Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of re...Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of rectal cancer in our hospital from April 2018 to April 2023 were selected,and 60 patients who met the requirements were included as research subjects.The patients were divided into an experimental group and a reference group by a double-blind mechanism,with 30 cases in each group.The experimental group underwent laparoscopic pelvic autonomic radical resection,while the reference group underwent ordinary radical resection.The voiding function,urodynamics,sexual function,and blood indexes of the patients of both groups were compared.Results:The total incidence of voiding dysfunction in the experimental group was significantly lower than in the reference group(P<0.05).Urodynamics such as abdominal leak point pressure(ALPP),maximum urethral pressure(MUP),maximum urethral closure pressure(MUCP),and functional urethral length(FUL)in the experimental group were significantly better than those in the reference group(P<0.05).The incidences of erectile dysfunction and ejaculatory dysfunction in the experimental group were significantly lower than those in the reference group(P<0.05).Before the surgery,there were no significant differences in the blood indexes such as C-reactive protein(CRP),cortisol(Cor),and pre-albumin(PA)between the two groups(P>0.05);after the operation,the blood indexes of the patients in the experimental group were significantly better than those in the reference group(P<0.05).Conclusion:Laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer has lesser effects on urinary and sexual functions.展开更多
BACKGROUND: Transplantation of Akt-over-expressing mesenchymal stem cells (Akt-MSCs) has been shown to repair infarcted myocardium and improve cardiac function. However, little is known about the therapeutic effects o...BACKGROUND: Transplantation of Akt-over-expressing mesenchymal stem cells (Akt-MSCs) has been shown to repair infarcted myocardium and improve cardiac function. However, little is known about the therapeutic effects of Akt-MSCs on cardiac autonomic neuropathy in chronic heart failure (CHF). OBJECTIVE: The present study used adriamycin-induced CHF rat models to observe the effect of Akt-MSCs on cardiac autonomic nervous regeneration and the factors mediating this effect. DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at the Central Laboratory of Basic Medical College, China Medical University, between September 2008 and April 2009. MATERIALS: Rabbit anti-choline acetyltransferase (ChAT), growth associated protein-43 (GAP-43), synaptophysin (SYN) polyclonal antibodies and the secondary antibody (goat anti-rabbit IgG) were purchased from Boster, China. Cat-A-Kit assay system was provided by Amersham, USA. METHODS: (1) Adult rat MSCs were isolated and cultured for the preparation of Akt-MSCs. (2) Forty male Wistar rats were intramyocardially administered adriamycin at 2 mg/kg over 3 days for a total of five times and once a week for additional five times thereafter to establish CHF models. At 2 weeks after final adriamycin treatment, 34 successful CHF rat models were randomized to three groups: Akt-MSCs (n = 11), simple MSCs (s-MSCs, n =11), and control (n = 12). Each group was intravenously administered Akt-MSCs (2×106 cells in 100 μL PBS), s-MSCs (2×106 cells in 100 μL PBS) or equal volume of phosphate buffered saline, once a day for a total of three times. MAIN OUTCOME MEASURES: At 4 weeks after final adriamycin treatment, myocardial norepi- nephrine (NE) content was detected using a Cat-A-Kit assay system. Myocardial ChAT, SYN and GAP-43 were performed by immunohistochemistry and Western blot analysis. Prior to, 2 and 4 weeks after adriamycin treatment, echocardiographic examination was performed and left ventricular ejection fraction (LVEF) was determined. RESULTS: Myocardial NE content, as well as SYN-positive and GAP-43-positive nerve fiber density and expression, and LVEF, was the greatest in the Akt-MSCs group, followed by the s-MSCs group, and lastly the control group (P < 0.05 or P < 0.01). ChAT expression was similar between Akt-MSCs and s-MSCs groups, but it was higher compared with the control group (P < 0.05). NE contents were negatively correlated to LVEF (r = -0.64, P = 0.015). CONCLUSION: Transplantation of MSCs, in particular Akt-MSCs, promotes cardiac nervous regeneration in failing heart, which might be mediated by GAP-43.展开更多
