Gastrointestinal stromal tumours(GISTs)are tumours that originate from mesenchymal tissue,are predominantly located in the stomach,and typically do not metastasize to the lymph nodes.Surgical intervention remains the ...Gastrointestinal stromal tumours(GISTs)are tumours that originate from mesenchymal tissue,are predominantly located in the stomach,and typically do not metastasize to the lymph nodes.Surgical intervention remains the primary treatment modality for GISTs.Historically,open surgery was the predominant approach;however,advancements in medical technology have led to laparoscopic surgery becoming the standard practice.Compared with traditional open surgical techniques,laparoscopic surgery is less invasive and facilitates more rapid postoperative recovery.Given that GISTs can arise at any location within the gas-trointestinal tract,the specific surgical methods employed vary according to both the tumour's anatomical site and its growth characteristics.The aim of this review is to examine laparoscopic surgical strategies for managing GISTs across different regions of the gastrointestinal tract by synthesizing recent research trends and relevant evidence-based medical literature.展开更多
Objective:To explore the key points of early identification and comprehensive nursing intervention strategy for necrotizing fasciitis patients,to improve the efficiency of clinical diagnosis and treatment and the qual...Objective:To explore the key points of early identification and comprehensive nursing intervention strategy for necrotizing fasciitis patients,to improve the efficiency of clinical diagnosis and treatment and the quality of prognosis.Methods:The clinical data of a 70-year-old female patient with right-hand trauma complicated by infection progressing to necrotizing fasciitis were reviewed and analyzed.Laboratory,imaging,and surgical findings were integrated to summarize the early identification features and key nursing considerations.Results:The patient retained the affected limb,albeit with some functional limitations,following early identification,timely surgical debridement,broad-spectrum anti-infective therapy,and comprehensive nursing care.Conclusion:The early clinical manifestations of necrotizing fasciitis are often subtle,and the disease progresses rapidly.This necessitates heightened vigilance among medical staff in all healthcare settings.Implementing multidisciplinary collaboration and systematic nursing interventions can improve patient prognosis while reducing amputation rates and mortality.展开更多
The“longevity protein”SIRT5 could hold the key to delaying age-related muscle decline.A study led by researchers from the Institute of Zoology(IOZ)of the Chinese Academy of Sciences and Capital Medical University in...The“longevity protein”SIRT5 could hold the key to delaying age-related muscle decline.A study led by researchers from the Institute of Zoology(IOZ)of the Chinese Academy of Sciences and Capital Medical University in Beijing reveals that SIRT5 mitigates skeletal muscle aging by blocking pro-inflammatory pathways.Published in Nature Metabolism on March 14,2025,the work identifies SIRT5’s interaction with protein kinase TBK1 as critical to preserving muscle mass and function.展开更多
Recent advances in diagnostic techniques have allowed the diagnosis of gastric cancer(GC)at an early stage.Due to the low incidence of lymph node metastasis and favorable prognosis in early GC,function-preserving surg...Recent advances in diagnostic techniques have allowed the diagnosis of gastric cancer(GC)at an early stage.Due to the low incidence of lymph node metastasis and favorable prognosis in early GC,function-preserving surgery which improves postoperative quality of life may be possible.Pylorus-preserving gastrectomy(PPG)is one such function-preserving procedure,which is expected to offer advantages with regards to dumping syndrome,bile reflux gastritis,and the frequency of flatus,although PPG may induce delayed gastric emptying.Proximal gastrectomy(PG)is another functionpreserving procedure,which is thought to be advantageous in terms of decreased duodenogastric reflux and good food reservoir function in the remnant stomach,although the incidence of heartburn or gastric fullness associated with this procedure is high.However,these disadvantages may be overcome by the reconstruction method used.The other important problem after PG is remnant GC,which was reported to occur in approximately 5%of patients.Therefore,the reconstruction technique used with PG should facilitate postoperativeendoscopic examinations for early detection and treatment of remnant gastric carcinoma.Oncologic safety seems to be assured in both procedures,if the preoperative diagnosis is accurate.Patient selection should be carefully considered.Although many retrospective studies have demonstrated the utility of function-preserving surgery,no consensus on whether to adopt functionpreserving surgery as the standard of care has been reached.Further prospective randomized controlled trials are necessary to evaluate survival and postoperative quality of life associated with function-preserving surgery.展开更多
