Endoscopic treatment of scarred polyps with a non-thermal device(Endorotor):A review of the literature

Endoscopic resection(ER)of colorectal polyps has become a daily practice in most endoscopic units providing a colorectal cancer screening program and requires the availability of local experts and high-end endoscopic devices.ER procedures have evolved over the past few years from endoscopic mucosal resection(EMR)to more advanced techniques,such as endoscopic submucosal dissection and endo-scopic full-thickness resection.Complete resection and disease eradication are the ultimate goals of ER-based techniques,and novel devices have been developed to achieve these goals.The EndoRotor®Endoscopic Powered Resection System(Interscope Medical,Inc.,Northbridge,Massachusetts,United States)is one such device.The EndoRotor is a powered resection tool for the removal of alimentary tract mucosa,including post-EMR persistent lesions with scarring,and has both CE Mark and FDA clearance.This review covers available published evidence documenting the usefulness of EndoRotor for the management of recurrent colorectal polyps.

The global Antarctic Research event,SCAR 2024

We are pleased to announce that“The 11th SCAR Open Science Conference”will take place in Pucón,Chile from 19-23 August 2024,hosted by the Chilean Antarctic Institute.Detailed information at https://www.scar2024.org/.The 11th SCAR Open Science Conference theme“Antarctic Science:Crossroads for a New Hope”,recognizes the importance of Antarctica as a unique and fragile ecosystem.With increasing concerns about climate change and its impact on the polar regions,this theme aims to highlight the significance of Antarctic research in shaping our understanding of global environmental challenges.By fostering collaboration and knowledge exchange,the SCAR Open Science conference hopes to inspire new solutions and a renewed sense of hope for the future of our planet.

通过改良RAPD技术获得黑毛石斛、蜂腰石斛和石仙桃的3条SCAR新标记

目的寻找快速区分黑毛石斛、蜂腰石斛和石仙桃的序列特征扩增区域(sequence characterized amplified regions,SCAR)新标记。方法在改良的随机扩增多态性DNA(random amplified polymorphic DNA,RAPD)的基础上对10个物种进行基因组DNA随机扩增、分子克隆和测序,分别设计了可鉴别3个物种的SCAR标记。结果成功筛选出3个SCAR标记,其相应的特异性标记分别为N2-12、A2-17和A6-33;其中SCAR标记N2-12在黑毛种属中扩增出约750 bp的特异性条带,SCAR标记A2-17在蜂腰石斛中扩增出约750 bp的特异性条带,SCAR标记A6-33在石仙桃种属中扩增出约600 bp的特异性条带。结论N2-12、A2-17和A6-33这3对特异性SCAR新标记能快速、准确的区分出黑毛石斛、蜂腰石斛和石仙桃这3个物种,为今后进行该中药道地药材样品的鉴定提供了实验依据。

Microglial depletion impairs glial scar formation and aggravates inflammation partly by inhibiting STAT3 phosphorylation in astrocytes after spinal cord injury

Astrocytes and microglia play an orchestrated role following spinal cord injury;however,the molecular mechanisms through which microglia regulate astrocytes after spinal cord injury are not yet fully understood.Herein,microglia were pharmacologically depleted and the effects on the astrocytic response were examined.We further explored the potential mechanisms involving the signal transducers and activators of transcription 3(STAT3)pathway.For in vivo experiments,we constructed a contusion spinal cord injury model in C57BL/6 mice.To deplete microglia,all mice were treated with colony-stimulating factor 1 receptor inhibitor PLX3397,starting 2 weeks prior to surgery until they were sacrificed.Cell proliferation was examined by 5-ethynyl-2-deoxyuridine(EdU)and three pivotal inflammatory cytokines were detected by a specific Bio-Plex Pro^(TM) Reagent Kit.Locomotor function,neuroinflammation,astrocyte activation and phosphorylated STAT3(pSTAT3,a maker of activation of STAT3 signaling)levels were determined.For in vitro experiments,a microglia and astrocyte coculture system was established,and the small molecule STA21,which blocks STAT3 activation,was applied to investigate whether STAT3 signaling is involved in mediating astrocyte proliferation induced by microglia.PLX3397 administration disrupted glial scar formation,increased inflammatory spillover,induced diffuse tissue damage and impaired functional recovery after spinal cord injury.Microglial depletion markedly reduced EdU+proliferating cells,especially proliferating astrocytes at 7 days after spinal cord injury.RNA sequencing analysis showed that the JAK/STAT3 pathway was downregulated in mice treated with PLX3397.Double immunofluorescence staining confirmed that PLX3397 significantly decreased STAT3 expression in astrocytes.Importantly,in vitro coculture of astrocytes and microglia showed that microglia-induced astrocyte proliferation was abolished by STA21 administration.These findings suggest that microglial depletion impaired astrocyte proliferation and astrocytic scar formation,and induced inflammatory diffusion partly by inhibiting STAT3 phosphorylation in astrocytes following spinal cord injury.

