Anatomical Retrofitting:Pi(脾)as Spleen and the Persistence of Ontological Ambivalence

Over the past decade,medical researchers in China have debated whether the Pi(脾)corresponds to the biomedical spleen or pancreas.This debate exemplifies a broader phenomenon of“anatomical retrofitting”,or the anachronistic imposition of contemporary categories onto living historical objects.“Anatomical retrofitting”as a means of rectifying cases of mistranslation further positions the biomedical spleen and pancreas as representing ahistorical,universal truths.This framework gives rise to a conceptual binary:while the biomedical spleen is universalized as what philosophers may describe as“logical”ontology,the Pi connects to a different nature of reality,or“metaphysical”ontology.Far from being an object of imprecision,the Pi was a dynamic vessel that also shared characteristics with the humoral spleen.Given that scholars in China have already subjected Pi to historical scrutiny,this paper urges scholars to do the same with biomedical anatomy.For instance,historically situating the humoral spleen demonstrates that it became less known and less articulated as it transformed into the biomedical spleen.Meanwhile,the pancreas remained an unstable epistemic object that took on the dynamic functions of the humoral spleen in nineteenth-century organotherapy.Through primary source analysis and literature review,this paper contends that the apparent ontological incommensurability between Pi and spleen is neither mutually exclusive nor irreconcilable.Instead,the dynamic nature of internal viscera,their many functions,and their participation in epistemic practices contribute to an ongoing ontological ambivalence that persists despite the forced certainty of anatomical retrofitting.

Insights into the dwarfing mechanism of pear(Pyrus betulaefolia) based on anatomical and structural analysis using X-ray scanning

The lack of a suitable rootstock to control scion growth has limited the development of high-density plantations in pear production, which is partly attributed to poor understanding of the dwarfing mechanism. In the present study, the rootstock of the dwarf-type pear (Pyrus betulaefolia)PY-9’ was identified and used as the material for anatomical analysis.PY-9’ grew to half the tree height of the normal cultivar Zhengdu’, along with fewer internodes and shorter length. Significant differences in growth rate betweenPY-9’ andZhengdu’ were detected at approximately 30 days after full bloom, which corresponded with the time of the greatest difference in water potential between the dwarf and normal cultivar.PY-9’ showed a higher photosynthetic rate thanZhengdu’. Anatomical analysis showed thatPY-9’ had higher area ratios of both phloem and xylem and more developed vascular tissues thanZhengdu’. The three-dimensional reconstructed skeleton of the xylem from X-ray computed tomography scanning revealed greater intervessel connectivity inZhengdu’ than inPY-9’, which could contribute to the more vigorous growth ofZhengdu’. This study thus provides the first comparison of the microstructural properties of xylem elements between a dwarfing-type and vigorous-type pear rootstock, providing new insights into the dwarfing mechanism in pear and facilitating breeding of dwarf pear rootstocks to increase crop productivity.

High Prevalence of Anatomical Variations and Anomalies of the Coronary Arteries Detected by CT Angiography in Symptomatic Patients

Objective:Coronary artery anatomical variations and anomalies are an important topic due to their potential clinical manifestations.This study aims to investigate the prevalence of coronary artery anatomical variations and anomalies in symptomatic patients with coronary computed tomography angiography(CCTA).Methods:This is a retrospective study that included all symptomatic patients who had CCTA in a tertiary care hospital in Saudi Arabia during a period of seven years.Results:The total number of included patients was 507(60%males)with a mean age of 57.4 years.Approximately 41%had luminal stenoses,averaging 49.7%.The total num-ber of patients with coronary anatomical variations(CAV)and coronary artery anomalies(CAA)was 217(43%).CAV prevalence was 26%,which included 14%non-right coronary dominance,5%short left main coronary artery(LMCA),and 7%division variations(trifurcation and quadrifurcarion)of the LMCA.The prevalence of CAA was 29%,which included 5%origin anomalies,22%myocardial bridge,and 2%course anomalies.Conclusions:A high prevalence of coronary artery anatomic variations and anomalies in symptomatic patients is reported in this study.Systematic reviews,meta-analyses,reporting guidelines,and unified definitions and classifications of cor-onary variations and anomalies are lacking in the literature,presenting potential opportunities for future research and publications.

