopolitical tensions,the world faces a stark choice:embrace multilateral cooperation or succumb to unilateral hegemony.The United States’punitive tariff policies have exp...In an era marked by rising protectionism and geopolitical tensions,the world faces a stark choice:embrace multilateral cooperation or succumb to unilateral hegemony.The United States’punitive tariff policies have exposed the negative effect of economic coercion and isolation.Meanwhile,China’s commitment to openness,innovation,and shared prosperity offers a contrast,a testament to the enduring vitality of multilateralism and global integration.展开更多
BACKGROUND Unilateral biportal endoscopic(UBE)surgery has developed rapidly during the past decade.Continuous epidural space irrigation is generally considered the principal reason for cerebral complications following...BACKGROUND Unilateral biportal endoscopic(UBE)surgery has developed rapidly during the past decade.Continuous epidural space irrigation is generally considered the principal reason for cerebral complications following UBE surgery.We present a case of mental symptoms during the general anesthesia awakening period due to pneumocephalus.CASE SUMMARY A 70-year-old woman with lumbar disc herniation underwent UBE surgery stably under general anesthesia.Uncontrollable hypertension occurred immediately after transfer to the postoperative care unit,accompanied by increased heart rate and tachypnea.During the recovery process,the patient responded to external stimuli but was confused and unable to complete command actions.Neck stiff-ness and significantly increased muscle strength on the left side indicated the presence of de-cerebrate rigidity.An urgent brain computed tomography scan showed pneumocephalus compressing the brainstem.After receiving analgesia and sedation treatment,the patient was conscious three hours later and recovered rapidly.She was discharged on the fifth postoperative day and followed up for 3 months with no surgical or brain complications.CONCLUSION Cerebral complications emerging during the general anesthesia awakening period following UBE surgery are not entirely due to increased intracranial pressure.Pneumocephalus induced by dural injury may also be a potential cause.展开更多
BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which ...BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.展开更多
The Regional Comprehensive Economic Partnership(RCEP)is a significant achievement in terms of Asia’s exploration and efforts toward regional economic integration.It integrates regional economic and trade cooperation ...The Regional Comprehensive Economic Partnership(RCEP)is a significant achievement in terms of Asia’s exploration and efforts toward regional economic integration.It integrates regional economic and trade cooperation mechanisms,demonstrates the determination and capabilities of Asian countries to promote open cooperation.展开更多
Highlights●CRISPR/Cas9 RNP complex-based strategy demonstrates robustness and accuracy in generating gene-edited sheep.●Sheep horn development remains unaffected by partial RXFP2 knockout.●Partial RXFP2 knockout re...Highlights●CRISPR/Cas9 RNP complex-based strategy demonstrates robustness and accuracy in generating gene-edited sheep.●Sheep horn development remains unaffected by partial RXFP2 knockout.●Partial RXFP2 knockout results in unilateral cryptorchidism in sheep.展开更多
The U.S.administration's decision tounilaterally impose sweeping tariff increas-es on tmported goods represents a signifi-cant challenge to the existing global tradingsystem,which has long been structuredaround mu...The U.S.administration's decision tounilaterally impose sweeping tariff increas-es on tmported goods represents a signifi-cant challenge to the existing global tradingsystem,which has long been structuredaround multilateral(WTO),regional,andbilateral(FTA)trade agreements.展开更多
Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors co...Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors compared to sporadic SBRM cases.3,4 Notably,the prognosis for sporadic cases,in terms of cancerspecific and distant metastasis-free survival,is comparable to that of unilateral renal masses.展开更多
