BACKGROUND Endoscopic submucosal dissection is considered curative for patients with early rectal cancer when level of submucosal invasion is<1000 microns with favourable histopathological features.Recent data sugg...BACKGROUND Endoscopic submucosal dissection is considered curative for patients with early rectal cancer when level of submucosal invasion is<1000 microns with favourable histopathological features.Recent data suggests even deeper submucosal invasion can potentially be curative if R0 resection can be achieved and when no high-risk histopathological features are seen in the resected specimen.To achieve R0 resection,deeper dissection is required.CASE SUMMARY A 66 year old New Zealand European male presented with 3 mo history of per rectal bleeding.He was referred for a colonoscopy test to investigate this further.This revealed a malignant appearing lesion in the rectum.Biopsies however showed high grade dysplasia only.Given endoscopic appearances suspicious for deep submucosal invasion,patient was consented for endoscopic intermuscular dissection(EID).The case was successfully performed,and the presence of muscularis propria was confirmed in the resected specimen.There were no complications and total procedure time was 124 min.Lesion was clear of radial margins however deep margins were positive confirming it was at least a pT2 cancer.Patient was recommended to have further treatment but could not have radical surgery due to comorbidities and instead was referred for long course chemoradiotherapy.CONCLUSION EID is a safe and feasible option for management of rectal cancer in highly selected patients.展开更多
Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury(SCI). Ectopic adiposity is characterized by the storage ...Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury(SCI). Ectopic adiposity is characterized by the storage of adipose tissue in non-subcutaneous sites. Magnetic resonance imaging(MRI) has proven to be an effective tool in quantifying ectopic adiposity and provides the opportunity to measure different adipose depots including intermuscular adipose tissue(IMAT) and intramuscular adipose tissue(Intra MAT) or intramuscular fat(IMF). It is highly important to distinguish and clearly define these compartments, because controversy still exists on how to accurately quantify these adipose depots. Investigators have relied on separating muscle from fat pixels based on their characteristic signal intensities. A common technique is plotting a threshold histogram that clearly separates between muscle and fat peaks. The cut-offs to separate between muscle and fat peaks are still not clearly defined and different cut-offs have been identified. This review will outline and compare the Midpoint and Otsu techniques, two methods used to determine the threshold between muscle and fat pixels on T1 weighted MRI. The process of water/fat segmentation using the Dixon method will also be outlined. We are hopeful that this review will trigger more research towards accurately quantifying ectopic adiposity due to its high relevance to cardiometabolic health after SCI.展开更多
Intermuscular bones(IBs)are slender linear bones embedded in muscle,which ossify from tendons through a process of intramembranous ossification,and only exist in basal teleosts.IBs are essential for fish swimming,but ...Intermuscular bones(IBs)are slender linear bones embedded in muscle,which ossify from tendons through a process of intramembranous ossification,and only exist in basal teleosts.IBs are essential for fish swimming,but they present a choking risk during human consumption,especially in children,which can lead to commercial risks that have a negative impact on the aquaculture of these fish.In this review,we discuss the morphogenesis and functions of IBs,including their underlying molecular mechanisms,as well as the advantages and disadvantages of different methods for IB studies and techniques for breeding and generating IB-free fish lines.This review reveals that the many key genes involved in tendon development,osteoblast differentiation,and bone formation,e.g.,scxa,msxC,sost,twist,bmps,and osterix,also play roles in IB development.Thus,this paper provides useful information for the breeding of new fish strains without IBs via genome editing and artificial selection.展开更多