M2 macrophages mediate fibrotic scar formation in the early stages after cerebral ischemia in rats

In the central nervous system, the formation of fibrotic scar after injury inhibits axon regeneration and promotes repair. However, the mechanism underlying fibrotic scar formation and regulation remains poorly understood. M2 macrophages regulate fibrotic scar formation after injury to the heart, lung, kidney, and central nervous system. However, it remains to be clarified whether and how M2 macrophages regulate fibrotic scar formation after cerebral ischemia injury. In this study, we found that, in a rat model of cerebral ischemia induced by middle cerebral artery occlusion/reperfusion, fibrosis and macrophage infiltration were apparent in the ischemic core in the early stage of injury(within 14 days of injury). The number of infiltrated macrophages was positively correlated with fibronectin expression. Depletion of circulating monocyte-derived macrophages attenuated fibrotic scar formation. Interleukin 4(IL4) expression was strongly enhanced in the ischemic cerebral tissues, and IL4-induced M2 macrophage polarization promoted fibrotic scar formation in the ischemic core. In addition, macrophage-conditioned medium directly promoted fibroblast proliferation and the production of extracellular matrix proteins in vitro. Further pharmacological and genetic analyses showed that sonic hedgehog secreted by M2 macrophages promoted fibrogenesis in vitro and in vivo, and that this process was mediated by secretion of the key fibrosis-associated regulatory proteins transforming growth factor beta 1 and matrix metalloproteinase 9. Furthermore, IL4-afforded functional restoration on angiogenesis, cell apoptosis, and infarct volume in the ischemic core of cerebral ischemia rats were markedly impaired by treatment with an sonic hedgehog signaling inhibitor, paralleling the extent of fibrosis. Taken together, our findings show that IL4/sonic hedgehog/transforming growth factor beta 1 signaling targeting macrophages regulates the formation of fibrotic scar and is a potential therapeutic target for ischemic stroke.

基于sCARS-PSO-SVM的土壤硒含量高光谱定量反演

硒(Se)是人体必需的微量元素之一。人主要通过食用农产品来获取硒,而农产品中的硒主要来自土壤。因此,研究土壤中硒的含量和分布,对人体健康和农作物生产具有重要的意义。高光谱遥感技术的发展,使得高效、低成本、大范围估测土壤中硒的含量和分布成为可能。但是,土壤中硒的含量对光谱的敏感性较弱,严重影响了高光谱硒含量定量反演精度。该研究以广东连州地区富硒土壤为研究对象,系统采集研究区土壤样品50份,分析土壤样本硒含量,同步采集土壤反射光谱数据;利用Savitzky-Golay卷积平滑算法、多元散射校正(MSC)、对数一阶微分(lg(R)-FD)、标准正态变量校正(SNV)、多元散射校正一阶微分(MSC-FD)对原始光谱进行增强处理;应用稳定竞争自适应重加权采样(sCARS)算法结合皮尔逊相关性分析(PCC)进行特征波段选择;对比分析偏最小二乘(PLS)、支持向量机(SVM)和粒子群优化支持向量(PSO-SVM)模型土壤硒含量高光谱定量反演效果。结果表明:将sCARS算法应用于光谱增强后的回归模型,并结合皮尔逊相关性(PCC)选择与土壤硒含量敏感性较大的特征波段,不仅可以降低土壤硒含量高光谱预测模型复杂度并有效避免大量有用信息的损失,还能提高高光谱回归模型的反演效率;对比不同回归模型训练集和预测集的决定系数R^(2)和均方根误差RMSE,发现支持向量(SVM)模型比偏最小二乘(PLSR)模型预测效果更好,模型稳定性更高,且非线性模型更适用于土壤硒含量的预测;通过粒子群(PSO)算法优化SVM的核函数和正则化参数,SVM模型的反演精度和稳定性都有所提升;MSC-PSO-SVM模型(R^(2)=0.53、RMSE=0.34)和MSC-FD模型(R^(2)=0.50、RMSE=0.04)预测效果较为突出。综上所述:利用sCARS结合PSO-SVM算法建立土壤硒含量的高光谱定量反演模型,能够为土壤硒含量的高光谱大面积估测提供新的途径。

