During long term storage at 25℃ in the dark,a large number of cell content were transferred from the senescing scape to the developing cloves,and the transfer from the basal part of scape was earlier than that from t...During long term storage at 25℃ in the dark,a large number of cell content were transferred from the senescing scape to the developing cloves,and the transfer from the basal part of scape was earlier than that from the apical part in the excised garlic scape ( Allium sativum var Taichang).Levels of H 2O 2 decreased in the cloves and significantly increased up to 10 folds and then declined quickly in the scape.Levels of H 2O 2 were enhanced early in the basal part of scape.In the treatment of GA 3 at the cloves,levels of H 2O 2 were strongly enhanced in the cloves and inhibited in the scape,coinciding with the distinct inhibition of cell content tansfer.The results indicated that H 2O 2 may be involved in cell content redistribution and its regulation.3-Amino-1,2,4-triazole (AT) is a specific inhibitor of catalase.Effects of AT on cell content redistribution and levels of H 2O 2 were almost similar to those of GA 3,It further proved the above concept.According to the changes of H 2O 2 leves and activities of peroxidase and catalase in the cloves and in the scape,we suggest that the accumulation of H 2O 2 in the scape was transducted from the cloves,and the decline of H 2O 2 level in the scape with GA 3 or AT at the cloves was mainly through the inhibition of H 2O 2 synthesis in the cloves.展开更多
The efficient maintenance of the activity of excised branches is the powerful guarantee to accurately determine gas exchange flux between the detached branches of tall trees and the atmosphere. In this study, the net ...The efficient maintenance of the activity of excised branches is the powerful guarantee to accurately determine gas exchange flux between the detached branches of tall trees and the atmosphere. In this study, the net photosynthetic rate(NPR) of the excised branches and branches in situ were measured simultaneously by using two photosynthetic instruments to characterize the activity of the excised branches of Phyllostachys nigra. The ratio of normalized NPR of excised branches to NPR in situ was used to assess the photosynthetic activity of detached branches. Based on photosynthetic activity, an optimal hydroponics protocol for maintaining activity of excised P. nigra branches was presented:1/8 times the concentration of Gamborg B5 vitamin mixture with p H = 6. Under the best cultivation protocol, photosynthetic activity of excised P. nigra branches could be maintained more than 90% within 6 hr in the light intensity range of 200–2000 μmol/(m2·sec) and temperature range of 13.4–28.7°C. The nitrogen dioxide(NO2) flux differences between in situ and in vitro branches and the atmosphere were compared using double dynamic chambers.Based on the maintenance method of excised branches, the NO2 exchange flux between the excised P. nigra branches and the atmosphere(from-1.01 to-2.72 nmol/(m2·sec) was basically consistent with between the branches in situ and the atmosphere(from-1.12 to-3.16 nmol/(m2 sec)) within 6 hr. Therefore, this study provided a feasible protocol for in vitro measurement of gas exchange between tall trees and the atmosphere for a period of time.展开更多
The administration of drugs via the buccal route has attracted much attention in recent years.However,the development of delivery systems that adhere well in moist conditions while releasing drugs successfully across ...The administration of drugs via the buccal route has attracted much attention in recent years.However,the development of delivery systems that adhere well in moist conditions while releasing drugs successfully across the buccal mucosa remains challenging[1].Currently,the gold standard for determining buccal drug permeability is the vertical Franz diffusion cell(FDC),which is using freshly excised tissue[2].展开更多
BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually be...BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.展开更多
BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomica...BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomical constraints in the periocular region.Precise diagnosis is essential to guide appropriate surgical management and prevent recurrence.CASE SUMMARY A 32-year-old female presented with a recurrent tumor in the medial canthus,previously diagnosed as a solitary fibrous tumor in an outside institution.After complete radiological and systemic workup,she was scheduled for a wide local excision followed by reconstruction after getting tumor clear margins on frozen section.Histopathology confirmed DFSP,characterized by storiform spindle cell proliferation,diffuse cluster of differentiation 34 positivity,and signal transducer and activator of transcription 6 negativity.CONCLUSION This case highlights the challenges in the diagnostic and surgical management of DFSP in periocular tumors.Comprehensive surgical excision with appropriate reconstruction is critical for achieving oncological control while preserving aesthetics and function.展开更多