Background:The Mongolian gerbil is an excellent laboratory animal for preparing the cerebral ischemia model due to its inherent deficiency in the circle of Willis.However,the low incidence and unpredictability of symp...Background:The Mongolian gerbil is an excellent laboratory animal for preparing the cerebral ischemia model due to its inherent deficiency in the circle of Willis.However,the low incidence and unpredictability of symptoms are caused by numerous complex variant types of the circle.Additionally,the lack of an evaluation system for the cer-ebral ischemia/reperfusion(I/R)model of gerbils has shackled the application of this model.Methods:We created a symptom-oriented principle and detailed neurobehavioral scoring criteria.At different time points of reperfusion,we analyzed the alteration in locomotion by rotarod test and grip force score,infarct volume by triphenyltetrazo-lium chloride(TTC)staining,neuron loss using Nissl staining,and histological charac-teristics using hematoxylin-eosin(H&E)straining.Results:With a successful model rate of 56%,32 of the 57 gerbils operated by our method harbored typical features of cerebral I/R injury,and the mortality rate in the male gerbils was significantly higher than that in the female gerbils.The suc-cessfully prepared I/R gerbils demonstrated a significant reduction in motility and grip strength at 1 day after reperfusion;formed obvious infarction;exhibited typi-cal pathological features,such as tissue edema,neuronal atrophy and death,and vacuolated structures;and were partially recovered with the extension of reperfu-sion time.Conclusion:This study developed a new method for the unilateral common carotid artery ligation I/R model of gerbil and established a standardized evaluation system for this model,which could provide a new cerebral I/R model of gerbils with more practical applications.展开更多
OBJECTIVE:To elucidate the mechanism by which Huoxue Jiedu Huayu recipe(活血解毒化瘀方,HJHR)regulates angiogenesis in the contralateral kidney of unilateral ureteral obstruction(UUO)rats and the mechanism by which it ...OBJECTIVE:To elucidate the mechanism by which Huoxue Jiedu Huayu recipe(活血解毒化瘀方,HJHR)regulates angiogenesis in the contralateral kidney of unilateral ureteral obstruction(UUO)rats and the mechanism by which it reduces of renal fibrosis.METHODS:Male Wistar rats were randomly divided into 4 groups:the sham group,UUO group(180 d of left ureter ligation),UUO plus eplerenone(EPL)group,and UUO plus HJHR group.After 180 d of oral drug administration,blood and contralateral kidneys were collected for analysis.Angiogenesis-and fibrosis-related indexes were detected.RESULTS:HJHR and EPL improved structural damage and renal interstitial fibrosis in the contralateral kidney and reduced the protein expression levels ofα-smooth muscle actin(α-SMA),vimentin and collagen I.Moreover,these treatments could reduce the expression of vascular endothelial growth factor-A(VEGFA)by inhibiting the infiltration of macrophages.Furthermore,HJHR and EPL significantly reduced the expression of CD34 and CD105 by downregulating VEGFA production,which inhibited angiogenesis.Finally,the coexpressions of CD34,CD105 andα-SMA were decreased in the HJHR and EPL groups,indicating that endothelial-to-mesenchymal transition was inhibited.CONCLUSIONS:These findings confirm that HJHR alleviates contralateral renal fibrosis by inhibiting VEGFAinduced angiogenesis,encourage the use of HJHR against renal interstitial fibrosis and provide a theoretical basis for the clinical management of patients with CKD.展开更多
AIM:To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath(CFS)suspension.METHODS:A retrospective st...AIM:To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath(CFS)suspension.METHODS:A retrospective study of patients who underwent unilateral minimally invasive CFS suspension surgery between January 2018 and December 2021.Inclusion criteria included unilateral mild and moderate ptosis,good levator muscle function(>9 mm)and follow-up of at least 6mo.Pre-and post-operative symmetry was graded subjectively for marginal reflex distance 1(MRD1),tarsal platform show(TPS)and eyebrow fat span(BFS).A t-test was used to evaluate MRD1,TPS and BFS asymmetry by calculating delta values.The Bézier curve tool of the Image J software was used to extract the upper eyelid contours,where the symmetry was measured by the percentage of overlapping curvatures(POC).RESULTS:Totally 105 patients(105 eyelids)were included(mild group,n=84;moderate group,n=21).Postoperatively,all patients increased MRD1 and decreased TPS in the ptotic eye while maintaining unchanged BFS.The asymmetric delta value for MRD1 was measured to be 1.48±0.86 preoperatively,and it decreased to 0.58±0.67 postoperatively in all cases(P=0.0004).In patients with mild ptosis,the asymmetry value of TPS fell significantly from 1.15±0.62 to 0.68±0.38(P=0.0187).The symmetry of the upper eyelid contour increased in all subgroups of patients,with a POC of 59.39%±13.45%preoperatively and POC of 78.29%±13.80%postoperatively.CONCLUSION:Minimally invasive CFS suspension is proved to be an effective means of improving the symmetry of unilateral ptosis in terms of MRD1(all subgroups),POC(all subgroups)and TPS(only mild group),whereas BFS is unaffected.展开更多
BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perfo...BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.展开更多
In this paper,we study the following Kirchhoff type problem:{-M(∫_(R^(N))|▽u|^(2)dx)△u=λa(x)f(u),x∈R^(N),u=0 as|x|→+∞.Unilateral global bifurcation result is established for this problem.As applications of the ...In this paper,we study the following Kirchhoff type problem:{-M(∫_(R^(N))|▽u|^(2)dx)△u=λa(x)f(u),x∈R^(N),u=0 as|x|→+∞.Unilateral global bifurcation result is established for this problem.As applications of the bifurcation result,we determine the intervals ofλfor the existence,nonexistence,and exact multiplicity of one-sign solutions for this problem.展开更多
文摘Ever since the Bush administration took office, the U. S. national security strategy has given rise to much controversy. Whether the U. S. national security strategy is of unilateralism or multilateralistm is a question in dispute. Many people think it is a unilateralist strategy. According to their views, to achieve its own objective, the U. S. administration has rarely considered the interests and feelings of other coun-
文摘BRICS and Global South must unite against unilateralism and coercion In the face of US President Donald Trump’s aggressive tariff policies and coercive tactics,the Global South is increasingly choosing resistance over submission.
文摘The world is now undergoing profound changes unseen in a century,with unilateralism and protectionism gaining momentum.As the head of the Asia-Pacific Think Tank,I would like to discuss the mission and responsibilities of China and ASEAN under the tariff hegemony of the United States.
文摘China-Africa cooperation sets a benchmark for equitable development in a multipolar world Despite rising unilateralism and protectionism in the West and increasing uncertainties in global trade,China-Africa economic and trade cooperation remains on a fast track,backed by concrete actions towards common modernisation.This collaboration reinforces solidarity across the Global South and contributes to greater stability and confidence in the global multilateral trading system.
基金Supported by Joint Traditional Chinese Medicine Science and Technology Projects of National Demonstration Zones for Comprehensive Traditional Chinese Medicine,No.GZY-KJS-SD-2023-031.
文摘Lumbar interbody fusion is essential for treating degenerative lumbar diseases.The disadvantages of open surgery have led to the evolution of minimally invasive spine surgery,including endoscopic techniques such as unilateral biportal endoscopy(UBE).Leveraging arthroscopic principles,UBE offers superior visualization and flexibility and expands from decompression to fusion(UBE fusion).However,achieving robust UBE fusion presents challenges,such as suboptimal arthrodesis rates and implant-related complications,requiring more than surgical skill alone.Optimizing UBE fusion critically depends on the effective integration of advanced biomaterials with the surgical technique.This minireview assessed recent advances in UBE,focusing on the development of novel biomaterials,such as functionalized porous,expandable,or double-cage designs,to improve bone regeneration outcomes.These advancements address challenges,like washout of bone graft material and biologics,and utilize growth factors,such as recombinant human bone morphogenetic proteins,while exploring pathway modulation to improve outcomes.We also evaluated clinical optimization strategies involving technical refinements,fluid and hemostasis control,key complication mitigation especially concerning dural tears and hematomas,and technologies such as navigation and robotics.While UBE shows promise particularly for early recovery,its long-term success hinges on these biotechnological advancements.High-quality evidence,especially from randomized controlled trials and longterm studies,is needed to validate integrated strategies and define the optimal role of UBE fusion.