This study sought to conduct a bibliometric analysis of acupuncture studies focusing on heart rate variability(HRV)and to investigate the correlation between various acupoints and their effects on HRV by utilizing ass...This study sought to conduct a bibliometric analysis of acupuncture studies focusing on heart rate variability(HRV)and to investigate the correlation between various acupoints and their effects on HRV by utilizing association rule mining and network analysis.A total of 536 publications on the topic of acupuncture studies based on HRV.The disease keyword analysis revealed that HRV-related acupuncture studies were mainly related to pain,inflammation,emotional disorders,gastrointestinal function,and hypertension.A separate analysis was conducted on acupuncture prescriptions,and Neiguan(PC6)and Zusanli(ST36)were the most frequently used acupoints.The core acupoints for HRV regulation were identified as PC6,ST36,Shenmen(HT7),Hegu(LI4),Sanyinjiao(SP6),Jianshi(PC5),Taichong(LR3),Quchi(LI11),Guanyuan(CV4),Baihui(GV20),and Taixi(KI3).Additionally,the research encompassed 46 reports on acupuncture animal experiments conducted on HRV,with ST36 being the most frequently utilized acupoint.The research presented in this study offers valuable insights into the global research trend and hotspots in acupuncture-based HRV studies,as well as identifying frequently used combinations of acupoints.The findings may be helpful for further research in this field and provide valuable information about the potential use of acupuncture for improving HRV in both humans and animals.展开更多
The current randomized controlled trial was performed at the China Rehabilitation Science Institute, China to test the hypothesis that musical auditory stimulation has positive effects on the autonomic nervous system ...The current randomized controlled trial was performed at the China Rehabilitation Science Institute, China to test the hypothesis that musical auditory stimulation has positive effects on the autonomic nervous system of patients with disorder of consciousness.Although past studies have recommended that patients with disorder of consciousness listen to patient-preferred music, this practice is not universally accepted by researchers.Twenty patients with severe disorder of consciousness listened to either therapist-selected(n = 10, 6 males and 4 females;43.33 ± 18.76 years old) or patient-preferred(n = 10, 5 males and 5 females, 48.83 ± 18.79 years old) musical therapy, 30 minutes/day, 5 times/week for 6 weeks.The results showed no obvious differences in heart rate variability-related parameters including heart rate, standard deviation of normal-to-normal R-R intervals, and the root-mean-square of successive heartbeat interval differences of successive heartbeat intervals between the two groups of patients.However, percentage of differences exceeding 50 ms between adjacent normal number of intervals, low-frequency power/high-frequency power, high-frequency power norm, low-frequency power norm, and total power were higher in patients receiving therapist-selected music than in patients receiving their own preferred music.In contrast, this relationship was reversed for the high-frequency power and very-low-frequency band.These results suggest that compared with preferred musical stimulation, therapist-selected musical stimulation resulted in higher interactive activity of the autonomic nervous system.Therefore, therapist-selected musical stimulation should be used to arouse the autonomic nervous system of patients with disorder of consciousness.This study was approved by the Institutional Ethics Committee of China Rehabilitation Research Center, China(approval No.2018-022-1) on March 12, 2018 and registered with the Chinese Clinical Trial Registry(registration number Chi CTR1800017809) on August 15, 2018.展开更多
BACKGROUND Vitamin C(VC)is a common antioxidant with cell protection potentials.However,its possible protective effect on cardiac autonomic nerves from diabetic induced insults is yet to be explored.AIM To investigate...BACKGROUND Vitamin C(VC)is a common antioxidant with cell protection potentials.However,its possible protective effect on cardiac autonomic nerves from diabetic induced insults is yet to be explored.AIM To investigate the effects of VC on diabetic cardiac autonomic neuropathy.METHODS Thirty male Wistar rats were equally grouped into control,diabetic and diabetic+VC.Type 2 diabetes was induced with fructose diet and alloxan.VC(1 g/kg)was administered for 4 wk via oral canula.Blood pressure and heart rate were measured non-invasively using tail flick blood pressure monitor.Spectral analysis of heart rate variability(HRV)was used to assess cardiac autonomic neuropathy.Blood was collected from the ocular sinus for biochemical analysis.Urethane(1 g/kg-ip)was used