Background:Platinum chemotherapy(CT)remains the backbone of systemic therapy for patients with smallcell lung cancer(SCLC).The nucleotide excision repair(NER)pathway plays a central role in the repair of the DNA damag...Background:Platinum chemotherapy(CT)remains the backbone of systemic therapy for patients with smallcell lung cancer(SCLC).The nucleotide excision repair(NER)pathway plays a central role in the repair of the DNA damage exerted by platinum agents.Alteration in this repair mechanism may affect patients’survival.Materials and Methods:We conducted a retrospective analysis of data from 38 patients with extensive disease(ED)-SCLC who underwent platinum-CT at the Clinical Oncology Unit,Careggi University Hospital,Florence(Italy),from 2015 to 2020.mRNA expression analysis and single nucleotide polymorphism(SNP)characterization of three NER pathway genes—namely ERCC1,ERCC2,and ERCC5—were performed on patient tumor samples.Results:Overall,elevated expression of ERCC genes was observed in SCLC patients compared to healthy controls.Patients with low ERCC1 and ERCC5 expression levels exhibited a better median progression-free survival(mPFS=7.1 vs.4.9 months,p=0.39 for ERCC1 and mPFS=6.9 vs.4.8 months,p=0.093 for ERCC5)and overall survival(mOS=8.7 vs.6.0 months,p=0.4 for ERCC1 and mOS=7.2 vs.6.2 months,p=0.13 for ERCC5).Genotyping analysis of five SNPs of ERCC genes showed a longer survival in patients harboring the wild-type genotype or the heterozygous variant of the ERCC1 rs11615 SNP(p=0.24 for PFS and p=0.14 for OS)and of the rs13181 and rs1799793 ERCC2 SNPs(p=0.43 and p=0.26 for PFS and p=0.21 and p=0.16 for OS,respectively)compared to patients with homozygous mutant genotypes.Conclusions:The comprehensive analysis of ERCC gene expression and SNP variants appears to identify patients who derive greater survival benefits from platinum-CT.展开更多
BACKGROUND Osteochondroma,a benign bone tumour,is commonly seen in the metaphyseal region of long bones.It is not so common in short bones and occurs rarely in carpals.The literature involving an osteochondroma of pis...BACKGROUND Osteochondroma,a benign bone tumour,is commonly seen in the metaphyseal region of long bones.It is not so common in short bones and occurs rarely in carpals.The literature involving an osteochondroma of pisiform is scarce.CASE SUMMARY We present a 12-year-old male Asian child with a gradually progressive,bony,hard swelling on the volar aspect of the right wrist,which,on investigation,was suggestive of a solitary osteochondroma of the pisiform and its management.CONCLUSION The current report describes a child with a wrist swelling which on evaluation was found to be an osteochondroma of the pisiform,which is seldom described in the literature,and managed by excision biopsy.Though osteochondromas of the carpal bones are rare they should be included in the differential of any wrist swelling with the symptom complex varying from pressure effects to surrounding soft tissues and nerves,attritional tendon ruptures,carpal instabilities and arthritis.展开更多
In this article,we provide an important commentary on the original study Lu et al,which offers insight into the surgical efficacy of transanal total mesorectal excision(TaTME)vs laparoscopic total mesorectal excision(...In this article,we provide an important commentary on the original study Lu et al,which offers insight into the surgical efficacy of transanal total mesorectal excision(TaTME)vs laparoscopic total mesorectal excision(LapTME)in the management of low-lying locally advanced rectal cancer(LARC).We focus specifically on the rate of postoperative complications between the two using existing data from the literature.We additionally introduce robotic total mesorectal excision(RTME)and look at its postoperative complications relative to the TaTME and LapTME.LARC has been conventionally approached by open surgery.However,minimally invasive techniques have emerged over the past two decades as alternatives to open total mesorectal excision,namely robotic,laparoscopic,and transanal.Each approach has its supporters,but conflicting data on resection outcomes and complications has fueled ongoing debate over the optimal minimally invasive technique for low/mid-LARC.This article aims to extend on the data regarding the use of TaTME and RTME in the treatment of low/mid-LARC and further elaborate on their comparative efficacy relative to LapTME.展开更多
Local excision(LE)is an effective treatment option for rectal cancer that shows significant regression following neoadjuvant chemoradiotherapy.Compared to traditional total mesorectal excision(TME),LE can achieve comp...Local excision(LE)is an effective treatment option for rectal cancer that shows significant regression following neoadjuvant chemoradiotherapy.Compared to traditional total mesorectal excision(TME),LE can achieve comparable on-cological outcomes while preserving function and improving quality of life(QoL).The indications for LE have been gradually expanded,but there are uncertainties regarding postoperative oncological results.Long-term follow-up prospective randomized controlled trials comparing TME and LE in terms of both oncological outcomes and QoL could help reduce uncertainties between these two approaches and contribute to the development of evidence-based guidelines for rectal cancer treatment.展开更多
BACKGROUND Paraganglioma(PGL)is a neuroendocrine tumor originating from paraganglia that can occur in various locations,such as the head,neck,chest,abdomen,and pelvis.Retroperitoneal PGLs are rare,and recurrent cases ...BACKGROUND Paraganglioma(PGL)is a neuroendocrine tumor originating from paraganglia that can occur in various locations,such as the head,neck,chest,abdomen,and pelvis.Retroperitoneal PGLs are rare,and recurrent cases in this area are partic-ularly uncommon,posing considerable surgical complexities.Owing to their neu-roendocrine activity,PGLs are capable of secreting hormones like catecholamines,thereby presenting significant challenges in hemodynamic management during the perioperative period.CASE SUMMARY We report a 64-year-old man with a recurrent retroperitoneal PGL.The patient underwent retroperitoneal mass resection in 2013,with postoperative