Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from Nov...Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.展开更多
Henry Vandyke Carter(1831–1897),physician and illustrator from Saint George’s Hospital in London,England.He worked with Henry Williamson Gray(1827–1861)on anatomical dissections and Carter’s illustrations contribu...Henry Vandyke Carter(1831–1897),physician and illustrator from Saint George’s Hospital in London,England.He worked with Henry Williamson Gray(1827–1861)on anatomical dissections and Carter’s illustrations contributed significantly to the success of the Treaty of Anatomy,Descriptive and Surgical.Henry Carter never achieved any credit or royalty for his work.This book is currently regarded as one of the most influential human anatomy textbooks.The paper aims to present a brief review of Henry Carter’s contributions to the medical field.展开更多
The visualization and evaluation of fruit vascular bundles in grape are indispensable for understanding the development and growth of the fruit. The vascular bundles in grape are as thin as human hair, and strongly ad...The visualization and evaluation of fruit vascular bundles in grape are indispensable for understanding the development and growth of the fruit. The vascular bundles in grape are as thin as human hair, and strongly adhere to flesh cells, making it difficult to isolate individual intact vessel elements. Currently there is little information about methods to characterize grape vascular tissue. In this study, we describe an easy and effective technique to visualize the xylem cell structure of the ‘Red Globe' grape(Vitis L.). The intact vascular bundles of the grape were isolated through enzymatic degradation of flesh cells by hydrolases which were effective in removing flesh cells from vascular bundles. This enabled the illustration of the fine surface structure of vessel elements and their arrangement in the vascular bundles of the grape. This modified method to separate the vascular bundles into individual vessel elements was more effective than former methods of manually shaking to isolate individual vessels. Clear images of xylem vessel arrangement and structural characteristics of individual vessel element were acquired by light microscopy(BX51, Olympus, Tokyo, Japan), transmission electron microscopy(Tecnai 12, Philips, Netherlands) and scanning electron microscopy(GeminiSEM 300, Carl Zeiss, Germany). In addition, the 3D structure of vessel elements was observed using confocal laser scanning microscopy(Zeiss: model: LSM-880, Oberkochen, Germany). The imaging techniques for visualizing and analyzing the structure of xylem vessels in grape described in this study are an improvement of past methods. An effective method to isolate grape vascular bundles from flesh cells was also developed, which enables the imaging of the fine surface structure of vessel elements and their arrangement in grape vascular bundles. By adjusting the process of maceration of vascular bundles, an easy and effective method was developed to gently disrupt the plant tissue and isolate individual vessel elements. These improved techniques are suitable to observe the intact morphology of vascular bundles in the grape, improve experimental efficiency and accelerate new discoveries on the anatomical structure of the grape.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP)is the preferred modality for drainage of the obstructed biliary tree.In patients with surgically altered anatomy,ERCP using standard techniques may not be feasible....Endoscopic retrograde cholangiopancreatography(ERCP)is the preferred modality for drainage of the obstructed biliary tree.In patients with surgically altered anatomy,ERCP using standard techniques may not be feasible.Enteroscope assisted ERCP is usually employed with variable success rate.With advent of endoscopic ultrasound(EUS),biliary drainage procedures in patients with biliary obstruction and surgically altered anatomy is safe and effective.In this narrative review,we discuss role of EUS guided biliary drainage in patients with altered anatomy and the various approaches used in patients with benign and malignant biliary obstruction.展开更多
BACKGROUND Total mesorectal excision along the“holy plane”is the only radical surgery for rectal cancer,regardless of tumor size,localization or even tumor stage.However,according to the concept of membrane anatomy,...BACKGROUND Total mesorectal excision along the“holy plane”is the only radical surgery for rectal cancer,regardless of tumor size,localization or even tumor stage.However,according to the concept of membrane anatomy,multiple fascial spaces around the rectum could be used as the surgical plane to achieve radical resection.AIM To propose a new membrane anatomical and staging-oriented classification system for tailoring the radicality during rectal cancer surgery.METHODS A three-dimensional template of the member anatomy of the pelvis was established,and the existing anatomical nomenclatures were clarified by cadaveric dissection study and laparoscopic surgical observation.Then,we suggested a new and simple classification system for rectal cancer surgery.For simplification,the classification was based only on the lateral extent of resection.RESULTS The fascia propria of the rectum,urogenital fascia,vesicohypogastric fascia and parietal fascia lie side by side around the rectum and form three spaces(medial,middle and lateral),and blood vessels and nerves are precisely positioned in the fascia or space.Three types of radical surgery for rectal cancer are described,as are a few subtypes that consider nerve preservation.The surgical planes of the proposed radical surgeries(types A,B and C)correspond exactly to the medial,middle,and lateral spaces,respectively.CONCLUSION Three types of radical surgery can be precisely defined based on membrane anatomy,including nerve-sparing procedures.Our classification system may offer an optimal tool for tailoring rectal cancer surgery.展开更多
Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to s...Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to study the epidemiological, clinical and pathological aspects of Helicobacter pylori infection among adults in a digestive endoscopy unit and the pathological anatomy service of Parakou. Patients and Methods: This was a descriptive and analytical cross-sectional study conducted from January 2020 to September 2020 in the digestive endoscopy unit and pathological anatomy service at the Departmental University Hospital Center of Borgou. Patients aged 18 years and older, who had undergone a gastroscopy with biopsies and who gave their oral consent were included. Three antral biopsies and two fundic biopsies were performed. The search for Hp was done under an optical microscope after staining with hematoxylin eosin. Results: A total of 151 patients were included and 51.66% were infected with Hp. Their average age was 40.63 ± 15.32 years and the sex ratio was 0.9. Epigastric pain was the most reported symptom (71.01%). Endoscopically, the prevalence of erythematous gastropathy was 98.72%. The study of chronic Hp gastritis according to Sydney system had shown signs of activity in 100% of patients with Hp and glandular atrophy in 83.33% of them. Intestinal metaplasia and dysplasia accounted for 24.35% and 29.48% of cases, respectively. Factors associated with Hp infection were: absence of proton pump inhibitor intake prior to examination, absence of handwashing with soap and water before eating, erythematous aspect of gastritis on gastroscopy, absence of intestinal metaplasia of the fundus, active and chronic aspects of gastritis on histology. Conclusion: The frequency of Hp infection in hospitals among adults admitted to the Digestive Endoscopy Unit of Parakou is high. To reduce this prevalence, it will be necessary to act on the factors identified.展开更多