文摘Unilateral pulmonary artery agenesis(UPAA)is a rare congenital cardiovascular anomaly defined by the complete absence of one pulmonary artery,most often affecting the right side.[1]Although typically identified in childhood due to symptomatic presentation,certain cases may remain undiagnosed until adulthood,particularly in asymptomatic patients or those with subtle clinical signs.
文摘Coloboma is due to a defect in the closure of the colobomic cleft generally occurring between the 5th and 7th week of embryonic life. Coloboma can affect the adnexa and/or the eyeball. We report the iconography of two cases of ocular colobomas and one case of eyelids coloboma at the IOTA CHU. Case 1: This was a 32-year-old patient who consulted for decreased visual acuity in the left eye. The clinical examination found visual acuity of 10/10 in the right eye and hand movement in the left eye. Biomicroscopic examination revealed an iris and chorioretinal coloboma encompassing the papilla. Case 2: This was a 3-year-old child. Who consulted for eyelid malformation since birth. On ophthalmological examination, there was a bilateral coloboma of the inner half of the upper eyelid, associated with an underlying symblepharon and left eye corneal dystrophy. Our course of action consisted of a release of the symblepharon followed by a blepharoplasty which allowed a good anatomical and functional restitution. Case 3: This was a 15-year-old patient who consulted for bilateral visual acuity loss measured by counting fingers at 1m in the right eye and counting fingers at 3m in the left eye. The biomicroscopic examination found a bilateral papillary coloboma associated with a bilateral progressive cataract, an old detachment of the left retina. The etiological assessment was unremarkable. Conclusion: Coloboma is a congenital condition that can affect all parts of the eye. We reported three cases of colobomas, one palpebral, one iris and chorioretinal, and finally, one papillary associated with other ocular pathologies.
文摘In an era marked by rising protectionism and geopolitical tensions,the world faces a stark choice:embrace multilateral cooperation or succumb to unilateral hegemony.The United States’punitive tariff policies have exposed the negative effect of economic coercion and isolation.Meanwhile,China’s commitment to openness,innovation,and shared prosperity offers a contrast,a testament to the enduring vitality of multilateralism and global integration.
文摘BACKGROUND Unilateral biportal endoscopic(UBE)surgery has developed rapidly during the past decade.Continuous epidural space irrigation is generally considered the principal reason for cerebral complications following UBE surgery.We present a case of mental symptoms during the general anesthesia awakening period due to pneumocephalus.CASE SUMMARY A 70-year-old woman with lumbar disc herniation underwent UBE surgery stably under general anesthesia.Uncontrollable hypertension occurred immediately after transfer to the postoperative care unit,accompanied by increased heart rate and tachypnea.During the recovery process,the patient responded to external stimuli but was confused and unable to complete command actions.Neck stiff-ness and significantly increased muscle strength on the left side indicated the presence of de-cerebrate rigidity.An urgent brain computed tomography scan showed pneumocephalus compressing the brainstem.After receiving analgesia and sedation treatment,the patient was conscious three hours later and recovered rapidly.She was discharged on the fifth postoperative day and followed up for 3 months with no surgical or brain complications.CONCLUSION Cerebral complications emerging during the general anesthesia awakening period following UBE surgery are not entirely due to increased intracranial pressure.Pneumocephalus induced by dural injury may also be a potential cause.
基金Supported by the Provincial Natural Science Foundation of Gansu,No.24JRRF008Science and Technology Research Project of Songjiang District,No.2024SJKJGG105+1 种基金National Natural Science Foundation of China,No.82202694Clinical Research Innovation Plan of Shanghai General Hospital,No.CTCCR-2021C10.
文摘BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.
文摘The Regional Comprehensive Economic Partnership(RCEP)is a significant achievement in terms of Asia’s exploration and efforts toward regional economic integration.It integrates regional economic and trade cooperation mechanisms,demonstrates the determination and capabilities of Asian countries to promote open cooperation.