pathology revealing a PGL.Regular follow-up was not conducted until April 2024,when a computed tomography scan revealed a huge mass in the retroperitoneum,closely adjacent to the abdominal aorta.Laboratory examinations revealed elevated levels of catecholamines in the patient's blood serum.Upon admission,volume expan-sion and blood pressure(BP)monitoring were carried out for one week,with catecholamine levels reviewed and normalized.Adequate preoperative prepa-ration was conducted,including central venous access,arterial BP monitoring,and the preparation of vasoactive agents.During tumor resection,the patient ex-perienced acute,significant fluctuations in BP.The timely intervention of the anesthesiologist stabilized the BP,facilitating the successful resection of the tumor which was confirmed as a recurrent PGL.Postoperative follow-up revealed no evidence of tumor residual or recurrence.CONCLUSION PGL recurrence is rare but non-negligible.PGLs adjacent to major arteries com-plicate surgery,and perioperative hemodynamic stability demands meticulous attention.Core Tip:Recurrent retroperitoneal paragangliomas are infrequent but pose substantial surgical challenges,particularly when located adjacent to critical vascular structures such as the abdominal aorta.Effective perioperative management of he-modynamic fluctuations,driven by catecholamine secretion,requires meticulous preoperative planning,including volume expansion,blood pressure monitoring,and vasoactive agent preparation.Surgical intervention demands prompt and coordinated anesthetic support to stabilize hemodynamics,ensuring successful tumor resection.Given the potential for late recurrence,long-term follow-up is essential for early detection and management of asymptomatic recurrences.INTRODUCTION Paraganglioma(PGL)is a neuroendocrine tumor originating from paraganglia,which are associated with the autonomic nervous system[1].These tumors arise from chromaffin cells or similar cells capable of secreting catecholamines,such as adrenaline and noradrenaline.PGLs manifest in various anatomical locations,including the head,neck,chest,abdomen,and pelvis,and are characterized by neurosecretory and chief cells surrounded by prominent vascular stroma.Although typically benign,malignant forms of PGL are also recognized,and they may exhibit a tendency for recurrence or me-tastasis[2].PGLs located in the retroperitoneum are relatively uncommon and present greater surgical challenges because of their complex anatomical location near vital organs and major blood vessels.Their catecholamine-secreting nature further complicates the maintenance of hemodynamic stability during the perioperative period.In May 2024,a patient with recurrent retroperitoneal PGL was admitted to our hospital,and the details are reported below.展开更多
Due to the increasing ageing population,femoral neck fracture(FNF)is a common and significant public health issue in the elderly,as it significantly impacts patients’quality of life,frequently leading to severe disab...Due to the increasing ageing population,femoral neck fracture(FNF)is a common and significant public health issue in the elderly,as it significantly impacts patients’quality of life,frequently leading to severe disability.Undoubtedly,hip replacement is the standard current of care for displaced FNF in this population,as it can provide pain relief and allow immediate return to mobility.However,hip arthroplasty may present severe specific complications,such as implant dislocation and infection,which may increase mortality and morbidity,especially in more frail patients.Therefore,in this particular population,alternative treatments should be considered.Girdlestone resection arthroplasty,which includes excision of the femoral head,is a salvage procedure which was first described for the management of chronic tuberculous coxitis,and then widely used in uncontrolled infected hip replacements.This article provides an updated outcome analysis of hip resection arthroplasty as a primary definitive treatment for FNF in frail non-ambulatory patients.展开更多
BACKGROUND Lymphadenectomy of the infrapyloric region remains technically demanding in laparoscopic radical gastrectomy.Traditional vessel-guided approaches often result in incomplete dissection and higher complicatio...BACKGROUND Lymphadenectomy of the infrapyloric region remains technically demanding in laparoscopic radical gastrectomy.Traditional vessel-guided approaches often result in incomplete dissection and higher complication rates,especially at station No.6.AIM To propose a mesentery-based strategy for infrapyloric lymphadenectomy and evaluate its safety,feasibility,and efficacy.METHODS By identifying key anatomical landmarks and defining the inferior mesenteric boundary of the pyloric region(right gastro-omental mesentery),this approach enables full exposure and en bloc resection of anterior and posterior mesenteric planes,with proximal ligation at the root of feeding vessels.A retrospective cohort study was conducted on 330 gastric cancer patients who underwent D2 lymphadenectomy(D2)from January 2020 to December 2021.Outcomes were compared between 165 patients treated with D2 plus complete mesogastric excision(D2+CME)and 165 matched controls receiving conventional D2.RESULTS The D2+CME group demonstrated significantly improved surgical outcomes,including shorter total operative time(279.19±45.50 minutes vs 301.25±52.30 minutes,P<0.001),reduced infrapyloric dissection time(22.24±3.80 minutes vs 27.58±4.20 minutes,P<0.001),and lower blood loss(4.71±1.12 mL vs 24.83±6.35 mL,P<0.001).More lymph nodes were retrieved overall(43.80±10.05 vs 37.25±8.80,P<0.001),particularly at station No.6(5.26±0.87 vs 4.14±0.41,P<0.001).Postoperative recovery indicators and hospital stay were comparable between groups,while the complication rate was significantly lower in the D2+CME group(20%vs 30.3%,P=0.042).CONCLUSION The mesentery-based approach enables safe pyloric lymphadenectomy.Systematic mesogastric excision improves operative efficiency and lymph node yield,especially at station No.6,offering potential oncological benefits in gastric cancer surgery.展开更多