To provide anatomic basis for transposition of vascularized radial midforearm flap.Methods On 40 adult cadaveric upper limb specimens injected with red dye,the origin,course,branchs,diameters and anastomosis of interm...To provide anatomic basis for transposition of vascularized radial midforearm flap.Methods On 40 adult cadaveric upper limb specimens injected with red dye,the origin,course,branchs,diameters and anastomosis of intermuscular branch of radial artery and its cutaneous branch were observed.Results Originating from radial artery,intermuscular branch of radial artery descended along periosteum closely between pronator teres and supinator,the main stem was (4.8±1.0)cm in length and (1.2±0.2)mm in diameter.After its periosteal branches were sent off to distribute over middle and inferior shaft of radius,its cutaneous branch perforated from intermuscle and deep fascia and anastomosed with some other cutaneous branches in the forearm.Perforating point of the cutaneous branch was located (11.1±1.3)cm beneath lateral epicondyle of humerus,its diameter was about (0.6±0.1)mm.Conclusion Radial midforrarm flap pedicled with intermuscular branch of radial artery can be transferred to repair soft tissue defect of elbow,forearm or hand.7 refs.展开更多
Intermuscular bones(IBs)are ossified from tendons and only occur in lower teleosts.Positive association between the regulation of scleraxis gene(scx)and tendon development gave us reasons to speculate that the scx gen...Intermuscular bones(IBs)are ossified from tendons and only occur in lower teleosts.Positive association between the regulation of scleraxis gene(scx)and tendon development gave us reasons to speculate that the scx gene may play a potential role in regulating the development of IBs.A phylogenetic analysis conducted for this study revealed potential functional differentiation between two scx orthologues,scxa and scxb.The scxa^(-/-) and scxb^(-/-) zebrafish were generated through CRISPR-Cas9 technology to study the role of scx in the IB and rib development.The results showed a significant reduction of the number of IBs in adult scxa-1^(-/-) zebrafish,with almost 70%reduction(15-25 IBs)compared to the wild type scxa-1^(+/+)zebrafish(76-80 IBs).In the scxa-1^(+/+)adults,IBs were observed in both dorsal and tail segments;however,in scxa-1^(-/-)fish IBs were observed only in the tail segment(none in the dorsal segment).Although scxa-1^(-/-) zebrafish had rib defects,the mutants were viable and fertile as adult fish.The scxb^(-/-) zebrafish had the same number of IBs and same skeletal phenotype as the wild-type fish.This suggests that only scxa has a crucial role in the IB development,and confirms functional differentiation of scx orthologues.To further clarify the molecular mechanism by which scxa affects the IB development,we conducted comparative transcriptome analysis of dorsal tissue samples of scxa-1^(+/+)(with IBs)and scxa-1^(-/-) (without IBs),and further verified the expression of key genes via qPCR.This is the first study to identify a gene that controls the amount of IBs in fish,and it provides a new sight into the effects of scxa on the molecular mechanism of IB development in fish.展开更多
We documented the number, morphology, and distribution of intermuscular bones in five fishes of different ploidy: Carassius auratus (Abbr.WCC, 2n=100), Carassius auratus variety PengZe (Abbr.PZCC, 3n=150), improved tr...We documented the number, morphology, and distribution of intermuscular bones in five fishes of different ploidy: Carassius auratus (Abbr.WCC, 2n=100), Carassius auratus variety PengZe (Abbr.PZCC, 3n=150), improved triploid crucian carp (Abbr.ITCC, 3n=150), improved red crucian carp (Carassius auratus red var., Abbr.IRCC, ♀, 2n=100), and improved allotetraploids (Abbr.G×AT, ♂, 4n=200). The number of intermuscular bones in WCC, PZCC, and G×AT ranged from 78 to 83 ( =81), 80 to 86 ( =84), and 77 to 84 (=82), respectively. The numbers in ITCC and IRCC were significantly lower, ranging from 77 to 82 (=79) and 58 to 77 (=71), respectively. The average number of intermuscular bones in each sarcomere, ranked in order from highest to lowest, was 0.721 (WCC), 0.673 (PZCC), 0.653 (G×AT), 0.633 (ITCC), and 0.608 (IRCC). There was no difference between ITCC and G×AT or between G×AT and PZCC. However, the average number of intermuscular bones in the sarcomeres of ITCC, WCC, and PZCC differed significantly, as did that of IRCC and the four other kinds of fish. The intermuscular bone of these five fishes was divided into seven shape categories, non-forked (I), one-end-unequal-bi-fork (卜), one-end-equal-bi-fork (Y), one-end-multi-fork, two-end-bi-fork, two-end-multi-fork, and treebranch types. Generally, the morphological complexity was higher in the anterior intermuscular bones than in the posterior body. The number of intermuscular bones was similar but not equal between the left and right sides of the body. ITCC had significantly fewer intermuscular bones than either WCC or PZCC, making it of greater commercial value. Additionally, IRCC and ITCC had fewer intermuscular bones than WCC. Our observations are significant in both fish bone developmental biology and genetic breeding.展开更多