We establish the concept of shapes of functions by using partial differential inequalites. Our definition about shapes includes some usual shapes such as convex,subharmonic,etc.,and gives many new shapes of functions....We establish the concept of shapes of functions by using partial differential inequalites. Our definition about shapes includes some usual shapes such as convex,subharmonic,etc.,and gives many new shapes of functions.The main results show that the shape preserving approxi- mation has close relation to the shape preserving extension.One of our main results shows that if f∈C(Ω)has some shape defined by our definition,then f can be uniformly approximated by polynomials P_n ∈p_n(n∈N)which have the same shape in Ω,and the degree of the ap- proximation is Cω(f,n^(-β))with constants C,β>0.展开更多
Splenic artery aneurysm is one of the most common visceral aneurysms,and patients with this type of aneurysm often present without symptoms.However,when rupture occurs,it can be a catastrophic event.Although most of t...Splenic artery aneurysm is one of the most common visceral aneurysms,and patients with this type of aneurysm often present without symptoms.However,when rupture occurs,it can be a catastrophic event.Although most of these aneurysms can be treated with percutaneous embolization,some located in uncommon parts of the splenic artery may make this approach impossible.We present a patient with an aneurysm in the proximal splenic artery,close to the celiac trunk,which was treated by laparoscopic ligation only,without resection of the aneurysm,and with long-term preservation of splenic function.展开更多
BACKGROUND Lymphatic basin dissection is a sentinel node biopsy method that is specific for gastric cancer.In this method,the dyed lymphatic system is dissected en bloc,and sentinel nodes are identified at the back ta...BACKGROUND Lymphatic basin dissection is a sentinel node biopsy method that is specific for gastric cancer.In this method,the dyed lymphatic system is dissected en bloc,and sentinel nodes are identified at the back table(ex vivo).Even with lymphatic basin dissection,blood flow to the residual stomach can be preserved,and functionpreserving curative gastrectomy can be performed.The oncological safety of function-preserving curative gastrectomy combined with lymphatic basin dissection has not yet been fully investigated.We hypothesized that the oncological safety of sentinel node navigation surgery(SNNS)is not inferior to that of the guidelines.AIM To investigate the life prognosis of SNNS for gastric cancer in comparison with guidelines surgery.METHODS This was a retrospective cohort study.Patients were selected from gastric cancer patients who underwent sentinel node biopsy from April 1999 to March 2016.Patients from April 1999 to August 2008 were from the Department of Surgery II,Kanazawa University Hospital,and patients from August 2009 to March 2016 were from the Department of Surgical Oncology,Kanazawa Medical University Hospital.Patients who were diagnosed with gastric cancer,which was preoperatively diagnosed as superficial type(type 0),5 cm or less in length,clinical T1-2 and node negative,and underwent various gastrectomies guided by sentinel node navigation were retrospectively collected.The overall survival(OS)and relapsefree survival(RFS)of these patients(SNNS group)were investigated.Patients with gastric cancer of the same stage and who underwent guidelines gastrectomy with standard nodal dissection were also selected as the control group.RESULTS A total of 239 patients in the SNNS group and 423 patients in the control group were included.Pathological nodal metastasis was observed in 10.5%and 10.4%of the SNNS and control groups,respectively.The diagnostic abilities of sentinel node biopsy were 84%and 98.6%for sensitivity and accuracy,respectively.In the SNNS group,81.6%of patients underwent modified gastrectomy or functionpreserving curative gastrectomy with lymphatic basin dissection,in which the extent of nodal dissection was further reduced compared to the guidelines.The OS rate in the SNNS group was 96.8%at 5 years and was significantly better than 91.3%in the control group(P=0.0014).The RFS rates were equal in both groups.After propensity score matching,there were 231 patients in both groups,and the cumulative recurrence rate was 0.43%at 5 years in the SNNS group and 1.30%in the control group,which was not statistically different.CONCLUSION The oncological safety of patients who undergo gastrectomy guided by sentinel node navigation is not inferior to that of the guidelines surgery.展开更多
Gastric cancer(GC)remains a substantial health burden worldwide,ranking fifth in incidence and third in mortality among all cancer types.Surgeons have persistently attempted to address this growing burden through surg...Gastric cancer(GC)remains a substantial health burden worldwide,ranking fifth in incidence and third in mortality among all cancer types.Surgeons have persistently attempted to address this growing burden through surgical management of GC encompassing various aspects of surgery,including advances in surgical techniques and tools for minimally invasive surgery,novel technology for real-time image-guided surgery,and function-preserving and oncometabolic surgeries,aimed at improving patients’quality of life.The current perspective discusses the five most critical dimensions of the recent technical improvements and conceptual changes in GC surgery.We recommend further exploration of long-term benefits of these advancements,identification of breakthrough solutions to address current challenges,and delivery of the best quality of care.展开更多