BACKGROUND Colon cancer is a significant health issue in China,with high incidence and mortality rates.Surgical resection remains the primary treatment,with the introduction of complete mesocolic excision in 2009 impr...BACKGROUND Colon cancer is a significant health issue in China,with high incidence and mortality rates.Surgical resection remains the primary treatment,with the introduction of complete mesocolic excision in 2009 improving precision and outcomes.Laparoscopic techniques,including laparoscopic-assisted right hemicolectomy(LARH)and total laparoscopic right hemicolectomy(TLRH),have further advanced colon cancer treatment by reducing trauma,blood loss,and recovery time.While TLRH offers additional benefits such as faster recovery and fewer complications,its adoption has been limited by longer operative times and technical challenges.AIM To compare the short-term outcomes of TLRH and LARH for the treatment of right-sided colon cancer and explore the advantages and feasibility of TLRH.METHODS Clinical data from 109 right-sided colon cancer patients admitted between January 2019 and May 2021 were retrospectively analyzed.Patients were divided into an observation group(TLRH,n=50)and a control group(LARH,n=59).Study variables were operation time,intraoperative bleeding volume,postoperative hospital stays,length of surgical specimen,number of lymph nodes dissected,and postoperative inflammatory factor levels of the two groups of patients.The postoperative complications were analyzed and compared,and survival,recurrence,and remote metastasis rates of the two groups were compared during a 2-year follow-up period.RESULTS The TLRH group showed the advantages of reduced intraoperative bleeding,shorter hospital stays,and quicker recovery.Lymph node dissection outcomes were comparable,and postoperative inflammatory markers were lower in the TLRH group.Complication rates were similar.Short-term follow-up(2 years)revealed no significant differences in recurrence,metastasis,or survival rates.CONCLUSION Compared to LARH,TLRH offers significant advantages in terms of reducing surgical trauma,lowering postoperative inflammatory factor levels,and mitigating the impact on intestinal function.This approach contributes to a shorter hospital stay and promotes postoperative recovery in patients.The study suggests that TLRH may offer favorable outcomes for colorectal cancer patients.展开更多
The management of rectal lesions has been significantly enhanced by advancements in endoscopic and minimally invasive surgical techniques.Endoscopic submucosal dissection(ESD),transanal endoscopic microsurgical submuc...The management of rectal lesions has been significantly enhanced by advancements in endoscopic and minimally invasive surgical techniques.Endoscopic submucosal dissection(ESD),transanal endoscopic microsurgical submucosal dissection(TEM-ESD),and transanal minimally invasive surgery(TAMIS)offer precision and reduced morbidity for treating these conditions.This minireview evaluates the efficacy,safety,and clinical outcomes of ESD,TEM-ESD,and TAMIS,highlighting their roles in the contemporary management of rectal lesions.A desktop research study with a particular focus on ESD,TEM-ESD,and TAMIS for rectal lesions was conducted.Key outcomes assessed include complete resection rates,complication rates,recurrence rates,and functional outcomes following the procedure.ESD is noted for its high rate of en bloc resection with minimal invasiveness,suitable for large or flat lesions.TEM-ESD has demonstrated similar efficacy,with additional benefits including shorter procedure times and a more favorable learning curve,compared to traditional ESD,as evidenced by recent comparative studies.TAMIS offers a less invasive option with enhanced visualization and accessibility,supporting its use in a broader range of rectal lesion cases.ESD,TEM-ESD,and TAMIS are all effective therapeutic options for rectal lesions,each presenting unique advantages depending on lesion characteristics and patient factors.展开更多
Magnolia sinica is one of the most endangered Magnoliaceae species in China.Seed biology information concerning its long-term ex situ conservation and utilization is insufficient.This study investigated dormancy statu...Magnolia sinica is one of the most endangered Magnoliaceae species in China.Seed biology information concerning its long-term ex situ conservation and utilization is insufficient.This study investigated dormancy status,germination requirements and storage behavior of M.sinica.Freshly matured seeds germinated to ca.86.5%at 25/15℃but poorly at 30℃;GA3 and moist chilling promoted germination significantly at 20℃.Embryos grew at temperatures(alternating or constant)between 20℃and 25℃,but not at 5℃or 30℃.Our results indicate that M.sinica seeds possibly have non-deep simple mor-phophysiological dormancy(MPD).Seeds survived desiccation to 9.27%and 4.85%moisture content(MC)as well as a further 6-month storage at-20℃and in liquid nitrogen,including recovery in vitro as excised embryos.The established protocol ensured that at least 58%of seedlings were obtained after both cold storage and cryopreservation.These results indicate that both conventional seed banking and cryopreservation have potential as long-term ex situ conservation methods,although further optimized approaches are recommended for this critically endangered magnolia species.展开更多