High rate of clinically relevant improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis

BACKGROUND The minimal clinically important difference(MCID)is defined as the smallest meaningful change in a health domain that a patient would identify as important.Thus,an improvement that exceeds the MCID can be used to define a successful treatment for the individual patient.AIM To quantify the rate of clinical improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis.METHODS Patients were treated with the Global Unite total shoulder platform arthroplasty between March 2017 and February 2019 at Herlev and Gentofte Hospital,Denmark.The patients were evaluated preoperatively and 3 months,6 months,12 months,and 24 months postoperatively using the Western Ontario Osteoarthritis of the Shoulder index(WOOS),Oxford Shoulder Score(OSS)and Constant-Murley Score(CMS).The rate of clinically relevant improvement was defined as the proportion of patients who had an improvement 24 months postoperatively that exceeded the MCID.Based on previous literature,MCID for WOOS,OSS,and CMS were defined as 12.3,4.3,and 12.8 respectively.RESULTS Forty-nine patients with a Global Unite total shoulder platform arthroplasty were included for the final analysis.Mean age at the time of surgery was 66 years(range 49.0-79.0,SD:8.3)and 65%were women.One patient was revised within the two years follow-up.The mean improvement from the preoperative assessment to the two-year follow-up was 46.1 points[95%confidence interval(95%CI):39.7-53.3,P<0.005]for WOOS,18.2 points(95%CI:15.5-21.0,P<0.005)for OSS and 37.8 points(95%CI:31.5-44.0,P<0.005)for CMS.Two years postoperatively,41 patients(87%)had an improvement in WOOS that exceeded the MCID,45 patients(94%)had an improvement in OSS that exceeded the MCID,and 42 patients(88%)had an improvement in CMS that exceeded the MCID.CONCLUSION Based on three shoulder-specific outcome measures we find that approximately 90%of patients has a clinically relevant improvement.This is a clear message when informing patients about their prognosis.

Evaluation of Functional and Radiological Outcome of Arthroscopic-Assisted Anatomical Coracoclavicular (CC) and Acromioclavicular (AC) Ligament Reconstruction in Chronic AC Joint Dislocation

Introduction: Acromioclavicular (AC) joint dislocation is a common shoulder injury, comprising 9% - 12% of shoulder girdle injuries. Optimal management remains challenging, with treatment decisions guided by the Rockwood classification system. Controversies surround grade III injuries, necessitating further classification. Non-operative treatment has shown favorable outcomes, while surgical interventions vary. Anatomical coracoclavicular reconstruction (ACCR) has demonstrated biomechanical advantages over traditional methods. Arthroscopic techniques offer advantages, minimizing deltoid detachment and allowing concurrent pathology identification. This study evaluates the outcomes of arthroscopic-assisted ACCR in chronic AC joint dislocation. Surgical Technique: Arthroscopic-assisted ACCR involves meticulous portal placement, tendon graft harvesting, diagnostic arthroscopy, and coracoid exposure. The clavicle tunnels were made to mimic the conoid and trapezoid ligament positions, using FibreTape#2 loop and Dog Bone Button for correct placement against the coracoid base, and passing the semitendinosus graft through to reconstruct the conoid ligament, reduction done and graft follow through for anatomical reconstruction. Methods: A retrospective cohort study at Hospital Kuala Lumpur analyzed 35 patients undergoing arthroscopic-assisted ACCR for Rockwood grade III - V AC joint dislocations. Inclusion criteria encompassed trauma ≥ 3 weeks prior, no prior shoulder injuries, and ≥12-month follow-up. Functional and radiological assessments utilized ASES scores and coracoclavicular distances, respectively. Statistical analysis employed descriptive statistics and logistic regression. Results: The mean age was 38.9 years (SD 11.26), and 34 of 35 patients were male. Grade IV injuries were predominant (37.1%). Waiting time for surgery averaged 234.9 days. Functional improvement was substantial postoperatively (ASES: 55.5 to 88.9). Radiological outcomes demonstrated reduced coracoclavicular distances and maintained reduction. No significant correlation was observed between injury grade and outcomes. Conclusion: Arthroscopic-assisted ACCR for chronic AC joint dislocation yields significant functional and radiological improvement, irrespective of injury grade. Waiting time for surgery exhibits minor impact on outcomes, emphasizing the procedure’s efficacy. Concomitant injuries do not impede success, highlighting the versatility of this approach in managing shoulder instability. The study contributes valuable insights into the nuanced management of chronic AC joint dislocations and supports the adoption of arthroscopic-assisted ACCR as a viable treatment option.