Mapping and Functional Analysis of LE Gene in a Lethal Etiolated Rice Mutant at Seedling Stage

An EMS(ethy methanesulfonate)-induced lethal etiolated(le)mutant obtained from the rice variety Zhongjian 100 was characterized by lethal etiolated phenotypes,with significantly reduced levels of chlorophyll a,chlorophyll b,total chlorophyll,and carotenoids.Additionally,the mutant displayed a significantly decreased number of chloroplast grana,along with irregular and less-stacked grana lamellae.The le mutant showed markedly diminished root length,root surface area,and root volume compared with the wild type.It also exhibited significantly lower catalase activity and total protein content,while peroxidase activity was significantly higher.Using the map-based cloning method,we successfully mapped the LE gene to a 48-kb interval between markers RM16107 and RM16110 on rice chromosome 3.A mutation(from T to C)was identified at nucleotide position 692 bp of LOC_Os03g59640(ChlD),resulting in a change from leucine to proline.By crossing HM133(a pale green mutant with a single-base substitution of A for G in exon 10 of ChlD subunit)with a heterozygous line of le(LEle),we obtained two plant lines heterozygous at both the LE and HM133 loci.Among 15 transgenic plants,3 complementation lines displayed normal leaf color with significantly higher total chlorophyll,chlorophyll a,and chlorophyll b contents.The mutation in le led to a lethal etiolated phenotype,which has not been observed in other ChlD mutants.The mutation in the AAA+domain of ChlD disrupted the interaction of ChlDle with ChlI as demonstrated by a yeast two-hybrid assay,leading to the loss of ChlD function and hindering chlorophyll synthesis and chloroplast development.Consequently,this disruption is responsible for the lethal etiolated phenotype in the mutant.

Temporal dynamics of microglia-astrocyte interaction in neuroprotective glial scar formation after intracerebral hemorrhage

The role of glial scar after intracerebral hemorrhage(ICH)remains unclear.This study aimed to investigate whether microglia-astrocyte interaction affects glial scar formation and explore the specific function of glial scar.We used a pharmacologic approach to induce microglial depletion during different ICH stages and examine how ablating microglia affects astrocytic scar formation.Spatial transcriptomics(ST)analysis was performed to explore the potential ligand-receptor pair in the modulation of microglia-astrocyte interaction and to verify the functional changes of astrocytic scars at different periods.During the early stage,sustained microglial depletion induced disorganized astrocytic scar,enhanced neutrophil infiltration,and impaired tissue repair.ST analysis indicated that microglia-derived insulin like growth factor 1(IGF1)modulated astrocytic scar formation via mechanistic target of rapamycin(mTOR)signaling activation.Moreover,repopulating microglia(RM)more strongly activated mTOR signaling,facilitating a more protective scar formation.The combination of IGF1 and osteopontin(OPN)was necessary and sufficient for RM function,rather than IGF1 or OPN alone.At the chronic stage of ICH,the overall net effect of astrocytic scar changed from protective to destructive and delayed microglial depletion could partly reverse this.The vital insight gleaned from our data is that sustained microglial depletion may not be a reasonable treatment strategy for early-stage ICH.Inversely,early-stage IGF1/OPN treatment combined with late-stage PLX3397 treatment is a promising therapeutic strategy.This prompts us to consider the complex temporal dynamics and overall net effect of microglia and astrocytes,and develop elaborate treatment strategies at precise time points after ICH.