Background Anatomy is a required course for all medicine-related industries.In recent decades,the teaching quality and effect of anatomy have been compromised by factors including a decrease in human body specimens,da...Background Anatomy is a required course for all medicine-related industries.In recent decades,the teaching quality and effect of anatomy have been compromised by factors including a decrease in human body specimens,dampened enthusiasm for the discipline,reduced teaching hours of anatomy,scale expansion of medical education,and obstacles in performing field autopsies and observations.Methods Based on China's digitalized visible human research achievements,this article extracts the boundary information of anatomic structures from tomographic images,constructs three dimensional(3D)digital anatomical models with authentic texture information,and develops an anatomy assistive teaching system for teachers and students based on the knowledge points of anatomy,to meet the anatomy teaching requirements of different majors at various levels.Results This scientific,complete,and holistic system has produced over 60003D digital anatomical models,5000 anatomy knowledge points,50 anatomical operation videos,and 150 micro demonstration classes,with teaching contents for different majors and levels,such as systematic anatomy,topographic anatomy,sectional anatomy,anatomy of motion,and virtual anatomical operation table.Ranging from network terminals,desktops,touchscreen 3D displays,desktops,and projection 3D volumetric displays to augmented reality,its diversified interactive forms meet the requirements for a learning environment in different settings.Conclusions With multiple teaching and learning links covered,such as teaching environment,teaching resources,instructional slides,autonomous learning,and learning effect evaluation,this novel teaching system serves as a vital component and a necessary resource in anatomy teaching and functions as an important supplement to traditional anatomy teaching.Applied and promoted in most medical colleges and schools in China,this system has been recognized and approved by anatomy teachers and students,and plays a positive role in guaranteeing the effect and quality of anatomy teaching.展开更多
Specimen observation and dissection have been regarded as the best approach to teach anatomy,but due to the severe lack of anatomical specimens in recent years,the quality of anatomy teaching has been seriously affect...Specimen observation and dissection have been regarded as the best approach to teach anatomy,but due to the severe lack of anatomical specimens in recent years,the quality of anatomy teaching has been seriously affected.In order to disseminate anatomical knowledge effectively under such circumstances,this study discusses three key factors(modeling,perception,and interaction)involved in constructing virtual anatomy teaching systems in detail.To ensure the authenticity,integrity,and accuracy of modeling,detailed three-dimensional(3D)digital anatomical models are constructed using multi-scale data,such as the Chinese Visible Human dataset,clinical imaging data,tissue sections,and other sources.The anatomical knowledge ontology is built according to the needs of the particular teaching purposes.Various kinds of anatomical knowledge and 3D digital anatomical models are organically combined to construct virtual anatomy teaching system by means of virtual reality equipment and technology.The perception of knowledge is realized by the Yi Chuang Digital Human Anatomy Teaching System that we have created.The virtual interaction mode,which is similar to actual anatomical specimen observation and dissection,can enhance the transmissibility of anatomical knowledge.This virtual anatomy teaching system captures the three key factors.It can provide realistic and reusable teaching resources,expand the new medical education model,and effectively improve the quality of anatomy teaching.展开更多
characteristics,complex content,and it is difficult to understand.In view of the nature of the subject,many different models and specimens are required during teaching,increasing the difficulty of its teaching.Althoug...characteristics,complex content,and it is difficult to understand.In view of the nature of the subject,many different models and specimens are required during teaching,increasing the difficulty of its teaching.Although the mode of medical teaching is constantly updating,anatomical specimens are still important in the teaching of anatomy,as they help students to understand the organs,their positions,and structural forms as well as to better grasp the theoretical aspect.In addition,anatomical specimens and medical students contact condition can affect the teaching effect.Therefore,it is imperative to give full play to the role of anatomical specimens in anatomy teaching to improve the teaching effect.This paper summarizes the research on the use of anatomical specimens in the teaching of anatomy.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types o...Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed.展开更多
AIM: To investigate the splenic hilar vascular anatomy and the influence of splenic artery(Sp A) type in laparoscopic total gastrectomy with spleen-preserving splenic lymphadenectomy(LTGSPL).METHODS:The clinical anato...AIM: To investigate the splenic hilar vascular anatomy and the influence of splenic artery(Sp A) type in laparoscopic total gastrectomy with spleen-preserving splenic lymphadenectomy(LTGSPL).METHODS:The clinical anatomy data of 317 patients with upper- or middle-third gastric cancer who underwent LTGSPL in our hospital from January 2011 to December 2013 were collected. The patients were divided into two groups(concentrated group vs distributed group) according to the distance between the splenic artery's furcation and the splenic hilar region. Then, the anatomical layout, clinicopathologic characteristics, intraoperative variables, and postoperative variables were compared between the two groups.RESULTS: There were 205 patients with a concentrated type(64.7%) and 112 patients with a distributed type(35.3%) Sp A. There were 22 patients(6.9%) with a single branch of the splenic lobar vessels, 250(78.9%) with 2 branches, 43(13.6%) with 3 branches, and 2 patients(0.6%) with multiple branches. Eighty sevenpatients(27.4%) had type?Ⅰ?splenic artery trunk, 211(66.6%) had type Ⅱ, 13(4.1%) had type Ⅲ, and 6(1.9%) had type Ⅳ. The mean splenic hilar lymphadenectomy time(23.15 ± 8.02 vs 26.21 ± 8.84 min; P = 0.002), mean blood loss resulting from splenic hilar lymphadenectomy(14.78 ± 11.09 vs 17.37 ± 10.62 m L; P = 0.044), and number of vascular clamps used at the splenic hilum(9.64 ± 2.88 vs 10.40 ± 3.57; P = 0.040) were significantly lower in the concentrated group than in the distributed group. However, the mean total surgical time, mean total blood loss, and the mean number of harvested splenic hilar lymph nodes were similar in both groups(P > 0.05 for each comparison). There were also no significant differences in clinicopathological and postoperative characteristics between the groups(P > 0.05).CONCLUSION: It is of value for surgeons to know the splenic hilar vascular anatomy when performing LTGSPL. Patients with concentrated type Sp A may be optimal patients for training new surgeons.展开更多