目的探讨超声引导下阿芬太尼肌间沟臂丛神经阻滞的麻醉效果及对患者血流动力学、应激反应的影响。方法选取南阳医学高等专科学校第一附属医院2020年3月至2021年5月收治的80例上肢骨折手术患者进行随机对照试验。采用抽签法将入组患者分...目的探讨超声引导下阿芬太尼肌间沟臂丛神经阻滞的麻醉效果及对患者血流动力学、应激反应的影响。方法选取南阳医学高等专科学校第一附属医院2020年3月至2021年5月收治的80例上肢骨折手术患者进行随机对照试验。采用抽签法将入组患者分为研究组(41例)与对照组(39例)。研究组男22例,女19例,年龄(48.42±3.38)岁。对照组男21例,女18例,年龄(48.89±3.53)岁。两组均接受超声引导下肌间沟臂丛神经阻滞麻醉,对照组采用罗哌卡因,研究组采用阿芬太尼。对比麻醉不同时间动脉血氧饱和度(SaO2)、一氧化氮(NO)、平均动脉压(MAP)、肾上腺皮质激素(ACTH)、心率(HR)、超氧化物歧化酶(SOD)及疼痛评分[视觉模拟评分法(VAS)]。采用t检验。结果阻滞前,两组HR、SaO2、MAP差异均无统计学意义(t=0.191、0.182、0.020,均P>0.05);阻滞后30 min,研究组SaO2[(0.9935±0.1062)比(0.8745±0.0480)]、MAP[(90.50±10.21)mmHg(1 mmHg=0.133 kPa)比(83.45±9.68)mmHg]均高于对照组,HR[(69.05±8.43)次/min比(74.59±8.31)次/min]低于对照组(t=5.527、2.875、4.803,均P<0.05)。术前1 d,两组SOD、ACTH、NO差异均无统计学意义(t=0.937、0.984、0.071,均P>0.05);术后3 d,研究组SOD、ACTH、NO均低于对照组(t=7.589、3.989、5.319,均P<0.05)。研究组术后1.0 h VAS评分高于对照组(t=2.980,P<0.05);两组术后0.5、3.0、24.0、72.0 h VAS差异均无统计学意义(t=0.617、1.077、0.349、0.705,均P>0.05)。结论采用阿芬太尼进行超声引导下肌间沟臂丛神经阻滞可在有效改善患者术后疼痛、避免术后应激的同时,维持其术中血流动力学稳定,具有较高应用价值。展开更多
文摘BACKGROUND Endoscopic submucosal dissection is considered curative for patients with early rectal cancer when level of submucosal invasion is<1000 microns with favourable histopathological features.Recent data suggests even deeper submucosal invasion can potentially be curative if R0 resection can be achieved and when no high-risk histopathological features are seen in the resected specimen.To achieve R0 resection,deeper dissection is required.CASE SUMMARY A 66 year old New Zealand European male presented with 3 mo history of per rectal bleeding.He was referred for a colonoscopy test to investigate this further.This revealed a malignant appearing lesion in the rectum.Biopsies however showed high grade dysplasia only.Given endoscopic appearances suspicious for deep submucosal invasion,patient was consented for endoscopic intermuscular dissection(EID).The case was successfully performed,and the presence of muscularis propria was confirmed in the resected specimen.There were no complications and total procedure time was 124 min.Lesion was clear of radial margins however deep margins were positive confirming it was at least a pT2 cancer.Patient was recommended to have further treatment but could not have radical surgery due to comorbidities and instead was referred for long course chemoradiotherapy.CONCLUSION EID is a safe and feasible option for management of rectal cancer in highly selected patients.
基金supported in part by Grant-in-Aid for JSPS Research Fellow
文摘Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury(SCI). Ectopic adiposity is characterized by the storage of adipose tissue in non-subcutaneous sites. Magnetic resonance imaging(MRI) has proven to be an effective tool in quantifying ectopic adiposity and provides the opportunity to measure different adipose depots including intermuscular adipose tissue(IMAT) and intramuscular adipose tissue(Intra MAT) or intramuscular fat(IMF). It is highly important to distinguish and clearly define these compartments, because controversy still exists on how to accurately quantify these adipose depots. Investigators have relied on separating muscle from fat pixels based on their characteristic signal intensities. A common technique is plotting a threshold histogram that clearly separates between muscle and fat peaks. The cut-offs to separate between muscle and fat peaks are still not clearly defined and different cut-offs have been identified. This review will outline and compare the Midpoint and Otsu techniques, two methods used to determine the threshold between muscle and fat pixels on T1 weighted MRI. The process of water/fat segmentation using the Dixon method will also be outlined. We are hopeful that this review will trigger more research towards accurately quantifying ectopic adiposity due to its high relevance to cardiometabolic health after SCI.