基金supported by the National Key Research and Development Program of China(2022YFD1300200)the National Natural Science Foundation of China(32161143010,32202646,and 32272848)+2 种基金the China Agriculture Research System(CARS-39)the Key Special Project of Ningxia Science and Technology Department,China(2021BEF02024)the local grants,China(NXTS2021-001,2022GD-TSLD-46,NK2022010207,and NXTS2022-001)。
文摘Highlights●CRISPR/Cas9 RNP complex-based strategy demonstrates robustness and accuracy in generating gene-edited sheep.●Sheep horn development remains unaffected by partial RXFP2 knockout.●Partial RXFP2 knockout results in unilateral cryptorchidism in sheep.
文摘The U.S.administration's decision tounilaterally impose sweeping tariff increas-es on tmported goods represents a signifi-cant challenge to the existing global tradingsystem,which has long been structuredaround multilateral(WTO),regional,andbilateral(FTA)trade agreements.
文摘Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors compared to sporadic SBRM cases.3,4 Notably,the prognosis for sporadic cases,in terms of cancerspecific and distant metastasis-free survival,is comparable to that of unilateral renal masses.
基金National Key Research and Development Program of China,Grant/Award Number:2021YFF0702402National Natural Science Foundation of China,Grant/Award Number:32070531。
文摘Background:The Mongolian gerbil is an excellent laboratory animal for preparing the cerebral ischemia model due to its inherent deficiency in the circle of Willis.However,the low incidence and unpredictability of symptoms are caused by numerous complex variant types of the circle.Additionally,the lack of an evaluation system for the cer-ebral ischemia/reperfusion(I/R)model of gerbils has shackled the application of this model.Methods:We created a symptom-oriented principle and detailed neurobehavioral scoring criteria.At different time points of reperfusion,we analyzed the alteration in locomotion by rotarod test and grip force score,infarct volume by triphenyltetrazo-lium chloride(TTC)staining,neuron loss using Nissl staining,and histological charac-teristics using hematoxylin-eosin(H&E)straining.Results:With a successful model rate of 56%,32 of the 57 gerbils operated by our method harbored typical features of cerebral I/R injury,and the mortality rate in the male gerbils was significantly higher than that in the female gerbils.The suc-cessfully prepared I/R gerbils demonstrated a significant reduction in motility and grip strength at 1 day after reperfusion;formed obvious infarction;exhibited typi-cal pathological features,such as tissue edema,neuronal atrophy and death,and vacuolated structures;and were partially recovered with the extension of reperfu-sion time.Conclusion:This study developed a new method for the unilateral common carotid artery ligation I/R model of gerbil and established a standardized evaluation system for this model,which could provide a new cerebral I/R model of gerbils with more practical applications.