Finite time blow up of the solutions to Boussinesq equation with linear restoring force and combined power nonlinearities is studied. Sufficient conditions on the initial data for nonexistence of global solutions are ...Finite time blow up of the solutions to Boussinesq equation with linear restoring force and combined power nonlinearities is studied. Sufficient conditions on the initial data for nonexistence of global solutions are derived. The results are valid for initial data with arbitrary high positive energy. The proofs are based on the concave method and new sign preserving functionals.展开更多
Dear Editor Aging is linked to changes in brain function that lead to physical decline,including motor deficits and skeletal muscle loss.while maintaining motor activity is crucial for improving the quality of life in...Dear Editor Aging is linked to changes in brain function that lead to physical decline,including motor deficits and skeletal muscle loss.while maintaining motor activity is crucial for improving the quality of life in the elderly,there is limited research on strategies to prevent motor function decline and preserve skeletal muscle.Additionally.approaches to preserving the function of critical neural systems to mitigate age-related motor decline remain underexplored.展开更多
This paper explores the advancement and application of high-power blue diode lasers in treating benign prostatic hyperplasia(BPH).Addressing the challenges posed by existing techniques,the study focuses on optimizing ...This paper explores the advancement and application of high-power blue diode lasers in treating benign prostatic hyperplasia(BPH).Addressing the challenges posed by existing techniques,the study focuses on optimizing tissue removal methods.Energy platform for BPH should balance a range of factors,such as operative time,patient conditions,urinary functions,complications,durability,accessibility,and cost,all while prioritizing patient care.Blueray Medical's innovation of high-power blue diode laser systems for BPH surgery is explored,with emphasis on achieving a balance among these considerations.By illustrating the biomedical effects of lasers and their interaction with soft tissues,particularly emphasizing the role of photon absorption by biomolecules and proteins in tissue behavior,this study outlines the advantages of the highpower blue diode laser system.The initial laboratory experiments and clinical results consistently align with our theoretical predictions,especially in terms of tissue vaporization efficiency,tissue coagulation,and bleeding control.In conclusion,blue diode lasers hold potential to enhance surgical outcomes for BPH.Their unique properties offer benefits like improved tissue removal rate and reduced thermal damages.Integrating blue laser technology into BPH protocols could lead to shorter hospital stays,cost savings,and expanded patient eligibility,although rigorous clinical studies are needed to fully understand their benefits and limitations.展开更多
基金Supported by Quanzhou Science and Technology Plan Projects,No.2024NY033Key Clinical Specialty Discipline Construction Program of Fujian(Fujian Health Medicine and Politics),No.[2022]884.
文摘Gastrointestinal stromal tumours(GISTs)are tumours that originate from mesenchymal tissue,are predominantly located in the stomach,and typically do not metastasize to the lymph nodes.Surgical intervention remains the primary treatment modality for GISTs.Historically,open surgery was the predominant approach;however,advancements in medical technology have led to laparoscopic surgery becoming the standard practice.Compared with traditional open surgical techniques,laparoscopic surgery is less invasive and facilitates more rapid postoperative recovery.Given that GISTs can arise at any location within the gas-trointestinal tract,the specific surgical methods employed vary according to both the tumour's anatomical site and its growth characteristics.The aim of this review is to examine laparoscopic surgical strategies for managing GISTs across different regions of the gastrointestinal tract by synthesizing recent research trends and relevant evidence-based medical literature.
文摘Objective:To explore the key points of early identification and comprehensive nursing intervention strategy for necrotizing fasciitis patients,to improve the efficiency of clinical diagnosis and treatment and the quality of prognosis.Methods:The clinical data of a 70-year-old female patient with right-hand trauma complicated by infection progressing to necrotizing fasciitis were reviewed and analyzed.Laboratory,imaging,and surgical findings were integrated to summarize the early identification features and key nursing considerations.Results:The patient retained the affected limb,albeit with some functional limitations,following early identification,timely surgical debridement,broad-spectrum anti-infective therapy,and comprehensive nursing care.Conclusion:The early clinical manifestations of necrotizing fasciitis are often subtle,and the disease progresses rapidly.This necessitates heightened vigilance among medical staff in all healthcare settings.Implementing multidisciplinary collaboration and systematic nursing interventions can improve patient prognosis while reducing amputation rates and mortality.