基金This work was supported by the National Natural Science Foundation of China(U1702233 and U1902202)Program of the Chinese Academy of Sciences(XDA24030505 and XDA23080502)Program of Yunnan Provincial Science and Technology Department(202003AD150017 and 2018FY001-007)。
文摘Intermuscular bones(IBs)are slender linear bones embedded in muscle,which ossify from tendons through a process of intramembranous ossification,and only exist in basal teleosts.IBs are essential for fish swimming,but they present a choking risk during human consumption,especially in children,which can lead to commercial risks that have a negative impact on the aquaculture of these fish.In this review,we discuss the morphogenesis and functions of IBs,including their underlying molecular mechanisms,as well as the advantages and disadvantages of different methods for IB studies and techniques for breeding and generating IB-free fish lines.This review reveals that the many key genes involved in tendon development,osteoblast differentiation,and bone formation,e.g.,scxa,msxC,sost,twist,bmps,and osterix,also play roles in IB development.Thus,this paper provides useful information for the breeding of new fish strains without IBs via genome editing and artificial selection.
文摘To provide anatomic basis for transposition of vascularized radial midforearm flap.Methods On 40 adult cadaveric upper limb specimens injected with red dye,the origin,course,branchs,diameters and anastomosis of intermuscular branch of radial artery and its cutaneous branch were observed.Results Originating from radial artery,intermuscular branch of radial artery descended along periosteum closely between pronator teres and supinator,the main stem was (4.8±1.0)cm in length and (1.2±0.2)mm in diameter.After its periosteal branches were sent off to distribute over middle and inferior shaft of radius,its cutaneous branch perforated from intermuscle and deep fascia and anastomosed with some other cutaneous branches in the forearm.Perforating point of the cutaneous branch was located (11.1±1.3)cm beneath lateral epicondyle of humerus,its diameter was about (0.6±0.1)mm.Conclusion Radial midforrarm flap pedicled with intermuscular branch of radial artery can be transferred to repair soft tissue defect of elbow,forearm or hand.7 refs.
基金This work was financially supported by the National Natural Science Foundation of China(Grant No.31872559)National Key Research and Development Program(Grant No.2018YFD0900102)+2 种基金Modern Agriculture Industry Technology System Construction Projects of China titled as-Staple Freshwater Fishes Industry Technology System(Grant No.CARS-46-08)Fundamental Research Funds for the Central Universities(Grant No.2662018PY035)State Key Laboratory of Developmental Biology of Freshwater Fish(2018KF003).
文摘Intermuscular bones(IBs)are ossified from tendons and only occur in lower teleosts.Positive association between the regulation of scleraxis gene(scx)and tendon development gave us reasons to speculate that the scx gene may play a potential role in regulating the development of IBs.A phylogenetic analysis conducted for this study revealed potential functional differentiation between two scx orthologues,scxa and scxb.The scxa^(-/-) and scxb^(-/-) zebrafish were generated through CRISPR-Cas9 technology to study the role of scx in the IB and rib development.The results showed a significant reduction of the number of IBs in adult scxa-1^(-/-) zebrafish,with almost 70%reduction(15-25 IBs)compared to the wild type scxa-1^(+/+)zebrafish(76-80 IBs).In the scxa-1^(+/+)adults,IBs were observed in both dorsal and tail segments;however,in scxa-1^(-/-)fish IBs were observed only in the tail segment(none in the dorsal segment).Although scxa-1^(-/-) zebrafish had rib defects,the mutants were viable and fertile as adult fish.The scxb^(-/-) zebrafish had the same number of IBs and same skeletal phenotype as the wild-type fish.This suggests that only scxa has a crucial role in the IB development,and confirms functional differentiation of scx orthologues.To further clarify the molecular mechanism by which scxa affects the IB development,we conducted comparative transcriptome analysis of dorsal tissue samples of scxa-1^(+/+)(with IBs)and scxa-1^(-/-) (without IBs),and further verified the expression of key genes via qPCR.This is the first study to identify a gene that controls the amount of IBs in fish,and it provides a new sight into the effects of scxa on the molecular mechanism of IB development in fish.