The existence and composition of the lateral ligaments of the rectum (LLR) are still the subjects of anatomical confusion and surgical misconception up to now. Since Miles proposed abdominoperineal excision as radical...The existence and composition of the lateral ligaments of the rectum (LLR) are still the subjects of anatomical confusion and surgical misconception up to now. Since Miles proposed abdominoperineal excision as radical surgery for rectal cancer, the identification by "hooking them on the finger" has been accepted by many surgeons with no doubt; clamping, dividing and ligating are considered to be essential procedures in mobilization of the rectum in many surgical textbooks. But in cadaveric studies, many anatomists could not find LLR described by the textbooks, and more and more surgeons also failed to find LLR during the proctectomy according to the principle of total mesorectal excision. The anatomy of LLR has diverse descriptions in literatures. According to our clinical observations, the traditional anatomical structures of LLR do exist; LLR are constant dense connective bundles which are located in either lateral side of the lower part of the rectum, run between rectal visceral fascia and pelvic parietal fascia above the levator ani, and covered by superior fascia of pelvic diaphragm. They are pathways of blood vessels and nerve fibers toward the rectum and lymphatic vessels from the lower rectum toward the iliac lymph nodes.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERC...Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERCP(BEA-ERCP) is a safe and effective procedure.However,further improvements in outcomes and the development of simplified procedures are required.Percutaneous treatment,Laparoscopy-assisted ERCP,endoscopic ultrasoundguided anterograde intervention,and open surgery are effective treatments.However,treatment should be noninvasive,effective,and safe.We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications.BEA-ERCP still requires high expertiselevel techniques and is far from a routinely performed procedure.Various techniques have been proposed to facilitate scope insertion(insertion with percutaneous transhepatic biliary drainage(PTBD) rendezvous technique,Short type single-balloon enteroscopes with passive bending section,Intraluminal injection of indigo carmine,CO2 inflation guidance),cannulation(PTBD or percutaneous transgallbladder drainage rendezvous technique,Dilation using screw drill,Rendezvous technique combining DBE with a cholangioscope,endoscopic ultrasound-guided rendezvous technique),and treatment(overtube-assisted technique,Short type balloon enteroscopes) during BEA-ERCP.The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients.A standard procedure for ERCP yet to be established for patients with a reconstructed intestine.At present,BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as firstline treatment.In this article,we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy.展开更多
Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of &qu...Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of "tension-free repair" is generally accepted, and surgical repairs with mesh are categorized as "hernioplasties". Surgeons should have good knowledge of the relevant anatomy. Physicians generally focus on the preperitoneal space, myopectineal orifice, topographic nerves, and regional vessels. Currently, laparoscopic surgery has therapeutic potential in the surgical setting for hernioplasty, with laparoscopic transabdominal preperitoneal(TAPP) repair appearing to be a powerful tool for use in adult hernia patients. TAPP offers the advantages of accurate diagnoses, repair of bilateral and recurrent hernias, less postoperative pain, early recovery allowing work and activities, tension-free repair of the preperitoneal(posterior) space, ability to cover obturator hernias, and avoidance of potential injury to the spermatic cord. The disadvantages of TAPP are the need for general anesthesia, adhering to a learning curve, higher cost, unexpected complications related to abdominal organs, adhesion to the mesh, unexpected injuries to vessels, prolonged operative time, and as-yet-unknown long-term outcomes. Both technical skill and anatomical familiarity are important for safe, reliable surgery. With increasing awareness of the importance of anatomy during TAPP repair, we address the skills and pitfalls during laparoscopic TAPP repair in adult patients using illustrations and schemas. We also address debatable points on this subject.展开更多
BACKGROUND:The clinicopathological features of uncinate process pancreatic cancer(UPPC) are poorly described.Furthermore the anatomy of the uncinate process and its division during surgery are central to pancreaticodu...BACKGROUND:The clinicopathological features of uncinate process pancreatic cancer(UPPC) are poorly described.Furthermore the anatomy of the uncinate process and its division during surgery are central to pancreaticoduodenectomy for UPPC.We set out to describe the embryology and anatomy of the uncinate process and the clinicopathological features of UPPC.DATA SOURCES:All published case series of UPPC were reviewed and included in this review.RESULTS:The true incidence of UPPC is difficult to quantify,with the reported incidence ranging from 2.5% to 10.7% of pancreatic cancer.There are 5 published series of UPPC including 117 patients,72 males and 45 females,aged from 45-53 years to 61-84 years.The median survival was 5 or 5.5 months in 3 of the series,12.1 months in another based only on potentially resectable lesions and 17 months in another based only on resected cases.CONCLUSIONS:The number of reported series of UPPC is limited,with vague symptoms as the predominant presenting features of the disease.The prognosis is poor with synchronous venous resection demonstrating a survival advantage.展开更多
AIM: To evaluate the efficacy of endoscopic ultrasound guided biliary drainage(EUS-BD) in patients with surgically altered anatomies.METHODS: We performed a search of the MEDLINE database for studies published between...AIM: To evaluate the efficacy of endoscopic ultrasound guided biliary drainage(EUS-BD) in patients with surgically altered anatomies.METHODS: We performed a search of the MEDLINE database for studies published between 2001 to July2014 reporting on EUS-BD in patients with surgically altered anatomy using the terms "EUS drainage" and "altered anatomy". All relevant articles were accessed in full text. A manual search of the reference lists of relevant retrieved articles was also performed. Only fulltext English papers were included. Data regarding age, gender, diagnosis, method of EUS-BD and intervention, type of altered anatomy, technical success, clinical success, and complications were extracted and collected. Anatomic alterations were categorized as: group 1, Billroth Ⅰ; group 2, Billroth Ⅱ; group 4, Rouxen-Y with gastric bypass; and group 3, all other types. RESULTS: Twenty three articles identified in the literature search, three reports were from the same group with different numbers of cases. In total, 101 cases of EUS-BD in patients with altered anatomy were identified. Twenty-seven cases had no information and were excluded. Seventy four cases were included for analysis. Data of EUS-BD in patients categorized as group 1, 2 and 4 were limited with 2, 3 and 6 cases with EUS-BD done respectively. Thirty four cases with EUS-BD were reported in group 3. The pooled technical success, clinical success, and complication rates of all reports with available data were 89.18%, 91.07% and 17.5%, respectively. The results are similar to the reported outcomes of EUS-BD in general, however, with limited data of EUS-BD in patients with altered anatomy rendered it difficult to draw a firm conclusion. CONCLUSION: EUS-BD may be an option for patients with altered anatomy after a failed endoscopic-retrogradecholangiography in centers with expertise in EUS-BD procedures in a research setting.展开更多