An attempt had been made to isolate and identify the low polar volatile constituents from Isodon excisa. The dried plants were heat extracted with ethanol and then extracted with petroleum ether. The constituents were...An attempt had been made to isolate and identify the low polar volatile constituents from Isodon excisa. The dried plants were heat extracted with ethanol and then extracted with petroleum ether. The constituents were isolated and analyzed by GC-MS and then we retrieved them on NIST08 mass spectrometry database to determine their structures. Finally, successful results were achieved, 111 compounds were obtained and identified. 105 of them were reported for the first time in lsodon excisa and 22 of them were first found in natural products. Thus, the main constituents of it were found to be Sitosterol （33.28%）, 3-Amino-4-pyrazolecarbonitrile （9.55%）展开更多
文摘During long term storage at 25℃ in the dark,a large number of cell content were transferred from the senescing scape to the developing cloves,and the transfer from the basal part of scape was earlier than that from the apical part in the excised garlic scape ( Allium sativum var Taichang).Levels of H 2O 2 decreased in the cloves and significantly increased up to 10 folds and then declined quickly in the scape.Levels of H 2O 2 were enhanced early in the basal part of scape.In the treatment of GA 3 at the cloves,levels of H 2O 2 were strongly enhanced in the cloves and inhibited in the scape,coinciding with the distinct inhibition of cell content tansfer.The results indicated that H 2O 2 may be involved in cell content redistribution and its regulation.3-Amino-1,2,4-triazole (AT) is a specific inhibitor of catalase.Effects of AT on cell content redistribution and levels of H 2O 2 were almost similar to those of GA 3,It further proved the above concept.According to the changes of H 2O 2 leves and activities of peroxidase and catalase in the cloves and in the scape,we suggest that the accumulation of H 2O 2 in the scape was transducted from the cloves,and the decline of H 2O 2 level in the scape with GA 3 or AT at the cloves was mainly through the inhibition of H 2O 2 synthesis in the cloves.
基金supported by projects of the National Key Research and Development of China (No. 2017YFC0209700)the National Natural Science Foundation of China (Nos. 41575121, 91544211, 41727805, 21477142)
文摘The efficient maintenance of the activity of excised branches is the powerful guarantee to accurately determine gas exchange flux between the detached branches of tall trees and the atmosphere. In this study, the net photosynthetic rate(NPR) of the excised branches and branches in situ were measured simultaneously by using two photosynthetic instruments to characterize the activity of the excised branches of Phyllostachys nigra. The ratio of normalized NPR of excised branches to NPR in situ was used to assess the photosynthetic activity of detached branches. Based on photosynthetic activity, an optimal hydroponics protocol for maintaining activity of excised P. nigra branches was presented:1/8 times the concentration of Gamborg B5 vitamin mixture with p H = 6. Under the best cultivation protocol, photosynthetic activity of excised P. nigra branches could be maintained more than 90% within 6 hr in the light intensity range of 200–2000 μmol/(m2·sec) and temperature range of 13.4–28.7°C. The nitrogen dioxide(NO2) flux differences between in situ and in vitro branches and the atmosphere were compared using double dynamic chambers.Based on the maintenance method of excised branches, the NO2 exchange flux between the excised P. nigra branches and the atmosphere(from-1.01 to-2.72 nmol/(m2·sec) was basically consistent with between the branches in situ and the atmosphere(from-1.12 to-3.16 nmol/(m2 sec)) within 6 hr. Therefore, this study provided a feasible protocol for in vitro measurement of gas exchange between tall trees and the atmosphere for a period of time.
文摘The administration of drugs via the buccal route has attracted much attention in recent years.However,the development of delivery systems that adhere well in moist conditions while releasing drugs successfully across the buccal mucosa remains challenging[1].Currently,the gold standard for determining buccal drug permeability is the vertical Franz diffusion cell(FDC),which is using freshly excised tissue[2].
基金Supported by Health Research Project of Hunan Provincial Health Commission,No.D202315018915.
文摘BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.
文摘BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomical constraints in the periocular region.Precise diagnosis is essential to guide appropriate surgical management and prevent recurrence.CASE SUMMARY A 32-year-old female presented with a recurrent tumor in the medial canthus,previously diagnosed as a solitary fibrous tumor in an outside institution.After complete radiological and systemic workup,she was scheduled for a wide local excision followed by reconstruction after getting tumor clear margins on frozen section.Histopathology confirmed DFSP,characterized by storiform spindle cell proliferation,diffuse cluster of differentiation 34 positivity,and signal transducer and activator of transcription 6 negativity.CONCLUSION This case highlights the challenges in the diagnostic and surgical management of DFSP in periocular tumors.Comprehensive surgical excision with appropriate reconstruction is critical for achieving oncological control while preserving aesthetics and function.