文摘The“longevity protein”SIRT5 could hold the key to delaying age-related muscle decline.A study led by researchers from the Institute of Zoology(IOZ)of the Chinese Academy of Sciences and Capital Medical University in Beijing reveals that SIRT5 mitigates skeletal muscle aging by blocking pro-inflammatory pathways.Published in Nature Metabolism on March 14,2025,the work identifies SIRT5’s interaction with protein kinase TBK1 as critical to preserving muscle mass and function.
文摘Recent advances in diagnostic techniques have allowed the diagnosis of gastric cancer(GC)at an early stage.Due to the low incidence of lymph node metastasis and favorable prognosis in early GC,function-preserving surgery which improves postoperative quality of life may be possible.Pylorus-preserving gastrectomy(PPG)is one such function-preserving procedure,which is expected to offer advantages with regards to dumping syndrome,bile reflux gastritis,and the frequency of flatus,although PPG may induce delayed gastric emptying.Proximal gastrectomy(PG)is another functionpreserving procedure,which is thought to be advantageous in terms of decreased duodenogastric reflux and good food reservoir function in the remnant stomach,although the incidence of heartburn or gastric fullness associated with this procedure is high.However,these disadvantages may be overcome by the reconstruction method used.The other important problem after PG is remnant GC,which was reported to occur in approximately 5%of patients.Therefore,the reconstruction technique used with PG should facilitate postoperativeendoscopic examinations for early detection and treatment of remnant gastric carcinoma.Oncologic safety seems to be assured in both procedures,if the preoperative diagnosis is accurate.Patient selection should be carefully considered.Although many retrospective studies have demonstrated the utility of function-preserving surgery,no consensus on whether to adopt functionpreserving surgery as the standard of care has been reached.Further prospective randomized controlled trials are necessary to evaluate survival and postoperative quality of life associated with function-preserving surgery.
文摘We establish the concept of shapes of functions by using partial differential inequalites. Our definition about shapes includes some usual shapes such as convex,subharmonic,etc.,and gives many new shapes of functions.The main results show that the shape preserving approxi- mation has close relation to the shape preserving extension.One of our main results shows that if f∈C(Ω)has some shape defined by our definition,then f can be uniformly approximated by polynomials P_n ∈p_n(n∈N)which have the same shape in Ω,and the degree of the ap- proximation is Cω(f,n^(-β))with constants C,β>0.
基金Supported by Key Disciplines of Medicine,Zhejiang Province,China,No.11-CX21
文摘Splenic artery aneurysm is one of the most common visceral aneurysms,and patients with this type of aneurysm often present without symptoms.However,when rupture occurs,it can be a catastrophic event.Although most of these aneurysms can be treated with percutaneous embolization,some located in uncommon parts of the splenic artery may make this approach impossible.We present a patient with an aneurysm in the proximal splenic artery,close to the celiac trunk,which was treated by laparoscopic ligation only,without resection of the aneurysm,and with long-term preservation of splenic function.
基金This study was approved by the ethics committee of Kanazawa University Hospital and Kanazawa Medical University(Trial Number R093,M288)ICG mapping was approved by the ethics committee of Kanazawa Medical University(Trial NumberM404).