Ultrasound Evaluation of Caesarean Scar of Prelabour and Labour Caesarean Sections: A Cross Sectional Analytical Study

Caesarean section is dramatically increased throughout the world in recent years. Rupture of the uterus is a devastating complication in trial of labour following previous Caesarean section. Evidence suggests that the size of the uterine scar and the residual myometrial thickness (RMT) are associated directly with the risk of uterine rupture and risk of dehiscence in subsequent deliveries. Impact of the prelabour and labour Cesarean section on the RMT has not been studied in detail. Objectives: To compare RMT, Caesarean scar defects and to evaluate the elasticity of the Caesarean scar between women who underwent prelabour and labour Caesarean sections. Methods: This was a Cross sectional analytical study. Women who underwent Caesarean section in their first pregnancy were recruited. Sample was stratified to prelabour and labour Caesarean section groups. Transvaginal ultrasound scan was performed six months following the Caesarean section. Dimensions of the uterus, uterine scar defect, RMT and elastosonography of the uterine scar were assessed. Results: A total of 240 postpartum women were analyzed. Uterine niche was detectable in 194 subjects. Prelabour CS group had demonstrated 91.7% (n = 110) scar defects (uterine niche) out of 120 cases and the rate among labour CS group was 70% (n = 84). There was a significant difference in the presence of uterine niche among 2 groups as Prelabour group was found to have more scar defects (p mm (SD 1.2) and 4.99 mm (SD 1.3) respectively and there was no significant difference (t = 0.38, p = 0.71). There was no significant difference between the dimensions of the uterine CS defects of the studied groups. Prelabour CS group had significantly higher Target strain [0.28 vs. 0.24 (t = 2.12, p = 0.04)] and significantly less strain ratio [1.45 vs. 1.55 (t -2.42, p = 0.04)] than labour CS group indicating a better scar in prelabour group. Conclusion: There was no significant difference in RMT and uterine scar defects between prelabour and labour Caesarean section groups. But prelabour Caesarean section scars were less stiff than labour Caesarean section scars. Further studies are warranted to elaborate on the association.

Advances and established therapies in linear scar prevention

Linear scars are scars formed after surgery or other trauma-healing procedures that typically exhibit a linear morphology.Optimal linear scars are characterized by narrowness,flatness,and a color closely resembling the adjacent tissue.Failure to meet these criteria can have detrimental effects on the physical and psychological wellbeing of patients.Thus,early intervention for linear scars can effectively improve functionality and aesthetics.This review aimed to consolidate the prevailing agreement on scar prevention therapies and provide clinical physicians with comprehensive and cutting-edge guidance.

A randomized clinical trial assessing the efficacy of single and multiple intralesional collagenase injections for treating contracted scars

Background:Scar contractions caused by trauma or burns can cause secondary physical dysfunction and disfigurement.Many minimally invasive methods for scar contraction have shown limited applicability and efficacy.This study investigated the feasibility and efficacy of intralesional collagenase injections for scar contraction treatment.Methods:Patients with contracted scars who had limited joint movement and physical disfiguration for>1 year were enrolled in this single-blind,randomized clinical trial from July 2017 to February 2018 at Shanghai Ninth People’s Hospital.Collagenase was injected into the firm-contracted scar(15 U/cm^(2))three times at 4-week intervals in the multiple treatment group and once in the single treatment group,and a placebo injection was performed in the control group.Scar length and skin texture were documented at the 4-and 12-week follow-ups.The safety of the collagenase treatment was also evaluated.Results:The contracted scar was significantly elongated after both single and multiple collagenase treatments.The results showed that,compared to a one-time treatment,repeated injections were more effective at 12 weeks,with an average improvement of 26.83(15.79%).At 12 weeks,78.9% of the patients in the multiple group and 52.9%in the single group achieved significant improvement at 12 weeks.No severe adverse events were observed.Conclusion:Intralesional collagenase injection showed promising results in improving scar contraction and provides an alternative treatment for patients.