In rainfed areas of northwestern China,maize production is constrained mainly by low temperature during early growth and water limitation during the entire growth period.Plastic film mulching is commonly used to incre...In rainfed areas of northwestern China,maize production is constrained mainly by low temperature during early growth and water limitation during the entire growth period.Plastic film mulching is commonly used to increase maize yield in this area,because it increases topsoil temperature and moisture content as well as water use efficiency.However,the physiological and anatomical bases of maize yield improvement with plastic film mulching are not well understood.The effects of plastic film mulching and planting density on maize yield,photosynthetic characteristics,respiration,leaf anatomy,and root growth were studied in a two-year field experiment conducted on the Loess Plateau of China in 2017 and 2018.The experiment used a split-split plot design with two mulching treatments(plastic film mulching and no mulching),two planting densities(7.5×104 and10.5×104 plants ha-1),and two maize cultivars,Zhengdan 958 and Xianyu 335.Compared with no mulching,plastic film mulching increased maize yields by 31.1%–46.4%in 2017 and3.6%–34.7%in 2018.Compared with low planting density,high planting density significantly increased and slightly reduced yields of both cultivars in the dry year 2017 and the rainy year 2018,respectively.Plastic film mulching increased photosynthesis and respiration as well as leaf stomatal density and aperture.Photosynthetic rate,dark respiration,and stomatal conductance and aperture were lower at high planting than at low planting density.Maize yield was positively correlated with photosynthesis,dark respiration,and stomatal aperture.Mulching increased root dry weight and length in the 0–20 cm soil layer and root activity at maturity.Overall,the changes in root growth and leaf anatomy resulted in increased photosynthesis and dark respiration,and the increased photosynthesis contributed to the increase in grain yield and biomass production under plastic film mulching conditions.Our results increase understanding of the physiological mechanisms by which plastic film mulching increases maize yield in water-and temperature-limited areas.展开更多
DEAR EDITOR,The Chinese tree shrew(Tupaia belangeri chinensis)is a small mammal closely related to primates.It has a small body size,low maintenance cost,and a relatively short reproductive cycle,all of which has made...DEAR EDITOR,The Chinese tree shrew(Tupaia belangeri chinensis)is a small mammal closely related to primates.It has a small body size,low maintenance cost,and a relatively short reproductive cycle,all of which has made it the ideal model for the study of a variety of human diseases.In this study,we compared the anatomy of the skin of the Chinese tree shrew with that of the rhesus macaque,mouse and human,with the intention of providing the basic data required for the creation of skin disease models using this animal.Paraffin sections,hematoxylin-eosin(H&E)staining,masson staining and immunohistochemical techniques were used to examine the dorsal skin structure of the Chinese tree shrew.The epidermis was shown to be composed of 1–2 layers of cells.There were hair follicles,sebaceous glands and sweat glands in the dermis and the subcutaneous tissue,with apocrine glands being more common than eccrine glands.Both Keratin5(KRT5)and Keratin10(KRT10)were expressed in the skin of the Chinese tree shrew,with a localization in the cytoplasm.Overall,the skin morphology and histology of the Chinese tree shrew was basically the same as that of the human.We propose that the Chinese tree shrew has a strong potential to be used for creating animal models to help elucidate the molecular mechanisms underlying a variety of skin diseases.展开更多
Light spectrum plays an important role in regulating the growth and development of in vitro cultured potato(Solanum tuberosum L.) plantlets. The status of potato plantlets at the end of in vitro stage influences the m...Light spectrum plays an important role in regulating the growth and development of in vitro cultured potato(Solanum tuberosum L.) plantlets. The status of potato plantlets at the end of in vitro stage influences the minituber production after transplanting. With 100 μmol m^-2s^-1 total photosynthetic photon flux density(PPFD), a light spectrum study of 100% red light emitting diodes(LEDs) light spectrum(RR), 100% blue LEDs light spectrum(BB), 65% red+35% blue LEDs light spectrum(RB), and 45% red+35% blue+20% green LEDs light spectrum(RBG) providing illumination at the in vitro cultured stage of potato plantlets for 4 weeks using fluorescent lamp as control(CK) was performed to investigate the effects of LEDs light spectrum on the growth, leaf anatomy, and chloroplast ultrastructure of potato plantlets in vitro as well as the minituber yield after 2 months transplanting in the greenhouse. Compared to CK, RB and RBG promoted the growth of potato plantlets in vitro with increased stem diameter, plantlet fresh weight, plantlet dry weight, and health index. Furthermore, BB induced the greatest stem diameter as well as the highest health index in potato plantlets in vitro. Root activity, soluble protein, and free amino acid were also significantly enhanced by BB, whereas carbohydrates were improved by RR. In addition, thickness of leaf, palisade parenchyma and spongy parenchyma was significantly increased by BB and RBG. Chloroplasts under BB and RBG showed well-developed grana thylakoid and stroma thylakoid. Unexpectedly, distinct upper epidermis with greatest thickness was induced and palisade parenchyma and spongy parenchyma were arranged neatly in RR. After transplanting in the greenhouse for 2 months, potato plantlets in vitro from BB, RB, and RBG produced high percentage of large size tuber. BB improved fresh and dry weights of the biggest tuber but decreased tuber number per plantlet. In addition, RBG increased tuber number as well as tuber fresh and dry weight slightly. Our results suggested monochromatic blue LEDs as well as combined red, blue or/and green LEDs light spectrum were superior to fluorescent lamp spectrum in micro-propagation of potato plantlets. Therefore, the application of RBG was suitable;BB and RB could be used as alternatives.展开更多
The medial ulnar collateral ligament complex of the elbow, which is comprised of the anterior bundle [AB, more formally referred to as the medial ulnar collateral ligament(MUCL)], posterior(PB), and transverse ligamen...The medial ulnar collateral ligament complex of the elbow, which is comprised of the anterior bundle [AB, more formally referred to as the medial ulnar collateral ligament(MUCL)], posterior(PB), and transverse ligament, is commonly injured in overhead throwing athletes. Attenuation or rupture of the ligament results in valgus instability with variable clinical presentations. The AB or MUCL is the strongest component of the ligamentous complex and the primary restraint to valgus stress. It is also composed of two separate bands(anterior and posterior) that provide reciprocal function with the anterior band tight in extension, and the posterior band tight in flexion. In individuals who fail co-mprehensive non-operative treatment, surgical repair or reconstruction of the MUCL is commonly required to restore elbow function and stability. A comprehensive understanding of the anatomy and biomechanical properties of the MUCL is imperative to optimize reconstructive efforts, and to enhance clinical and radiographic outcomes. Our understanding of the native anatomy and biomechanics of the MUCL has evolved over time. The precise locations of the origin and insertion footprint centers guide surgeons in proper graft placement with relation to bony anatomic landmarks. In recent studies, the ulnar insertion of the MUCL is described as larger than previously thought, with the center of the footprint at varying distances relative to the ulnar ridge, joint line, or sublime tubercle. The purpose of this review is to consolidate and summarize the existing literature regarding the native anatomy, biomechanical, and clinical significance of the entire medial ulnar collateral ligament complex, including the MUCL(AB), PB, and transverse ligament.展开更多
文摘Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.