for anaesthesia prior to HRV and cervical dislocation to harvest hearts.Intracardiac autonomic nerve was assessed using tyrosine hydroxylase immunohistochemistry on fixed heart sections.RESULTS Results were analysed using ANOVA atα0.05.Unlike VC and control groups,diabetic rats showed significantly(P<0.0001)reduced HRV,increased heart-rate and blood pressure,initial increase in cardiac tyrosine hydroxylase activities at week-2 and sparse activity at week-4 of diabetes.Furthermore,apolipoprotein B,Oxidative stress and inflammatory markers were significantly(P<0.01)reduced in VC treated rats.CONCLUSION VC possesses cardio-autonomic nerve protective potential and ameliorates the symptoms of cardiac autonomic neuropathy in type 2 diabetes.The possible mechanisms via which VC exert these effects may be via downregulation of oxidative stress,inflammation and apolipoprotein B.展开更多
In October 2021,an international collaborative study on the use of electroacupuncture(EA)to treat inflammation was published in the journal Nature by Dr.Qiufu Ma’s team.Based on the results of EA on inflammation in t...In October 2021,an international collaborative study on the use of electroacupuncture(EA)to treat inflammation was published in the journal Nature by Dr.Qiufu Ma’s team.Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm,the study showed that the distal effect of acupuncture can be achieved by“driving the vagus-adrenal axis(through the adrenal medulla,by releasing catecholamines).”PROKR2Cre-marked sensory neurons,which innervate the deep hindlimb fascia but not the abdominal fascia,are crucial for driving this axis.The study suggests the existence of specificity distribution of acupoints,that different EA stimulation intensities or different needle penetration depths have different therapeutic effects,that photosensitive stimulation may be a substitute for needle acupuncture,and that massage,stretching and body movements may also activate PROKR2Cremarkable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects.However,results of some other studies are contrary to the conclusions of Ma’s team.For examples:low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation,which is more relevant to the real daily acupuncture practice,and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone;manual acupuncture(similar to the low-intensity EA)at KI3,Zhichuan point(an extra point),etc.was effective in a severe COVID-19 patient with sepsis;stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations;the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings.Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems,multi-levels and multi-targets,which does not limit to“driving the vagus-adrenal axis.”展开更多
Background:The high rate of urogenital dysfunction after traditional total mesorectal excision(TME)has caused doubts among scholars on the standard fashion of dissection.We have proposed the necessity to preserve the ...Background:The high rate of urogenital dysfunction after traditional total mesorectal excision(TME)has caused doubts among scholars on the standard fashion of dissection.We have proposed the necessity to preserve the Denonvilliers’fascia in patients with rectal cancer.However,how to accurately locate the Denonvilliers’fascia is unclear.This study aimed to explore anatomical features of the Denonvilliers’fascia by comparing autopsy findings and observations of surgical videos so as to propose a dissection method for the preservation of pelvic autonomic nerves during rectal cancer surgery.Methods:Five adult male cadaver specimens were dissected,and surgical videos of 135 patients who underwent TME for mid-low rectal cancer between January 2009 and February 2019 were reviewed to identify and compare the structure of the Denonvilliers’fascia.Results:The monolayer structure of the Denonvilliers’fascia was observed in 5 male cadaver specimens,and it was located between the rectum,the bottom of the bladder,the seminal vesicles,the vas deferens,and the prostate.The Denonvilliers’fascia was originated from the rectovesical pouch(or rectum-uterus pouch),down to fuse caudally with the rectourethral muscle at the apex of the prostate,and fused to the lateral ligaments on both sides.The fascia was thinner on the midline with a thickness of 1.06±0.10 mm.The crown shape of the Denonvilliers’fascia was slightly triangular,with a height of approximately 5.42±0.16 cm at midline.Nerves were more densely distributed in front of the Denonvilliers’fascia than behind,especially on both sides of it.Under laparoscopic view,the Denonvilliers’fascia was originated at the lowest point of the rectovesical pouch(or rectum-uterus pouch),with a thickened white line which was a good mark for identifying the Denonvilliers’fascia.Conclusion:Identification of the surgical indication line for the Denonvilliers’fascia could help us identify the Denonvilliers’fascia,and it would improve our ability to protect the pelvic autonomic function of patients undergoing TME for rectal cancer.展开更多