A Novel Method in Wood Identification Based on Anatomical Image Using Hybrid Model

Nowadays,wood identification is made by experts using hand lenses,wood atlases,and field manuals which take a lot of cost and time for the training process.The quantity and species must be strictly set up,and accurate identification of the wood species must be made during exploitation to monitor trade and enforce regulations to stop illegal logging.With the development of science,wood identification should be supported with technology to enhance the perception of fairness of trade.An automatic wood identification system and a dataset of 50 commercial wood species from Asia are established,namely,wood anatomical images collected and used to train for the proposed model.In the convolutional neural network(CNN),the last layers are usually soft-max functions with dense layers.These layers contain the most parameters that affect the speed model.To reduce the number of parameters in the last layers of the CNN model and enhance the accuracy,the structure of the model should be optimized and developed.Therefore,a hybrid of convolutional neural network and random forest model(CNN-RF model)is introduced to wood identification.The accuracy’s hybrid model is more than 98%,and the processing speed is 3 times higher than the CNN model.The highest accuracy is 1.00 in some species,and the lowest is 0.92.These results show the excellent adaptability of the hybrid model in wood identification based on anatomical images.It also facilitates further investigations of wood cells and has implications for wood science.

Ultrasonographic identification of lateral femoral cutaneous nerve anatomical variation in persistent meralgia paresthetica:A case report

BACKGROUND Meralgia paresthetica(MP)is an entrapment mononeuropathy of the lateral femoral cutaneous nerve(LFCN).Although structural abnormalities in nerve tissues can be confirmed using ultrasonography,this is not routinely performed.CASE SUMMARY Herein,we present the case of a 52-year-old woman who developed MP after laparoscopic gynecological surgery.The patient was referred to our clinic from an obstetrics and gynecology clinic with symptoms of numbness and a tingling sensation in the left anterolateral thigh,which developed after surgery performed 5 mo earlier.Tests were performed to assess the disease status and determine the underlying causes.Ultrasonographic examination revealed an anatomical variation,where the left LFCN was entrapped within the inguinal ligament.This case suggests that performing ultrasonographic examination before and after surgery in the lithotomy position could help prevent MP.CONCLUSION This case demonstrates the value of ultrasonography in detecting anatomical variation and diagnosing persistent MP.Ultrasonography should be considered an adjunct to electromyography for optimal MP management.Further,this case would help other clinicians determine patient prognosis and decide on targeted treatment strategies.

The application of the extraglissonian approach for selective hepatic inflow occlusion during laparoscopic anatomical segmentectomy