基金Natural Science Foundation-funded Project:Effect of Macrophage-to-Myofibroblast Transition in Contralateral Kidney of Unilateral Ureteral Obstruction Rats Through the Aldosterone/MR/SGK1 Pathway and Inhibition of Chinese Herbs(No.81873251)Natural Science Foundation-funded Project:Aldosterone Stimulates MR Activation to Induce Lymphangiogenesis in the Contralateral Kidney of UUO Rats and the Protective Effect of Yiqi Jiedu Huayu Herbs(No.82174317)+1 种基金Hebei Provincial Postgraduate Innovative Ability Cultivation Funding Project:Aldosterone Induced Macrophages to Secrete VEGFA to Participate in Renal Angiogenesis and the Protective Effect of Huoxue Jiedu Huayu Recipe(CXZZBS2023140)Construction Program of New Research and Development Platform and Institution,Hebei Province Innovation Ability Promotion Plan under Grant No.20567624H。
文摘OBJECTIVE:To elucidate the mechanism by which Huoxue Jiedu Huayu recipe(活血解毒化瘀方,HJHR)regulates angiogenesis in the contralateral kidney of unilateral ureteral obstruction(UUO)rats and the mechanism by which it reduces of renal fibrosis.METHODS:Male Wistar rats were randomly divided into 4 groups:the sham group,UUO group(180 d of left ureter ligation),UUO plus eplerenone(EPL)group,and UUO plus HJHR group.After 180 d of oral drug administration,blood and contralateral kidneys were collected for analysis.Angiogenesis-and fibrosis-related indexes were detected.RESULTS:HJHR and EPL improved structural damage and renal interstitial fibrosis in the contralateral kidney and reduced the protein expression levels ofα-smooth muscle actin(α-SMA),vimentin and collagen I.Moreover,these treatments could reduce the expression of vascular endothelial growth factor-A(VEGFA)by inhibiting the infiltration of macrophages.Furthermore,HJHR and EPL significantly reduced the expression of CD34 and CD105 by downregulating VEGFA production,which inhibited angiogenesis.Finally,the coexpressions of CD34,CD105 andα-SMA were decreased in the HJHR and EPL groups,indicating that endothelial-to-mesenchymal transition was inhibited.CONCLUSIONS:These findings confirm that HJHR alleviates contralateral renal fibrosis by inhibiting VEGFAinduced angiogenesis,encourage the use of HJHR against renal interstitial fibrosis and provide a theoretical basis for the clinical management of patients with CKD.
基金Supported by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-016A).
文摘AIM:To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath(CFS)suspension.METHODS:A retrospective study of patients who underwent unilateral minimally invasive CFS suspension surgery between January 2018 and December 2021.Inclusion criteria included unilateral mild and moderate ptosis,good levator muscle function(>9 mm)and follow-up of at least 6mo.Pre-and post-operative symmetry was graded subjectively for marginal reflex distance 1(MRD1),tarsal platform show(TPS)and eyebrow fat span(BFS).A t-test was used to evaluate MRD1,TPS and BFS asymmetry by calculating delta values.The Bézier curve tool of the Image J software was used to extract the upper eyelid contours,where the symmetry was measured by the percentage of overlapping curvatures(POC).RESULTS:Totally 105 patients(105 eyelids)were included(mild group,n=84;moderate group,n=21).Postoperatively,all patients increased MRD1 and decreased TPS in the ptotic eye while maintaining unchanged BFS.The asymmetric delta value for MRD1 was measured to be 1.48±0.86 preoperatively,and it decreased to 0.58±0.67 postoperatively in all cases(P=0.0004).In patients with mild ptosis,the asymmetry value of TPS fell significantly from 1.15±0.62 to 0.68±0.38(P=0.0187).The symmetry of the upper eyelid contour increased in all subgroups of patients,with a POC of 59.39%±13.45%preoperatively and POC of 78.29%±13.80%postoperatively.CONCLUSION:Minimally invasive CFS suspension is proved to be an effective means of improving the symmetry of unilateral ptosis in terms of MRD1(all subgroups),POC(all subgroups)and TPS(only mild group),whereas BFS is unaffected.
基金Supported by National Natural Science Foundation of China(Regional Program),No.82060879,No.82360947Gansu Province Key Talent Project,No.2024-4+2 种基金Natural Science Foundation of Gansu Province,No.20JR10RA356Gansu Provincial Joint Research Fund,No.23JRRA1534National Administration of Traditional Chinese Medicine High Level Key Discipline Construction Project of Traditional Chinese Medicine(Traditional Chinese Orthopedics and Traumatology Science),No.203.
文摘BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.
基金Supported by the National Natural Science Foundation of China(11561038)。
文摘In this paper,we study the following Kirchhoff type problem:{-M(∫_(R^(N))|▽u|^(2)dx)△u=λa(x)f(u),x∈R^(N),u=0 as|x|→+∞.Unilateral global bifurcation result is established for this problem.As applications of the bifurcation result,we determine the intervals ofλfor the existence,nonexistence,and exact multiplicity of one-sign solutions for this problem.