文摘Henry Vandyke Carter(1831–1897),physician and illustrator from Saint George’s Hospital in London,England.He worked with Henry Williamson Gray(1827–1861)on anatomical dissections and Carter’s illustrations contributed significantly to the success of the Treaty of Anatomy,Descriptive and Surgical.Henry Carter never achieved any credit or royalty for his work.This book is currently regarded as one of the most influential human anatomy textbooks.The paper aims to present a brief review of Henry Carter’s contributions to the medical field.
基金supported by the National Natural Science Foundation of China (Grant Nos. 31872050 and 32102348)。
文摘The visualization and evaluation of fruit vascular bundles in grape are indispensable for understanding the development and growth of the fruit. The vascular bundles in grape are as thin as human hair, and strongly adhere to flesh cells, making it difficult to isolate individual intact vessel elements. Currently there is little information about methods to characterize grape vascular tissue. In this study, we describe an easy and effective technique to visualize the xylem cell structure of the ‘Red Globe' grape(Vitis L.). The intact vascular bundles of the grape were isolated through enzymatic degradation of flesh cells by hydrolases which were effective in removing flesh cells from vascular bundles. This enabled the illustration of the fine surface structure of vessel elements and their arrangement in the vascular bundles of the grape. This modified method to separate the vascular bundles into individual vessel elements was more effective than former methods of manually shaking to isolate individual vessels. Clear images of xylem vessel arrangement and structural characteristics of individual vessel element were acquired by light microscopy(BX51, Olympus, Tokyo, Japan), transmission electron microscopy(Tecnai 12, Philips, Netherlands) and scanning electron microscopy(GeminiSEM 300, Carl Zeiss, Germany). In addition, the 3D structure of vessel elements was observed using confocal laser scanning microscopy(Zeiss: model: LSM-880, Oberkochen, Germany). The imaging techniques for visualizing and analyzing the structure of xylem vessels in grape described in this study are an improvement of past methods. An effective method to isolate grape vascular bundles from flesh cells was also developed, which enables the imaging of the fine surface structure of vessel elements and their arrangement in grape vascular bundles. By adjusting the process of maceration of vascular bundles, an easy and effective method was developed to gently disrupt the plant tissue and isolate individual vessel elements. These improved techniques are suitable to observe the intact morphology of vascular bundles in the grape, improve experimental efficiency and accelerate new discoveries on the anatomical structure of the grape.
文摘Endoscopic retrograde cholangiopancreatography(ERCP)is the preferred modality for drainage of the obstructed biliary tree.In patients with surgically altered anatomy,ERCP using standard techniques may not be feasible.Enteroscope assisted ERCP is usually employed with variable success rate.With advent of endoscopic ultrasound(EUS),biliary drainage procedures in patients with biliary obstruction and surgically altered anatomy is safe and effective.In this narrative review,we discuss role of EUS guided biliary drainage in patients with altered anatomy and the various approaches used in patients with benign and malignant biliary obstruction.
基金the National Natural Science Foundation of China,No.81874201Technology Plan Project,No.20Y11908300+2 种基金Shanghai Medical Key Specialty Construction Plan,No.ZK2019A19Shanghai Municipal Commission of Health and Family Planning,No.202040122and Shanghai Pujiang Program,No.21PJD066.
文摘BACKGROUND Total mesorectal excision along the“holy plane”is the only radical surgery for rectal cancer,regardless of tumor size,localization or even tumor stage.However,according to the concept of membrane anatomy,multiple fascial spaces around the rectum could be used as the surgical plane to achieve radical resection.AIM To propose a new membrane anatomical and staging-oriented classification system for tailoring the radicality during rectal cancer surgery.METHODS A three-dimensional template of the member anatomy of the pelvis was established,and the existing anatomical nomenclatures were clarified by cadaveric dissection study and laparoscopic surgical observation.Then,we suggested a new and simple classification system for rectal cancer surgery.For simplification,the classification was based only on the lateral extent of resection.RESULTS The fascia propria of the rectum,urogenital fascia,vesicohypogastric fascia and parietal fascia lie side by side around the rectum and form three spaces(medial,middle and lateral),and blood vessels and nerves are precisely positioned in the fascia or space.Three types of radical surgery for rectal cancer are described,as are a few subtypes that consider nerve preservation.The surgical planes of the proposed radical surgeries(types A,B and C)correspond exactly to the medial,middle,and lateral spaces,respectively.CONCLUSION Three types of radical surgery can be precisely defined based on membrane anatomy,including nerve-sparing procedures.Our classification system may offer an optimal tool for tailoring rectal cancer surgery.
文摘Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to study the epidemiological, clinical and pathological aspects of Helicobacter pylori infection among adults in a digestive endoscopy unit and the pathological anatomy service of Parakou. Patients and Methods: This was a descriptive and analytical cross-sectional study conducted from January 2020 to September 2020 in the digestive endoscopy unit and pathological anatomy service at the Departmental University Hospital Center of Borgou. Patients aged 18 years and older, who had undergone a gastroscopy with biopsies and who gave their oral consent were included. Three antral biopsies and two fundic biopsies were performed. The search for Hp was done under an optical microscope after staining with hematoxylin eosin. Results: A total of 151 patients were included and 51.66% were infected with Hp. Their average age was 40.63 ± 15.32 years and the sex ratio was 0.9. Epigastric pain was the most reported symptom (71.01%). Endoscopically, the prevalence of erythematous gastropathy was 98.72%. The study of chronic Hp gastritis according to Sydney system had shown signs of activity in 100% of patients with Hp and glandular atrophy in 83.33% of them. Intestinal metaplasia and dysplasia accounted for 24.35% and 29.48% of cases, respectively. Factors associated with Hp infection were: absence of proton pump inhibitor intake prior to examination, absence of handwashing with soap and water before eating, erythematous aspect of gastritis on gastroscopy, absence of intestinal metaplasia of the fundus, active and chronic aspects of gastritis on histology. Conclusion: The frequency of Hp infection in hospitals among adults admitted to the Digestive Endoscopy Unit of Parakou is high. To reduce this prevalence, it will be necessary to act on the factors identified.