文摘Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of rectal cancer in our hospital from April 2018 to April 2023 were selected,and 60 patients who met the requirements were included as research subjects.The patients were divided into an experimental group and a reference group by a double-blind mechanism,with 30 cases in each group.The experimental group underwent laparoscopic pelvic autonomic radical resection,while the reference group underwent ordinary radical resection.The voiding function,urodynamics,sexual function,and blood indexes of the patients of both groups were compared.Results:The total incidence of voiding dysfunction in the experimental group was significantly lower than in the reference group(P<0.05).Urodynamics such as abdominal leak point pressure(ALPP),maximum urethral pressure(MUP),maximum urethral closure pressure(MUCP),and functional urethral length(FUL)in the experimental group were significantly better than those in the reference group(P<0.05).The incidences of erectile dysfunction and ejaculatory dysfunction in the experimental group were significantly lower than those in the reference group(P<0.05).Before the surgery,there were no significant differences in the blood indexes such as C-reactive protein(CRP),cortisol(Cor),and pre-albumin(PA)between the two groups(P>0.05);after the operation,the blood indexes of the patients in the experimental group were significantly better than those in the reference group(P<0.05).Conclusion:Laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer has lesser effects on urinary and sexual functions.
基金Scientific Research Program of Higher Education Institute in Liaoning Province, No. 2008S248
文摘BACKGROUND: Transplantation of Akt-over-expressing mesenchymal stem cells (Akt-MSCs) has been shown to repair infarcted myocardium and improve cardiac function. However, little is known about the therapeutic effects of Akt-MSCs on cardiac autonomic neuropathy in chronic heart failure (CHF). OBJECTIVE: The present study used adriamycin-induced CHF rat models to observe the effect of Akt-MSCs on cardiac autonomic nervous regeneration and the factors mediating this effect. DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at the Central Laboratory of Basic Medical College, China Medical University, between September 2008 and April 2009. MATERIALS: Rabbit anti-choline acetyltransferase (ChAT), growth associated protein-43 (GAP-43), synaptophysin (SYN) polyclonal antibodies and the secondary antibody (goat anti-rabbit IgG) were purchased from Boster, China. Cat-A-Kit assay system was provided by Amersham, USA. METHODS: (1) Adult rat MSCs were isolated and cultured for the preparation of Akt-MSCs. (2) Forty male Wistar rats were intramyocardially administered adriamycin at 2 mg/kg over 3 days for a total of five times and once a week for additional five times thereafter to establish CHF models. At 2 weeks after final adriamycin treatment, 34 successful CHF rat models were randomized to three groups: Akt-MSCs (n = 11), simple MSCs (s-MSCs, n =11), and control (n = 12). Each group was intravenously administered Akt-MSCs (2×106 cells in 100 μL PBS), s-MSCs (2×106 cells in 100 μL PBS) or equal volume of phosphate buffered saline, once a day for a total of three times. MAIN OUTCOME MEASURES: At 4 weeks after final adriamycin treatment, myocardial norepi- nephrine (NE) content was detected using a Cat-A-Kit assay system. Myocardial ChAT, SYN and GAP-43 were performed by immunohistochemistry and Western blot analysis. Prior to, 2 and 4 weeks after adriamycin treatment, echocardiographic examination was performed and left ventricular ejection fraction (LVEF) was determined. RESULTS: Myocardial NE content, as well as SYN-positive and GAP-43-positive nerve fiber density and expression, and LVEF, was the greatest in the Akt-MSCs group, followed by the s-MSCs group, and lastly the control group (P < 0.05 or P < 0.01). ChAT expression was similar between Akt-MSCs and s-MSCs groups, but it was higher compared with the control group (P < 0.05). NE contents were negatively correlated to LVEF (r = -0.64, P = 0.015). CONCLUSION: Transplantation of MSCs, in particular Akt-MSCs, promotes cardiac nervous regeneration in failing heart, which might be mediated by GAP-43.