文摘Background:Platinum chemotherapy(CT)remains the backbone of systemic therapy for patients with smallcell lung cancer(SCLC).The nucleotide excision repair(NER)pathway plays a central role in the repair of the DNA damage exerted by platinum agents.Alteration in this repair mechanism may affect patients’survival.Materials and Methods:We conducted a retrospective analysis of data from 38 patients with extensive disease(ED)-SCLC who underwent platinum-CT at the Clinical Oncology Unit,Careggi University Hospital,Florence(Italy),from 2015 to 2020.mRNA expression analysis and single nucleotide polymorphism(SNP)characterization of three NER pathway genes—namely ERCC1,ERCC2,and ERCC5—were performed on patient tumor samples.Results:Overall,elevated expression of ERCC genes was observed in SCLC patients compared to healthy controls.Patients with low ERCC1 and ERCC5 expression levels exhibited a better median progression-free survival(mPFS=7.1 vs.4.9 months,p=0.39 for ERCC1 and mPFS=6.9 vs.4.8 months,p=0.093 for ERCC5)and overall survival(mOS=8.7 vs.6.0 months,p=0.4 for ERCC1 and mOS=7.2 vs.6.2 months,p=0.13 for ERCC5).Genotyping analysis of five SNPs of ERCC genes showed a longer survival in patients harboring the wild-type genotype or the heterozygous variant of the ERCC1 rs11615 SNP(p=0.24 for PFS and p=0.14 for OS)and of the rs13181 and rs1799793 ERCC2 SNPs(p=0.43 and p=0.26 for PFS and p=0.21 and p=0.16 for OS,respectively)compared to patients with homozygous mutant genotypes.Conclusions:The comprehensive analysis of ERCC gene expression and SNP variants appears to identify patients who derive greater survival benefits from platinum-CT.
文摘BACKGROUND Osteochondroma,a benign bone tumour,is commonly seen in the metaphyseal region of long bones.It is not so common in short bones and occurs rarely in carpals.The literature involving an osteochondroma of pisiform is scarce.CASE SUMMARY We present a 12-year-old male Asian child with a gradually progressive,bony,hard swelling on the volar aspect of the right wrist,which,on investigation,was suggestive of a solitary osteochondroma of the pisiform and its management.CONCLUSION The current report describes a child with a wrist swelling which on evaluation was found to be an osteochondroma of the pisiform,which is seldom described in the literature,and managed by excision biopsy.Though osteochondromas of the carpal bones are rare they should be included in the differential of any wrist swelling with the symptom complex varying from pressure effects to surrounding soft tissues and nerves,attritional tendon ruptures,carpal instabilities and arthritis.
文摘In this article,we provide an important commentary on the original study Lu et al,which offers insight into the surgical efficacy of transanal total mesorectal excision(TaTME)vs laparoscopic total mesorectal excision(LapTME)in the management of low-lying locally advanced rectal cancer(LARC).We focus specifically on the rate of postoperative complications between the two using existing data from the literature.We additionally introduce robotic total mesorectal excision(RTME)and look at its postoperative complications relative to the TaTME and LapTME.LARC has been conventionally approached by open surgery.However,minimally invasive techniques have emerged over the past two decades as alternatives to open total mesorectal excision,namely robotic,laparoscopic,and transanal.Each approach has its supporters,but conflicting data on resection outcomes and complications has fueled ongoing debate over the optimal minimally invasive technique for low/mid-LARC.This article aims to extend on the data regarding the use of TaTME and RTME in the treatment of low/mid-LARC and further elaborate on their comparative efficacy relative to LapTME.
文摘Local excision(LE)is an effective treatment option for rectal cancer that shows significant regression following neoadjuvant chemoradiotherapy.Compared to traditional total mesorectal excision(TME),LE can achieve comparable on-cological outcomes while preserving function and improving quality of life(QoL).The indications for LE have been gradually expanded,but there are uncertainties regarding postoperative oncological results.Long-term follow-up prospective randomized controlled trials comparing TME and LE in terms of both oncological outcomes and QoL could help reduce uncertainties between these two approaches and contribute to the development of evidence-based guidelines for rectal cancer treatment.
基金Supported by Natural Science Foundation of Zhejiang Province,China,No.LQ21H020007.