基金Major Science and Technology Special Project of Shandong Province(Emerging Industry)(2015ZDXX0201A02)Key R&D Plan of Shandong Province in 2019(2019JZZY020106).
文摘Background Anatomy is a required course for all medicine-related industries.In recent decades,the teaching quality and effect of anatomy have been compromised by factors including a decrease in human body specimens,dampened enthusiasm for the discipline,reduced teaching hours of anatomy,scale expansion of medical education,and obstacles in performing field autopsies and observations.Methods Based on China's digitalized visible human research achievements,this article extracts the boundary information of anatomic structures from tomographic images,constructs three dimensional(3D)digital anatomical models with authentic texture information,and develops an anatomy assistive teaching system for teachers and students based on the knowledge points of anatomy,to meet the anatomy teaching requirements of different majors at various levels.Results This scientific,complete,and holistic system has produced over 60003D digital anatomical models,5000 anatomy knowledge points,50 anatomical operation videos,and 150 micro demonstration classes,with teaching contents for different majors and levels,such as systematic anatomy,topographic anatomy,sectional anatomy,anatomy of motion,and virtual anatomical operation table.Ranging from network terminals,desktops,touchscreen 3D displays,desktops,and projection 3D volumetric displays to augmented reality,its diversified interactive forms meet the requirements for a learning environment in different settings.Conclusions With multiple teaching and learning links covered,such as teaching environment,teaching resources,instructional slides,autonomous learning,and learning effect evaluation,this novel teaching system serves as a vital component and a necessary resource in anatomy teaching and functions as an important supplement to traditional anatomy teaching.Applied and promoted in most medical colleges and schools in China,this system has been recognized and approved by anatomy teachers and students,and plays a positive role in guaranteeing the effect and quality of anatomy teaching.
基金This work was funded by the National Natural Science Foundation of China(No.61190122).
文摘Specimen observation and dissection have been regarded as the best approach to teach anatomy,but due to the severe lack of anatomical specimens in recent years,the quality of anatomy teaching has been seriously affected.In order to disseminate anatomical knowledge effectively under such circumstances,this study discusses three key factors(modeling,perception,and interaction)involved in constructing virtual anatomy teaching systems in detail.To ensure the authenticity,integrity,and accuracy of modeling,detailed three-dimensional(3D)digital anatomical models are constructed using multi-scale data,such as the Chinese Visible Human dataset,clinical imaging data,tissue sections,and other sources.The anatomical knowledge ontology is built according to the needs of the particular teaching purposes.Various kinds of anatomical knowledge and 3D digital anatomical models are organically combined to construct virtual anatomy teaching system by means of virtual reality equipment and technology.The perception of knowledge is realized by the Yi Chuang Digital Human Anatomy Teaching System that we have created.The virtual interaction mode,which is similar to actual anatomical specimen observation and dissection,can enhance the transmissibility of anatomical knowledge.This virtual anatomy teaching system captures the three key factors.It can provide realistic and reusable teaching resources,expand the new medical education model,and effectively improve the quality of anatomy teaching.
文摘characteristics,complex content,and it is difficult to understand.In view of the nature of the subject,many different models and specimens are required during teaching,increasing the difficulty of its teaching.Although the mode of medical teaching is constantly updating,anatomical specimens are still important in the teaching of anatomy,as they help students to understand the organs,their positions,and structural forms as well as to better grasp the theoretical aspect.In addition,anatomical specimens and medical students contact condition can affect the teaching effect.Therefore,it is imperative to give full play to the role of anatomical specimens in anatomy teaching to improve the teaching effect.This paper summarizes the research on the use of anatomical specimens in the teaching of anatomy.
文摘Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed.
基金Supported by National Key Clinical Specialty Discipline Construction Program of China,No.[2012]649Key Project of Science and Technology Plan of Fujian Province,China,No.2014Y0025
文摘AIM: To investigate the splenic hilar vascular anatomy and the influence of splenic artery(Sp A) type in laparoscopic total gastrectomy with spleen-preserving splenic lymphadenectomy(LTGSPL).METHODS:The clinical anatomy data of 317 patients with upper- or middle-third gastric cancer who underwent LTGSPL in our hospital from January 2011 to December 2013 were collected. The patients were divided into two groups(concentrated group vs distributed group) according to the distance between the splenic artery's furcation and the splenic hilar region. Then, the anatomical layout, clinicopathologic characteristics, intraoperative variables, and postoperative variables were compared between the two groups.RESULTS: There were 205 patients with a concentrated type(64.7%) and 112 patients with a distributed type(35.3%) Sp A. There were 22 patients(6.9%) with a single branch of the splenic lobar vessels, 250(78.9%) with 2 branches, 43(13.6%) with 3 branches, and 2 patients(0.6%) with multiple branches. Eighty sevenpatients(27.4%) had type?Ⅰ?splenic artery trunk, 211(66.6%) had type Ⅱ, 13(4.1%) had type Ⅲ, and 6(1.9%) had type Ⅳ. The mean splenic hilar lymphadenectomy time(23.15 ± 8.02 vs 26.21 ± 8.84 min; P = 0.002), mean blood loss resulting from splenic hilar lymphadenectomy(14.78 ± 11.09 vs 17.37 ± 10.62 m L; P = 0.044), and number of vascular clamps used at the splenic hilum(9.64 ± 2.88 vs 10.40 ± 3.57; P = 0.040) were significantly lower in the concentrated group than in the distributed group. However, the mean total surgical time, mean total blood loss, and the mean number of harvested splenic hilar lymph nodes were similar in both groups(P > 0.05 for each comparison). There were also no significant differences in clinicopathological and postoperative characteristics between the groups(P > 0.05).CONCLUSION: It is of value for surgeons to know the splenic hilar vascular anatomy when performing LTGSPL. Patients with concentrated type Sp A may be optimal patients for training new surgeons.