文摘BACKGROUND Lymphatic basin dissection is a sentinel node biopsy method that is specific for gastric cancer.In this method,the dyed lymphatic system is dissected en bloc,and sentinel nodes are identified at the back table(ex vivo).Even with lymphatic basin dissection,blood flow to the residual stomach can be preserved,and functionpreserving curative gastrectomy can be performed.The oncological safety of function-preserving curative gastrectomy combined with lymphatic basin dissection has not yet been fully investigated.We hypothesized that the oncological safety of sentinel node navigation surgery(SNNS)is not inferior to that of the guidelines.AIM To investigate the life prognosis of SNNS for gastric cancer in comparison with guidelines surgery.METHODS This was a retrospective cohort study.Patients were selected from gastric cancer patients who underwent sentinel node biopsy from April 1999 to March 2016.Patients from April 1999 to August 2008 were from the Department of Surgery II,Kanazawa University Hospital,and patients from August 2009 to March 2016 were from the Department of Surgical Oncology,Kanazawa Medical University Hospital.Patients who were diagnosed with gastric cancer,which was preoperatively diagnosed as superficial type(type 0),5 cm or less in length,clinical T1-2 and node negative,and underwent various gastrectomies guided by sentinel node navigation were retrospectively collected.The overall survival(OS)and relapsefree survival(RFS)of these patients(SNNS group)were investigated.Patients with gastric cancer of the same stage and who underwent guidelines gastrectomy with standard nodal dissection were also selected as the control group.RESULTS A total of 239 patients in the SNNS group and 423 patients in the control group were included.Pathological nodal metastasis was observed in 10.5%and 10.4%of the SNNS and control groups,respectively.The diagnostic abilities of sentinel node biopsy were 84%and 98.6%for sensitivity and accuracy,respectively.In the SNNS group,81.6%of patients underwent modified gastrectomy or functionpreserving curative gastrectomy with lymphatic basin dissection,in which the extent of nodal dissection was further reduced compared to the guidelines.The OS rate in the SNNS group was 96.8%at 5 years and was significantly better than 91.3%in the control group(P=0.0014).The RFS rates were equal in both groups.After propensity score matching,there were 231 patients in both groups,and the cumulative recurrence rate was 0.43%at 5 years in the SNNS group and 1.30%in the control group,which was not statistically different.CONCLUSION The oncological safety of patients who undergo gastrectomy guided by sentinel node navigation is not inferior to that of the guidelines surgery.
文摘Gastric cancer(GC)remains a substantial health burden worldwide,ranking fifth in incidence and third in mortality among all cancer types.Surgeons have persistently attempted to address this growing burden through surgical management of GC encompassing various aspects of surgery,including advances in surgical techniques and tools for minimally invasive surgery,novel technology for real-time image-guided surgery,and function-preserving and oncometabolic surgeries,aimed at improving patients’quality of life.The current perspective discusses the five most critical dimensions of the recent technical improvements and conceptual changes in GC surgery.We recommend further exploration of long-term benefits of these advancements,identification of breakthrough solutions to address current challenges,and delivery of the best quality of care.
基金partially supported by Grant No.DFNI I-02/9 of the Bulgarian Science Fund
文摘Finite time blow up of the solutions to Boussinesq equation with linear restoring force and combined power nonlinearities is studied. Sufficient conditions on the initial data for nonexistence of global solutions are derived. The results are valid for initial data with arbitrary high positive energy. The proofs are based on the concave method and new sign preserving functionals.
基金supported by grants from the National Research Foundation of Korea(MSIT:RS-2024-00408736,NRF-2020R1A2C2007954,and2017R1A2B4002675)funded by the Korean government.
文摘Dear Editor Aging is linked to changes in brain function that lead to physical decline,including motor deficits and skeletal muscle loss.while maintaining motor activity is crucial for improving the quality of life in the elderly,there is limited research on strategies to prevent motor function decline and preserve skeletal muscle.Additionally.approaches to preserving the function of critical neural systems to mitigate age-related motor decline remain underexplored.
基金partially funded by Blueray Medicalpartially funded by China's National Key R&D Programs(NKPs)“Digital Diagnostic and Treatment Equipment”under 2019YFC0121500Shaanxi“Key Industry Innovation Chain-Social Development”under 2018ZDXM-SF-072.
文摘This paper explores the advancement and application of high-power blue diode lasers in treating benign prostatic hyperplasia(BPH).Addressing the challenges posed by existing techniques,the study focuses on optimizing tissue removal methods.Energy platform for BPH should balance a range of factors,such as operative time,patient conditions,urinary functions,complications,durability,accessibility,and cost,all while prioritizing patient care.Blueray Medical's innovation of high-power blue diode laser systems for BPH surgery is explored,with emphasis on achieving a balance among these considerations.By illustrating the biomedical effects of lasers and their interaction with soft tissues,particularly emphasizing the role of photon absorption by biomolecules and proteins in tissue behavior,this study outlines the advantages of the highpower blue diode laser system.The initial laboratory experiments and clinical results consistently align with our theoretical predictions,especially in terms of tissue vaporization efficiency,tissue coagulation,and bleeding control.In conclusion,blue diode lasers hold potential to enhance surgical outcomes for BPH.Their unique properties offer benefits like improved tissue removal rate and reduced thermal damages.Integrating blue laser technology into BPH protocols could lead to shorter hospital stays,cost savings,and expanded patient eligibility,although rigorous clinical studies are needed to fully understand their benefits and limitations.