基金supported by the Natural Science Foundation of Sichuan Province(2023NSFSC1799)the Science and Technology Development Fund of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine(21ZS05,23YY07)Chengdu University of Traditional Chinese Medicine Xinglin Scholar Postdoctoral Program BSH2023010.
文摘This study sought to conduct a bibliometric analysis of acupuncture studies focusing on heart rate variability(HRV)and to investigate the correlation between various acupoints and their effects on HRV by utilizing association rule mining and network analysis.A total of 536 publications on the topic of acupuncture studies based on HRV.The disease keyword analysis revealed that HRV-related acupuncture studies were mainly related to pain,inflammation,emotional disorders,gastrointestinal function,and hypertension.A separate analysis was conducted on acupuncture prescriptions,and Neiguan(PC6)and Zusanli(ST36)were the most frequently used acupoints.The core acupoints for HRV regulation were identified as PC6,ST36,Shenmen(HT7),Hegu(LI4),Sanyinjiao(SP6),Jianshi(PC5),Taichong(LR3),Quchi(LI11),Guanyuan(CV4),Baihui(GV20),and Taixi(KI3).Additionally,the research encompassed 46 reports on acupuncture animal experiments conducted on HRV,with ST36 being the most frequently utilized acupoint.The research presented in this study offers valuable insights into the global research trend and hotspots in acupuncture-based HRV studies,as well as identifying frequently used combinations of acupoints.The findings may be helpful for further research in this field and provide valuable information about the potential use of acupuncture for improving HRV in both humans and animals.
基金supported by the Beijing Science and Technology Project Foundation of China, No.Z181100001718066(to HTL)。
文摘The current randomized controlled trial was performed at the China Rehabilitation Science Institute, China to test the hypothesis that musical auditory stimulation has positive effects on the autonomic nervous system of patients with disorder of consciousness.Although past studies have recommended that patients with disorder of consciousness listen to patient-preferred music, this practice is not universally accepted by researchers.Twenty patients with severe disorder of consciousness listened to either therapist-selected(n = 10, 6 males and 4 females;43.33 ± 18.76 years old) or patient-preferred(n = 10, 5 males and 5 females, 48.83 ± 18.79 years old) musical therapy, 30 minutes/day, 5 times/week for 6 weeks.The results showed no obvious differences in heart rate variability-related parameters including heart rate, standard deviation of normal-to-normal R-R intervals, and the root-mean-square of successive heartbeat interval differences of successive heartbeat intervals between the two groups of patients.However, percentage of differences exceeding 50 ms between adjacent normal number of intervals, low-frequency power/high-frequency power, high-frequency power norm, low-frequency power norm, and total power were higher in patients receiving therapist-selected music than in patients receiving their own preferred music.In contrast, this relationship was reversed for the high-frequency power and very-low-frequency band.These results suggest that compared with preferred musical stimulation, therapist-selected musical stimulation resulted in higher interactive activity of the autonomic nervous system.Therefore, therapist-selected musical stimulation should be used to arouse the autonomic nervous system of patients with disorder of consciousness.This study was approved by the Institutional Ethics Committee of China Rehabilitation Research Center, China(approval No.2018-022-1) on March 12, 2018 and registered with the Chinese Clinical Trial Registry(registration number Chi CTR1800017809) on August 15, 2018.