Objective:Laparoscopic anatomical hepatectomy has been proven to be achievable for segmentectomy,subsegmentectomy and multi-segmentectomy.The extraglissonian approach in the context of selective hepatic inflow ocdlusion has been skilled under laparoscopy.This study aims to examine the suitability of the technique stated above for laparoscopic anatomical hepatectomy.Methods:This retrospective study analyzed the dinical data of 114 patients diagnosed with hepatocel-lular carcinoma who underwent laparoscopic anatomical hepatectomy using the extraglissonian hepatic inflow occlusion technique at the Faculty of Hepato-Pancreato-Biliary Surgery,Chinese PLA General Hospital between September 2020 and December 2022.Results:The success rate of achieving the ischemic area using the described methods was determined to be 74.6%.Out of the 85 cases that underwent laparoscopic anatomical hepatectomy,34 cases involved segmentectomy,5 cases involved subsegmentectomy,and 46 cases involved multi-segmentectomy.The average duration of the operation,blood loss volume,and postoperative hospi-tal stay were 229.0±85.0 min,133.0±112.0 mL,and 5.4±1.7 d,res pectively.Notably,no intraoperative blood transfusions were necessary,and no postoperative complications were observed.Conclusion:The extraglissonian hepatic inflow occlusion technique exhibits a notable advantage in terms of a high success rate,effectively guiding the selection process during laparoscopic parenchymal tran-section.Moreover,this technique has demonstrated safety,reproducibility,and significant potential for broader clinical adoption.

Introducing the Principles of Tendon Transfer for Surgical Trainees to Improve Anatomical Knowledge

This article reviewed the principles and outcomes of tendon transfer procedures described in the literature to restore function following injuries delivered in a workshop as a way of improving basic science and anatomical knowledge in surgical trainees preparing for surgical examinations. Post intervention surveys showed an improvement in trainees’ familiarity with musculoskeletal anatomy and engagement in learning with improved readiness for surgical examinations.

Morphological,Anatomical and Genetic Analysis for a Rice Mutant with Abnormal Hull

A mutant with abnormal hull was first discovered from a twin-seedling strain W2555 in rice （Oryza sativa L.）. The mutant had sparse branches and decreased number of florets from the base to the peak. Frequently, the florets at the top of the panicle did not develop completely. The underdeveloped florets often showed slender and white in their life cycle. Genetic analysis indicated that the mutant traits were controlled by a single recessive gene （temporarily designated as ah）. ah gene controlled the development of inflorescence meristem and the flower organ. The florets of mutant showed degenerated lemma and palea. Stamens and lodicules were homeoticly transformed into pistils and palea/lemma-like structures, respectively. It seemed that ah mutant phenotypes of the homeotic conversions in lodicules and stamens were very similar to that of the B loss-of-function spwl gene reported previously in rice.

Effect of TYLCV Infection on Leaf Anatomical Structure and Protective Enzyme System of Tomato

[Objective] The aim was to study the effect of tomato yellow leaf curl virus （TYLCV） infection on leaf anatomical structure and protective enzyme system of tomato. [Method] The anatomical structure of infected and healthy leaves of tomato were observed and compared by using paraffin section method. The activity changes of SOD, POD and CAT in the infected leaves of tomato were determined. [ Result] The results revealed that there were some differences in anatomical structure between healthy and infected leaves. Some cells of infected leaves were damaged so that the leaves curled and became yellow, which affected the normal function of organs. Compared with control, enzyme activities in the tomato plants infected by TYLCV were enhanced at the early periods and higher than that in control, then started to decline at the middle and late periods but lower than that in control.[ Conclusion] After infection by TYLCV, the leaf anatomical structure of tomato was changed greatly and the protective enzyme system was damaged severely, and affected the normal physJological metabolic functions of tissues and organs in tomato in further.

Research Progress on Leaf Anatomical Structures of Plants Under Drought Stress

Plants usually suffer drought stress during their growth process. As the photosynthetic activity center of plants, the leaf is the most sensitive organ under drought stress. In order to support the research on drought resistance of higher plants, this study reviewed the adaptation response and damage performance of epidermal structure, palisade tissue and spongy tissue, thickness, veins and stomata of plant leaves under drought stress.