文摘The existence and composition of the lateral ligaments of the rectum (LLR) are still the subjects of anatomical confusion and surgical misconception up to now. Since Miles proposed abdominoperineal excision as radical surgery for rectal cancer, the identification by "hooking them on the finger" has been accepted by many surgeons with no doubt; clamping, dividing and ligating are considered to be essential procedures in mobilization of the rectum in many surgical textbooks. But in cadaveric studies, many anatomists could not find LLR described by the textbooks, and more and more surgeons also failed to find LLR during the proctectomy according to the principle of total mesorectal excision. The anatomy of LLR has diverse descriptions in literatures. According to our clinical observations, the traditional anatomical structures of LLR do exist; LLR are constant dense connective bundles which are located in either lateral side of the lower part of the rectum, run between rectal visceral fascia and pelvic parietal fascia above the levator ani, and covered by superior fascia of pelvic diaphragm. They are pathways of blood vessels and nerve fibers toward the rectum and lymphatic vessels from the lower rectum toward the iliac lymph nodes.
文摘Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERCP(BEA-ERCP) is a safe and effective procedure.However,further improvements in outcomes and the development of simplified procedures are required.Percutaneous treatment,Laparoscopy-assisted ERCP,endoscopic ultrasoundguided anterograde intervention,and open surgery are effective treatments.However,treatment should be noninvasive,effective,and safe.We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications.BEA-ERCP still requires high expertiselevel techniques and is far from a routinely performed procedure.Various techniques have been proposed to facilitate scope insertion(insertion with percutaneous transhepatic biliary drainage(PTBD) rendezvous technique,Short type single-balloon enteroscopes with passive bending section,Intraluminal injection of indigo carmine,CO2 inflation guidance),cannulation(PTBD or percutaneous transgallbladder drainage rendezvous technique,Dilation using screw drill,Rendezvous technique combining DBE with a cholangioscope,endoscopic ultrasound-guided rendezvous technique),and treatment(overtube-assisted technique,Short type balloon enteroscopes) during BEA-ERCP.The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients.A standard procedure for ERCP yet to be established for patients with a reconstructed intestine.At present,BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as firstline treatment.In this article,we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy.
文摘Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of "tension-free repair" is generally accepted, and surgical repairs with mesh are categorized as "hernioplasties". Surgeons should have good knowledge of the relevant anatomy. Physicians generally focus on the preperitoneal space, myopectineal orifice, topographic nerves, and regional vessels. Currently, laparoscopic surgery has therapeutic potential in the surgical setting for hernioplasty, with laparoscopic transabdominal preperitoneal(TAPP) repair appearing to be a powerful tool for use in adult hernia patients. TAPP offers the advantages of accurate diagnoses, repair of bilateral and recurrent hernias, less postoperative pain, early recovery allowing work and activities, tension-free repair of the preperitoneal(posterior) space, ability to cover obturator hernias, and avoidance of potential injury to the spermatic cord. The disadvantages of TAPP are the need for general anesthesia, adhering to a learning curve, higher cost, unexpected complications related to abdominal organs, adhesion to the mesh, unexpected injuries to vessels, prolonged operative time, and as-yet-unknown long-term outcomes. Both technical skill and anatomical familiarity are important for safe, reliable surgery. With increasing awareness of the importance of anatomy during TAPP repair, we address the skills and pitfalls during laparoscopic TAPP repair in adult patients using illustrations and schemas. We also address debatable points on this subject.
文摘BACKGROUND:The clinicopathological features of uncinate process pancreatic cancer(UPPC) are poorly described.Furthermore the anatomy of the uncinate process and its division during surgery are central to pancreaticoduodenectomy for UPPC.We set out to describe the embryology and anatomy of the uncinate process and the clinicopathological features of UPPC.DATA SOURCES:All published case series of UPPC were reviewed and included in this review.RESULTS:The true incidence of UPPC is difficult to quantify,with the reported incidence ranging from 2.5% to 10.7% of pancreatic cancer.There are 5 published series of UPPC including 117 patients,72 males and 45 females,aged from 45-53 years to 61-84 years.The median survival was 5 or 5.5 months in 3 of the series,12.1 months in another based only on potentially resectable lesions and 17 months in another based only on resected cases.CONCLUSIONS:The number of reported series of UPPC is limited,with vague symptoms as the predominant presenting features of the disease.The prognosis is poor with synchronous venous resection demonstrating a survival advantage.
文摘AIM: To evaluate the efficacy of endoscopic ultrasound guided biliary drainage(EUS-BD) in patients with surgically altered anatomies.METHODS: We performed a search of the MEDLINE database for studies published between 2001 to July2014 reporting on EUS-BD in patients with surgically altered anatomy using the terms "EUS drainage" and "altered anatomy". All relevant articles were accessed in full text. A manual search of the reference lists of relevant retrieved articles was also performed. Only fulltext English papers were included. Data regarding age, gender, diagnosis, method of EUS-BD and intervention, type of altered anatomy, technical success, clinical success, and complications were extracted and collected. Anatomic alterations were categorized as: group 1, Billroth Ⅰ; group 2, Billroth Ⅱ; group 4, Rouxen-Y with gastric bypass; and group 3, all other types. RESULTS: Twenty three articles identified in the literature search, three reports were from the same group with different numbers of cases. In total, 101 cases of EUS-BD in patients with altered anatomy were identified. Twenty-seven cases had no information and were excluded. Seventy four cases were included for analysis. Data of EUS-BD in patients categorized as group 1, 2 and 4 were limited with 2, 3 and 6 cases with EUS-BD done respectively. Thirty four cases with EUS-BD were reported in group 3. The pooled technical success, clinical success, and complication rates of all reports with available data were 89.18%, 91.07% and 17.5%, respectively. The results are similar to the reported outcomes of EUS-BD in general, however, with limited data of EUS-BD in patients with altered anatomy rendered it difficult to draw a firm conclusion. CONCLUSION: EUS-BD may be an option for patients with altered anatomy after a failed endoscopic-retrogradecholangiography in centers with expertise in EUS-BD procedures in a research setting.