A comprehensive approach to the delayed treatment of post-burn facial scars

Background:Damage to the skin and underlying tissues due to thermal burns is relevant.Despite the success of modern medicine,repairing thermal damage to the skin is a difficult task in reconstructive plastic surgery because of the nature of the damage and the regenerative features.Characteristic post-burn changes are associated with different depths of damage when areas of deep damage are combined with more superficial areas.Methods:We described a clinical case of the staged surgical treatment of a cicatricial deformity of the buccalperiorbital-perioral region resulting from a childhood burn injury from a hot object.The 44-year-old patient complained of an aesthetic and functional deformity of the buccal-periorbital-perioral region and had previously undergone repeated nonsurgical corrections.Results:A comprehensive approach to the surgical treatment of a patient with post-burn deformities using a diplene adhesive membrane directly affected the stage of the surgical treatment and contributed to improved functional and aesthetic results.Conclusion:The positive treatment results with preserved contraction and relaxation processes of the facial muscles as well as satisfactory aesthetic results allow us to recommend the use of a biodegradable diplene film during facial reconstructive operations.

Effectiveness of conjunctival bleb scarring by knockdown of heat shock protein 47 in rat model

AIM:To evaluate the effectiveness of knock-down of heat shock protein 47(HSP47)on conjunctival bleb scarring in a rat model and its possible mechanism.METHODS:Male Sprague–Dawley rats were used for glaucoma filtration surgery(GFS)and were treated with either phosphate buffered solution,shControl,mitomycin C,or sh-HSP47 using a microsyringe immediately after GFS.The morphology of filtering blebs was observed postoperatively.The levels of HSP47 were analyzed at 2,5,8,and 11d after GFS via real‑time quantitative polymerase chain reaction(PCR)and Western blot.The silencing effect of HSP47,the expression of collagen I and III,and the potential signaling pathways of HSP47 during scarification were explored 11d post GFS.The protein levels of transforming growth factor-β1(TGF-β1),phospho-Smad2(pSmad2),phospho-Smad3(p-Smad3),and phospho-p38(p-p38)were also analyzed using Western blot.RESULTS:Sh-HSP47 treatment significantly prolonged the functional filtration bleb retention.The levels of HSP47 were increased significantly at 5,8,and 11d postoperatively compared to the control group(P<0.05,P<0.01,and P<0.001).The levels of HSP47 protein at day 11 postoperatively were significantly down-regulated after HSP47 silencing using sh-HSP47 adenovirus transfection(P<0.01).Expression levels of collagen I and III within the blebs were significantly reduced in the absence of HSP47(P<0.01).Moreover,the protein levels of TGF-β1,p-Smad2/3,and p-p38 were dramatically inhibited after treatment with sh-HSP47(P<0.01).CONCLUSION:The inhibitory effects of HSP47 knockdown on scarring after GFS have the potential to be an efficacious therapeutic option for the treatment of conjunctival bleb scarring.

Hypertrophic Scar Formation and Wound Healing Modulation Fatty Acids as Modulators of Severe Scars

Scar tissue usually generates severe discomfort in the short and long term. Common symptoms include anesthetics sequelae, pruritus, joint malfunction, new wounds on the scar surface, and pain. There are several treatments for scars, like compression, topical or intralesional steroid infiltration, 5-fluorouracil, dermabrasion, and surgeries with new scar tissue. For adult patients, it is easier to choose the treatment. However, compression is commonly applied in children to prevent treatments that have adverse effects. This study reports the outcomes of 15 patients submitted to abdominoplasty, traumatic wounds and post-burn scar treatments, which showed significant changes after the continuous use of an ointment composed of petrolatum, cod liver oil, BHT, Chamomilla recutita (chamomile) oil, Helianthus annuus (sunflower) oil, and Prunus amygdalus dulcis (sweet almond) oil. As components of the stratum corneum, unsaturated fatty acids influence the cutaneous structural and immune status and permeability. They also interfere with the maturation and differentiation of the stratum corneum and inhibit the production of proinflammatory eicosanoids, reactive species (ROS and RNS), and cytokines, thereby influencing the inflammatory response and possibly wound healing. This article aims to share our experience with the regular use of an ointment in adult and pediatric patients for three months. The increase in proinflammatory cytokine production at wound sites, resulting in a noninvasive, therapeutical, and effective cutaneous wound healing and scarring modulation, may provide a physiopathological explanation for the fast improvement of scars.