Effects of Salt Stress on Anatomical Structure of Leaves of Malus sieversii and Malus robusta

[Objective] This study was conducted to compare leaf anatomical structure of Malus sieversii and M. robusta under different salt concentration levels to determine their tolerance to salt and thus to provide rootstock materials for apple production in salinized soil in Southern Xinjiang. [Method] The experiment was conducted with M. sieversii and M. robusta as test materials. Salt stress was simulated using 8 g/L of NaCI solution, and Hoagland nutrient solution was used instead of NaCI solution as control group （CK）. Samples were collected on the 20^th d of treatment, sliced through paraffin processing. The prepared paraffin sections of M. sieversii and M. robusta were then observed under a light microscope for anatomical structures of leaf, upper epidermis, lower epidermis, palisade tissue and spongy tissue. [Result] Compared with the control, the leaf, upper epidermis, lower epidermis and spongy tissue of M. sieversii and M. robusta under salt stress were thickened at different degrees, while the thickness of the palisade tissue was decreased. Moreover, high salt concentration caused severer damage to the cell structure of M. sieversii than to that of M. robusta, as M. robusta cells maintained better structural integrity. [Conclusion] M. robusta has higher adaptability to salt stress than M. sieversii.

Anatomical vs nonanatomical liver resection for solitary hepatocellular carcinoma:A systematic review and meta-analysis

BACKGROUND The long-term survival of patients with solitary hepatocellular carcinoma(HCC)following anatomical resection(AR)vs non-anatomical resection(NAR)is still controversial.It is necessary to investigate which approach is better for patients with solitary HCC.AIM To compare perioperative and long-term survival outcomes of AR and NAR for solitary HCC.METHODS We performed a comprehensive literature search of PubMed,Medline(Ovid),Embase(Ovid),and Cochrane Library.Participants of any age and sex,who underwent liver resection,were considered following the following criteria:(1)Studies reporting AR vs NAR liver resection;(2)Studies focused on primary HCC with a solitary tumor;(3)Studies reporting the long-term survival outcomes(>5 years);and(4)Studies including patients without history of preoperative treatment.The main results were overall survival(OS)and disease-free survival(DFS).Perioperative outcomes were also compared.RESULTS A total of 14 studies,published between 2001 and 2020,were included in our meta-analysis,including 9444 patients who were mainly from China,Japan,and Korea.AR was performed on 4260(44.8%)patients.The synthetic results showed that the 5-year OS[odds ratio(OR):1.19;P<0.001]and DFS(OR:1.26;P<0.001)were significantly better in the AR group than in the NAR group.AR was associated with longer operating time[mean difference(MD):47.08;P<0.001],more blood loss(MD:169.29;P=0.001),and wider surgical margin(MD=1.35;P=0.04)compared to NAR.There was no obvious difference in blood transfusion ratio(OR:1.16;P=0.65)or postoperative complications(OR:1.24,P=0.18).CONCLUSION AR is superior to NAR in terms of long-term outcomes.Thus,AR can be recommended as a reasonable surgical option in patients with solitary HCC.

Anatomical and chemical characteristics associated with lodging resistance in wheat

Anatomical and chemical characteristics of stems affect lodging in wheat(Triticum aestivum L.) cultivars. Traits associated with lodging resistance, such as plant height, stem strength, culm wall thickness, pith diameter, and stem diameter, were extensively investigated in earlier studies. However, the solid stem trait was rarely considered. In this study, we measured a range of anatomical and chemical characteristics on solid and hollow stemmed wheat cultivars. Significant correlations were detected between resistance to lodging and several anatomical features, including width of mechanical tissue, weight of low internodes, and width of stem walls. Morphological features that gave the best indication of improved lodging resistance were increased stem width, width of mechanical tissue layer, and stem density. Multiple linear regression analysis showed that 99% of the variation in lodging resistance could be explained by the width of the mechanical tissue layer, suggesting that solid stemmed wheat has several anatomical features for increasing resistance to lodging. In addition, microsatellite markers GWM247 and GWM340 were linked to a single solid stem QTL on chromosome 3BL in a population derived from the cross Xinongshixin(solid stem)/Line 3159(hollow stem). These markers should be valuable in breeding wheat for solid stem.