基金supported by Special Fund for Agro-scientific Research in the Public Interest (200903046)the National Natural Science Foundation of China (30930071)+5 种基金Major International Cooperation Projects of the National Natural Science Foundation of China (31210103918)Innovative Research Groups of Hunan Provincial Natural Science Fund (10JJ7004)the National High Technology Research and Development Program of China (2011AA100403)Pre-project of the National Key Basic Research and Development Program (2012CB722305)the Construct Program of the Key Discipline in Hunan ProvinceConstruct Program of the National Key Discipline
文摘We documented the number, morphology, and distribution of intermuscular bones in five fishes of different ploidy: Carassius auratus (Abbr.WCC, 2n=100), Carassius auratus variety PengZe (Abbr.PZCC, 3n=150), improved triploid crucian carp (Abbr.ITCC, 3n=150), improved red crucian carp (Carassius auratus red var., Abbr.IRCC, ♀, 2n=100), and improved allotetraploids (Abbr.G×AT, ♂, 4n=200). The number of intermuscular bones in WCC, PZCC, and G×AT ranged from 78 to 83 ( =81), 80 to 86 ( =84), and 77 to 84 (=82), respectively. The numbers in ITCC and IRCC were significantly lower, ranging from 77 to 82 (=79) and 58 to 77 (=71), respectively. The average number of intermuscular bones in each sarcomere, ranked in order from highest to lowest, was 0.721 (WCC), 0.673 (PZCC), 0.653 (G×AT), 0.633 (ITCC), and 0.608 (IRCC). There was no difference between ITCC and G×AT or between G×AT and PZCC. However, the average number of intermuscular bones in the sarcomeres of ITCC, WCC, and PZCC differed significantly, as did that of IRCC and the four other kinds of fish. The intermuscular bone of these five fishes was divided into seven shape categories, non-forked (I), one-end-unequal-bi-fork (卜), one-end-equal-bi-fork (Y), one-end-multi-fork, two-end-bi-fork, two-end-multi-fork, and treebranch types. Generally, the morphological complexity was higher in the anterior intermuscular bones than in the posterior body. The number of intermuscular bones was similar but not equal between the left and right sides of the body. ITCC had significantly fewer intermuscular bones than either WCC or PZCC, making it of greater commercial value. Additionally, IRCC and ITCC had fewer intermuscular bones than WCC. Our observations are significant in both fish bone developmental biology and genetic breeding.
文摘目的探讨超声引导下阿芬太尼肌间沟臂丛神经阻滞的麻醉效果及对患者血流动力学、应激反应的影响。方法选取南阳医学高等专科学校第一附属医院2020年3月至2021年5月收治的80例上肢骨折手术患者进行随机对照试验。采用抽签法将入组患者分为研究组(41例)与对照组(39例)。研究组男22例,女19例,年龄(48.42±3.38)岁。对照组男21例,女18例,年龄(48.89±3.53)岁。两组均接受超声引导下肌间沟臂丛神经阻滞麻醉,对照组采用罗哌卡因,研究组采用阿芬太尼。对比麻醉不同时间动脉血氧饱和度(SaO2)、一氧化氮(NO)、平均动脉压(MAP)、肾上腺皮质激素(ACTH)、心率(HR)、超氧化物歧化酶(SOD)及疼痛评分[视觉模拟评分法(VAS)]。采用t检验。结果阻滞前,两组HR、SaO2、MAP差异均无统计学意义(t=0.191、0.182、0.020,均P>0.05);阻滞后30 min,研究组SaO2[(0.9935±0.1062)比(0.8745±0.0480)]、MAP[(90.50±10.21)mmHg(1 mmHg=0.133 kPa)比(83.45±9.68)mmHg]均高于对照组,HR[(69.05±8.43)次/min比(74.59±8.31)次/min]低于对照组(t=5.527、2.875、4.803,均P<0.05)。术前1 d,两组SOD、ACTH、NO差异均无统计学意义(t=0.937、0.984、0.071,均P>0.05);术后3 d,研究组SOD、ACTH、NO均低于对照组(t=7.589、3.989、5.319,均P<0.05)。研究组术后1.0 h VAS评分高于对照组(t=2.980,P<0.05);两组术后0.5、3.0、24.0、72.0 h VAS差异均无统计学意义(t=0.617、1.077、0.349、0.705,均P>0.05)。结论采用阿芬太尼进行超声引导下肌间沟臂丛神经阻滞可在有效改善患者术后疼痛、避免术后应激的同时,维持其术中血流动力学稳定,具有较高应用价值。