基金supported by the National Key Research and Development Program of China(2016YFD0300102)supported by the Innovation Program of the Chinese Academy of Agricultural Sciences and the Elite Youth Program of the Chinese Academy of Agricultural Sciences。
文摘In rainfed areas of northwestern China,maize production is constrained mainly by low temperature during early growth and water limitation during the entire growth period.Plastic film mulching is commonly used to increase maize yield in this area,because it increases topsoil temperature and moisture content as well as water use efficiency.However,the physiological and anatomical bases of maize yield improvement with plastic film mulching are not well understood.The effects of plastic film mulching and planting density on maize yield,photosynthetic characteristics,respiration,leaf anatomy,and root growth were studied in a two-year field experiment conducted on the Loess Plateau of China in 2017 and 2018.The experiment used a split-split plot design with two mulching treatments(plastic film mulching and no mulching),two planting densities(7.5×104 and10.5×104 plants ha-1),and two maize cultivars,Zhengdan 958 and Xianyu 335.Compared with no mulching,plastic film mulching increased maize yields by 31.1%–46.4%in 2017 and3.6%–34.7%in 2018.Compared with low planting density,high planting density significantly increased and slightly reduced yields of both cultivars in the dry year 2017 and the rainy year 2018,respectively.Plastic film mulching increased photosynthesis and respiration as well as leaf stomatal density and aperture.Photosynthetic rate,dark respiration,and stomatal conductance and aperture were lower at high planting than at low planting density.Maize yield was positively correlated with photosynthesis,dark respiration,and stomatal aperture.Mulching increased root dry weight and length in the 0–20 cm soil layer and root activity at maturity.Overall,the changes in root growth and leaf anatomy resulted in increased photosynthesis and dark respiration,and the increased photosynthesis contributed to the increase in grain yield and biomass production under plastic film mulching conditions.Our results increase understanding of the physiological mechanisms by which plastic film mulching increases maize yield in water-and temperature-limited areas.
基金supported by the Chinese Academy of Sciences(CAS zsys-02)CAS"Light of West China"Program(xbzg-zdsys-201909)。
文摘DEAR EDITOR,The Chinese tree shrew(Tupaia belangeri chinensis)is a small mammal closely related to primates.It has a small body size,low maintenance cost,and a relatively short reproductive cycle,all of which has made it the ideal model for the study of a variety of human diseases.In this study,we compared the anatomy of the skin of the Chinese tree shrew with that of the rhesus macaque,mouse and human,with the intention of providing the basic data required for the creation of skin disease models using this animal.Paraffin sections,hematoxylin-eosin(H&E)staining,masson staining and immunohistochemical techniques were used to examine the dorsal skin structure of the Chinese tree shrew.The epidermis was shown to be composed of 1–2 layers of cells.There were hair follicles,sebaceous glands and sweat glands in the dermis and the subcutaneous tissue,with apocrine glands being more common than eccrine glands.Both Keratin5(KRT5)and Keratin10(KRT10)were expressed in the skin of the Chinese tree shrew,with a localization in the cytoplasm.Overall,the skin morphology and histology of the Chinese tree shrew was basically the same as that of the human.We propose that the Chinese tree shrew has a strong potential to be used for creating animal models to help elucidate the molecular mechanisms underlying a variety of skin diseases.
基金supported by the National High-Tech R&D Program of China (2013 AA 103005)
文摘Light spectrum plays an important role in regulating the growth and development of in vitro cultured potato(Solanum tuberosum L.) plantlets. The status of potato plantlets at the end of in vitro stage influences the minituber production after transplanting. With 100 μmol m^-2s^-1 total photosynthetic photon flux density(PPFD), a light spectrum study of 100% red light emitting diodes(LEDs) light spectrum(RR), 100% blue LEDs light spectrum(BB), 65% red+35% blue LEDs light spectrum(RB), and 45% red+35% blue+20% green LEDs light spectrum(RBG) providing illumination at the in vitro cultured stage of potato plantlets for 4 weeks using fluorescent lamp as control(CK) was performed to investigate the effects of LEDs light spectrum on the growth, leaf anatomy, and chloroplast ultrastructure of potato plantlets in vitro as well as the minituber yield after 2 months transplanting in the greenhouse. Compared to CK, RB and RBG promoted the growth of potato plantlets in vitro with increased stem diameter, plantlet fresh weight, plantlet dry weight, and health index. Furthermore, BB induced the greatest stem diameter as well as the highest health index in potato plantlets in vitro. Root activity, soluble protein, and free amino acid were also significantly enhanced by BB, whereas carbohydrates were improved by RR. In addition, thickness of leaf, palisade parenchyma and spongy parenchyma was significantly increased by BB and RBG. Chloroplasts under BB and RBG showed well-developed grana thylakoid and stroma thylakoid. Unexpectedly, distinct upper epidermis with greatest thickness was induced and palisade parenchyma and spongy parenchyma were arranged neatly in RR. After transplanting in the greenhouse for 2 months, potato plantlets in vitro from BB, RB, and RBG produced high percentage of large size tuber. BB improved fresh and dry weights of the biggest tuber but decreased tuber number per plantlet. In addition, RBG increased tuber number as well as tuber fresh and dry weight slightly. Our results suggested monochromatic blue LEDs as well as combined red, blue or/and green LEDs light spectrum were superior to fluorescent lamp spectrum in micro-propagation of potato plantlets. Therefore, the application of RBG was suitable;BB and RB could be used as alternatives.
文摘The medial ulnar collateral ligament complex of the elbow, which is comprised of the anterior bundle [AB, more formally referred to as the medial ulnar collateral ligament(MUCL)], posterior(PB), and transverse ligament, is commonly injured in overhead throwing athletes. Attenuation or rupture of the ligament results in valgus instability with variable clinical presentations. The AB or MUCL is the strongest component of the ligamentous complex and the primary restraint to valgus stress. It is also composed of two separate bands(anterior and posterior) that provide reciprocal function with the anterior band tight in extension, and the posterior band tight in flexion. In individuals who fail co-mprehensive non-operative treatment, surgical repair or reconstruction of the MUCL is commonly required to restore elbow function and stability. A comprehensive understanding of the anatomy and biomechanical properties of the MUCL is imperative to optimize reconstructive efforts, and to enhance clinical and radiographic outcomes. Our understanding of the native anatomy and biomechanics of the MUCL has evolved over time. The precise locations of the origin and insertion footprint centers guide surgeons in proper graft placement with relation to bony anatomic landmarks. In recent studies, the ulnar insertion of the MUCL is described as larger than previously thought, with the center of the footprint at varying distances relative to the ulnar ridge, joint line, or sublime tubercle. The purpose of this review is to consolidate and summarize the existing literature regarding the native anatomy, biomechanical, and clinical significance of the entire medial ulnar collateral ligament complex, including the MUCL(AB), PB, and transverse ligament.