基金Afe Babalola University Ado-Ekiti for granting funds to support this research
文摘BACKGROUND Vitamin C(VC)is a common antioxidant with cell protection potentials.However,its possible protective effect on cardiac autonomic nerves from diabetic induced insults is yet to be explored.AIM To investigate the effects of VC on diabetic cardiac autonomic neuropathy.METHODS Thirty male Wistar rats were equally grouped into control,diabetic and diabetic+VC.Type 2 diabetes was induced with fructose diet and alloxan.VC(1 g/kg)was administered for 4 wk via oral canula.Blood pressure and heart rate were measured non-invasively using tail flick blood pressure monitor.Spectral analysis of heart rate variability(HRV)was used to assess cardiac autonomic neuropathy.Blood was collected from the ocular sinus for biochemical analysis.Urethane(1 g/kg-ip)was used for anaesthesia prior to HRV and cervical dislocation to harvest hearts.Intracardiac autonomic nerve was assessed using tyrosine hydroxylase immunohistochemistry on fixed heart sections.RESULTS Results were analysed using ANOVA atα0.05.Unlike VC and control groups,diabetic rats showed significantly(P<0.0001)reduced HRV,increased heart-rate and blood pressure,initial increase in cardiac tyrosine hydroxylase activities at week-2 and sparse activity at week-4 of diabetes.Furthermore,apolipoprotein B,Oxidative stress and inflammatory markers were significantly(P<0.01)reduced in VC treated rats.CONCLUSION VC possesses cardio-autonomic nerve protective potential and ameliorates the symptoms of cardiac autonomic neuropathy in type 2 diabetes.The possible mechanisms via which VC exert these effects may be via downregulation of oxidative stress,inflammation and apolipoprotein B.
文摘In October 2021,an international collaborative study on the use of electroacupuncture(EA)to treat inflammation was published in the journal Nature by Dr.Qiufu Ma’s team.Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm,the study showed that the distal effect of acupuncture can be achieved by“driving the vagus-adrenal axis(through the adrenal medulla,by releasing catecholamines).”PROKR2Cre-marked sensory neurons,which innervate the deep hindlimb fascia but not the abdominal fascia,are crucial for driving this axis.The study suggests the existence of specificity distribution of acupoints,that different EA stimulation intensities or different needle penetration depths have different therapeutic effects,that photosensitive stimulation may be a substitute for needle acupuncture,and that massage,stretching and body movements may also activate PROKR2Cremarkable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects.However,results of some other studies are contrary to the conclusions of Ma’s team.For examples:low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation,which is more relevant to the real daily acupuncture practice,and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone;manual acupuncture(similar to the low-intensity EA)at KI3,Zhichuan point(an extra point),etc.was effective in a severe COVID-19 patient with sepsis;stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations;the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings.Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems,multi-levels and multi-targets,which does not limit to“driving the vagus-adrenal axis.”
基金Sun Yat-sen University clinical research 5010 program,Grant/Award Number:2016Y9031。
文摘Background:The high rate of urogenital dysfunction after traditional total mesorectal excision(TME)has caused doubts among scholars on the standard fashion of dissection.We have proposed the necessity to preserve the Denonvilliers’fascia in patients with rectal cancer.However,how to accurately locate the Denonvilliers’fascia is unclear.This study aimed to explore anatomical features of the Denonvilliers’fascia by comparing autopsy findings and observations of surgical videos so as to propose a dissection method for the preservation of pelvic autonomic nerves during rectal cancer surgery.Methods:Five adult male cadaver specimens were dissected,and surgical videos of 135 patients who underwent TME for mid-low rectal cancer between January 2009 and February 2019 were reviewed to identify and compare the structure of the Denonvilliers’fascia.Results:The monolayer structure of the Denonvilliers’fascia was observed in 5 male cadaver specimens,and it was located between the rectum,the bottom of the bladder,the seminal vesicles,the vas deferens,and the prostate.The Denonvilliers’fascia was originated from the rectovesical pouch(or rectum-uterus pouch),down to fuse caudally with the rectourethral muscle at the apex of the prostate,and fused to the lateral ligaments on both sides.The fascia was thinner on the midline with a thickness of 1.06±0.10 mm.The crown shape of the Denonvilliers’fascia was slightly triangular,with a height of approximately 5.42±0.16 cm at midline.Nerves were more densely distributed in front of the Denonvilliers’fascia than behind,especially on both sides of it.Under laparoscopic view,the Denonvilliers’fascia was originated at the lowest point of the rectovesical pouch(or rectum-uterus pouch),with a thickened white line which was a good mark for identifying the Denonvilliers’fascia.Conclusion:Identification of the surgical indication line for the Denonvilliers’fascia could help us identify the Denonvilliers’fascia,and it would improve our ability to protect the pelvic autonomic function of patients undergoing TME for rectal cancer.