文摘BACKGROUND Paraganglioma(PGL)is a neuroendocrine tumor originating from paraganglia that can occur in various locations,such as the head,neck,chest,abdomen,and pelvis.Retroperitoneal PGLs are rare,and recurrent cases in this area are partic-ularly uncommon,posing considerable surgical complexities.Owing to their neu-roendocrine activity,PGLs are capable of secreting hormones like catecholamines,thereby presenting significant challenges in hemodynamic management during the perioperative period.CASE SUMMARY We report a 64-year-old man with a recurrent retroperitoneal PGL.The patient underwent retroperitoneal mass resection in 2013,with postoperative pathology revealing a PGL.Regular follow-up was not conducted until April 2024,when a computed tomography scan revealed a huge mass in the retroperitoneum,closely adjacent to the abdominal aorta.Laboratory examinations revealed elevated levels of catecholamines in the patient's blood serum.Upon admission,volume expan-sion and blood pressure(BP)monitoring were carried out for one week,with catecholamine levels reviewed and normalized.Adequate preoperative prepa-ration was conducted,including central venous access,arterial BP monitoring,and the preparation of vasoactive agents.During tumor resection,the patient ex-perienced acute,significant fluctuations in BP.The timely intervention of the anesthesiologist stabilized the BP,facilitating the successful resection of the tumor which was confirmed as a recurrent PGL.Postoperative follow-up revealed no evidence of tumor residual or recurrence.CONCLUSION PGL recurrence is rare but non-negligible.PGLs adjacent to major arteries com-plicate surgery,and perioperative hemodynamic stability demands meticulous attention.Core Tip:Recurrent retroperitoneal paragangliomas are infrequent but pose substantial surgical challenges,particularly when located adjacent to critical vascular structures such as the abdominal aorta.Effective perioperative management of he-modynamic fluctuations,driven by catecholamine secretion,requires meticulous preoperative planning,including volume expansion,blood pressure monitoring,and vasoactive agent preparation.Surgical intervention demands prompt and coordinated anesthetic support to stabilize hemodynamics,ensuring successful tumor resection.Given the potential for late recurrence,long-term follow-up is essential for early detection and management of asymptomatic recurrences.INTRODUCTION Paraganglioma(PGL)is a neuroendocrine tumor originating from paraganglia,which are associated with the autonomic nervous system[1].These tumors arise from chromaffin cells or similar cells capable of secreting catecholamines,such as adrenaline and noradrenaline.PGLs manifest in various anatomical locations,including the head,neck,chest,abdomen,and pelvis,and are characterized by neurosecretory and chief cells surrounded by prominent vascular stroma.Although typically benign,malignant forms of PGL are also recognized,and they may exhibit a tendency for recurrence or me-tastasis[2].PGLs located in the retroperitoneum are relatively uncommon and present greater surgical challenges because of their complex anatomical location near vital organs and major blood vessels.Their catecholamine-secreting nature further complicates the maintenance of hemodynamic stability during the perioperative period.In May 2024,a patient with recurrent retroperitoneal PGL was admitted to our hospital,and the details are reported below.
文摘Due to the increasing ageing population,femoral neck fracture(FNF)is a common and significant public health issue in the elderly,as it significantly impacts patients’quality of life,frequently leading to severe disability.Undoubtedly,hip replacement is the standard current of care for displaced FNF in this population,as it can provide pain relief and allow immediate return to mobility.However,hip arthroplasty may present severe specific complications,such as implant dislocation and infection,which may increase mortality and morbidity,especially in more frail patients.Therefore,in this particular population,alternative treatments should be considered.Girdlestone resection arthroplasty,which includes excision of the femoral head,is a salvage procedure which was first described for the management of chronic tuberculous coxitis,and then widely used in uncontrolled infected hip replacements.This article provides an updated outcome analysis of hip resection arthroplasty as a primary definitive treatment for FNF in frail non-ambulatory patients.
基金Supported by the Natural Science Foundation Program in Fujian Province of China,No.2023J011726.
文摘BACKGROUND Lymphadenectomy of the infrapyloric region remains technically demanding in laparoscopic radical gastrectomy.Traditional vessel-guided approaches often result in incomplete dissection and higher complication rates,especially at station No.6.AIM To propose a mesentery-based strategy for infrapyloric lymphadenectomy and evaluate its safety,feasibility,and efficacy.METHODS By identifying key anatomical landmarks and defining the inferior mesenteric boundary of the pyloric region(right gastro-omental mesentery),this approach enables full exposure and en bloc resection of anterior and posterior mesenteric planes,with proximal ligation at the root of feeding vessels.A retrospective cohort study was conducted on 330 gastric cancer patients who underwent D2 lymphadenectomy(D2)from January 2020 to December 2021.Outcomes were compared between 165 patients treated with D2 plus complete mesogastric excision(D2+CME)and 165 matched controls receiving conventional D2.RESULTS The D2+CME group demonstrated significantly improved surgical outcomes,including shorter total operative time(279.19±45.50 minutes vs 301.25±52.30 minutes,P<0.001),reduced infrapyloric dissection time(22.24±3.80 minutes vs 27.58±4.20 minutes,P<0.001),and lower blood loss(4.71±1.12 mL vs 24.83±6.35 mL,P<0.001).More lymph nodes were retrieved overall(43.80±10.05 vs 37.25±8.80,P<0.001),particularly at station No.6(5.26±0.87 vs 4.14±0.41,P<0.001).Postoperative recovery indicators and hospital stay were comparable between groups,while the complication rate was significantly lower in the D2+CME group(20%vs 30.3%,P=0.042).CONCLUSION The mesentery-based approach enables safe pyloric lymphadenectomy.Systematic mesogastric excision improves operative efficiency and lymph node yield,especially at station No.6,offering potential oncological benefits in gastric cancer surgery.