Anatomical resection of hepatocellular carcinoma: A critical review of the procedure and its benefits on survival

Hepatocellular carcinoma(HCC) is the sixth most common type of cancer and the third most frequent cause of cancer-related death. Advances in preoperative assessment of HCC(e.g., imaging studies and liver function tests), surgical techniques, and postoperative care have improved the surgical outcomes and survival of patients who undergo hepatic resection for HCC. However, in the last 20 years, the long-term survival after hepatectomy has remained unsatisfactory owing to the high rates of local recurrence and multicentric occurrence. Anatomical liver resection(AR) was introduced in the 1980 s. Although several studies have revealed tangible benefits of AR for HCC, these benefits are still debated. Because most HCCs occur in patients with liver cirrhosis and poor hepatic function, there are many factors that affect survival, including the surgical method. Nevertheless, many studies have documented the perioperative and long-term benefits of AR in various conditions. In this article, we review the results of several recently published, well-designed comparative studies of AR, to investigate whether AR provides real benefits on survival outcomes. We also discuss the potential pitfalls associated with this approach.

Propensity score analysis demonstrated the prognostic advantage of anatomical liver resection in hepatocellular carcinoma

AIM: To compare the prognoses of hepatocellular carcinoma (HCC) patients that underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matched populations.

Predicting anatomical results of surgical treatment of idiopathic macular hole

AIM： To determine the parameters most informative in predicting the anatomical results of surgical treatment of idiopathic full-thickness macular hole （IMH）. METHODS： One hundred and sixty-two consecutive patients （170 eyes） after primary operation for IMH were enrolled. Outcomes were classified as anatomical success when both IMH closure and restoration of the outer retinal structure were achieved. ＂Prospective＂ group included 108 patients （115 eyes） followed with optical coherence tomography （OCT） and microperimetry for ly after surgery. Potential prognostic criteria, except microperimetry data, were tested in ＂retrospective＂ group （54 patients, 55 eyes）. Prognostic value of each parameter was determined using receiver operating characteristic （ROC） analysis. Combined predictive power of the best prognostic parameters was tested with the use of linear discriminant analysis. RESULTS： IMH closure was achieved in 106 eyes （92%） in the prospective group and 49 eyes （89%） in the retrospective group. Despite anatomical closure, the outer retinal structure was not restored in two eyes in the first group and in one eye in the second group. Preoperative central subfield retinal thickness demonstrated the best discriminatory capability between eyes with anatomical success and failure： area under the ROC-curve （AUC） 0.938 （95% Ch 0.881-0.995）, sensitivity 64% at fixed specificity 95% （cut-off value 300um） in the prospective group; sensitivity 57% and specificity 90% in the retrospective group. Other continuous parameters except tractional hole index （AUC： 0.796, 95% Ch 0.591- 1.000） had significantly lower AUCs （P〈0.05）. The best combination of the parameters, established by discriminant analysis in the prospective group, could not confirm its predictive value in the retrospective group. CONCLUSION： Preoperative central subfield retinal thickness is a strong and probably the best predictor of anatomical results of IMH surgical treatment.

Anatomical berry characteristics during the development of grape berries with different shapes

The aim of this study was to characterize the changes in berry anatomy during the development of grape(Vitis vinifera L.,and Vitis vinifera×Vitis labrusca)with different shapes.Paraffin sectioning was used to examine the structural parameters of the cells.The results revealed that,with the development of berries,the transverse and longitudinal diameters of the flesh cells gradually increased,revealing certain regularity.However,the transverse and longitudinal diameters of the epidermal and sub-epidermal cells were different between varieties,reflecting the specificity of the varieties.The growth of the transverse and longitudinal diameters of the berries was found to be completed in the early stage of development.A combination of correlation analysis and size analysis for each cell layer revealed that,due to the small crosssectional area of the epidermal and sub-epidermal cells,the influence of these cells on the transverse and the longitudinal diameters of the berries would be small.In conclusion,the longitudinal and transverse diameters of the grape berries were mainly determined by the longitudinal and transverse diameters of the flesh cells.The different shapes of the grape berries could mainly be attributed to the different growth rates of the flesh cells in the longitudinal and transverse directions.These different rates of growth led to different lengths and widths of the berry.