文摘BACKGROUND Colon cancer is a significant health issue in China,with high incidence and mortality rates.Surgical resection remains the primary treatment,with the introduction of complete mesocolic excision in 2009 improving precision and outcomes.Laparoscopic techniques,including laparoscopic-assisted right hemicolectomy(LARH)and total laparoscopic right hemicolectomy(TLRH),have further advanced colon cancer treatment by reducing trauma,blood loss,and recovery time.While TLRH offers additional benefits such as faster recovery and fewer complications,its adoption has been limited by longer operative times and technical challenges.AIM To compare the short-term outcomes of TLRH and LARH for the treatment of right-sided colon cancer and explore the advantages and feasibility of TLRH.METHODS Clinical data from 109 right-sided colon cancer patients admitted between January 2019 and May 2021 were retrospectively analyzed.Patients were divided into an observation group(TLRH,n=50)and a control group(LARH,n=59).Study variables were operation time,intraoperative bleeding volume,postoperative hospital stays,length of surgical specimen,number of lymph nodes dissected,and postoperative inflammatory factor levels of the two groups of patients.The postoperative complications were analyzed and compared,and survival,recurrence,and remote metastasis rates of the two groups were compared during a 2-year follow-up period.RESULTS The TLRH group showed the advantages of reduced intraoperative bleeding,shorter hospital stays,and quicker recovery.Lymph node dissection outcomes were comparable,and postoperative inflammatory markers were lower in the TLRH group.Complication rates were similar.Short-term follow-up(2 years)revealed no significant differences in recurrence,metastasis,or survival rates.CONCLUSION Compared to LARH,TLRH offers significant advantages in terms of reducing surgical trauma,lowering postoperative inflammatory factor levels,and mitigating the impact on intestinal function.This approach contributes to a shorter hospital stay and promotes postoperative recovery in patients.The study suggests that TLRH may offer favorable outcomes for colorectal cancer patients.
文摘The management of rectal lesions has been significantly enhanced by advancements in endoscopic and minimally invasive surgical techniques.Endoscopic submucosal dissection(ESD),transanal endoscopic microsurgical submucosal dissection(TEM-ESD),and transanal minimally invasive surgery(TAMIS)offer precision and reduced morbidity for treating these conditions.This minireview evaluates the efficacy,safety,and clinical outcomes of ESD,TEM-ESD,and TAMIS,highlighting their roles in the contemporary management of rectal lesions.A desktop research study with a particular focus on ESD,TEM-ESD,and TAMIS for rectal lesions was conducted.Key outcomes assessed include complete resection rates,complication rates,recurrence rates,and functional outcomes following the procedure.ESD is noted for its high rate of en bloc resection with minimal invasiveness,suitable for large or flat lesions.TEM-ESD has demonstrated similar efficacy,with additional benefits including shorter procedure times and a more favorable learning curve,compared to traditional ESD,as evidenced by recent comparative studies.TAMIS offers a less invasive option with enhanced visualization and accessibility,supporting its use in a broader range of rectal lesion cases.ESD,TEM-ESD,and TAMIS are all effective therapeutic options for rectal lesions,each presenting unique advantages depending on lesion characteristics and patient factors.
文摘Magnolia sinica is one of the most endangered Magnoliaceae species in China.Seed biology information concerning its long-term ex situ conservation and utilization is insufficient.This study investigated dormancy status,germination requirements and storage behavior of M.sinica.Freshly matured seeds germinated to ca.86.5%at 25/15℃but poorly at 30℃;GA3 and moist chilling promoted germination significantly at 20℃.Embryos grew at temperatures(alternating or constant)between 20℃and 25℃,but not at 5℃or 30℃.Our results indicate that M.sinica seeds possibly have non-deep simple mor-phophysiological dormancy(MPD).Seeds survived desiccation to 9.27%and 4.85%moisture content(MC)as well as a further 6-month storage at-20℃and in liquid nitrogen,including recovery in vitro as excised embryos.The established protocol ensured that at least 58%of seedlings were obtained after both cold storage and cryopreservation.These results indicate that both conventional seed banking and cryopreservation have potential as long-term ex situ conservation methods,although further optimized approaches are recommended for this critically endangered magnolia species.
文摘An attempt had been made to isolate and identify the low polar volatile constituents from Isodon excisa. The dried plants were heat extracted with ethanol and then extracted with petroleum ether. The constituents were isolated and analyzed by GC-MS and then we retrieved them on NIST08 mass spectrometry database to determine their structures. Finally, successful results were achieved, 111 compounds were obtained and identified. 105 of them were reported for the first time in lsodon excisa and 22 of them were first found in natural products. Thus, the main constituents of it were found to be Sitosterol （33.28%）, 3-Amino-4-pyrazolecarbonitrile （9.55%）