A Case Report of Concurrent Acne-Related Occurrence Complications: Telangiectasia, Post-Inflammatory Erythema, Post-Inflammatory Hyperpigmentation, and Atrophic and Hypertrophic Scars

Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifestations of mandibular acne did not improve. At the time of initial examination, telangiectasia (TE), post-inflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), atrophic scars (ASs), and a hypertrophic scar (HS) with induration were observed on the right neck. We diagnosed this as an acne vulgaris complication. HS lesions were topically treated by injecting triamcinolone acetonide, and the patient was prescribed 8.1 g/day of oral Saireito (Japanese herb). Adapalene benzoyl peroxide gel and topical tacrolimus hydrate ointment were used to treat PIE and TE. Both HSs and PIE improved;however, TE and AS did not improve. Currently, the patient is under observation. We consider this to be a very rare concurrent occurrence of diverse complications of acne vulgaris, and present the following case study.

Emergency internal iliac artery temporary occlusion after massive hemorrhage during surgery of cesarean scar pregnancy:A case report

BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP are now diagnosed early and can be managed safely.However,some atypical patients are misdiagnosed,and their surgical risks are underestimated,increasing the risk of fatal hemorrhage.CASE SUMMARY A 27-year-old Asian woman visited our institution because of abnormal pregnancy,and she was diagnosed with a hydatidiform mole through transvaginal ultrasound(TVS).Under hysteroscopy,a large amount of placental tissue was found in the scar of the lower uterine segment,and a sudden massive hemorrhage occurred during the removal process.The bilateral internal iliac arteries were temporarily blocked under laparoscopy,and scar resection and repair were rapidly performed.She was discharged in good condition 5 d after the operation.CONCLUSION Although TVS is widely used in the diagnosis of CSP,delays in the diagnosis of atypical CSP remain.Surgical treatment following internal iliac artery temporary occlusion may be an appropriate management method for unanticipated massive hemorrhage during CSP surgery.

不同类型剖宫产瘢痕妊娠的病例特点与诊治分析

背景现行剖宫产瘢痕妊娠(CSP)分型依据仅参照超声影像特点,目前尚缺乏该分型标准下不同类型CSP病例临床特点的分析总结。目的探讨不同类型CSP的病例特点及诊治差异。方法纳入北京大学第三医院妇产科2014年7月—2022年6月收治的CSP患者共862例为研究对象,根据超声分型标准分为Ⅰ型、Ⅱ型、Ⅲ型组,并对其临床特点及诊治指标进行回顾性分析。结果本研究CSP患者中Ⅰ型组占36.5%(315/862),Ⅱ型组占53.1%(458/862),Ⅲ型组占10.3%(89/862)。3组患者的年龄、孕产史、既往宫腔手术史比例比较,差异均无统计学意义(P>0.05)。CSP患者中腹痛发生率为24.2%(209/862),阴道出血发生率为65.0%(560/862)。3组CSP患者腹痛及阴道出血发生率比较,差异均无统计学意义(P=0.261、0.062)。Ⅲ型组患者诊断时停经时间为55(46,64)d,妊娠物中位径线长29.6(19.1,43.3)mm,术前血β-人绒毛膜促性腺激素(β-HCG)水平为60673(17164,122203)mU/mL,需辅助药物杀胚治疗、腹腔镜监视下手术、子宫动脉阻断率分别为27.0%(24/89)、33.7%(30/89)、32.6%(29/89),手术时长101(67,125)min,住院时间4(3,7)d,治疗花费11933.7(8760.7,15250.6)元,术后24 h累计出血量、出血≥200 mL发生率及输血率分别为83(33,178)mL、24.7%(22/89)、7.9%(7/89),均高于其他两组(P<0.001)。所有患者持续性CSP发生率为3.1%(27/862),3组持续性CSP发生率比较,差异无统计学意义(χ^(2)=3.353,P=0.187)。结论不同类型CSP患者的年龄、孕产史、既往宫腔手术史及腹痛、阴道出血等临床特点无明显差异。Ⅰ型和Ⅱ型患者治疗侵入性较小,Ⅲ型患者的医疗资源消耗较多,对多学科团队及个体化管理有较高要求。不同类型患者经规范管理,其治疗预后均较理想。

Can we suppress excessive post-surgical scar formation:A case report

BACKGROUND Hypertrophic scars(HSs)formation is a complication that occurs after wounds heal with secondary intention and sometimes after clean surgical incisions.Many treatments are in vogue now with varying successes.Although the mechanism or mechanisms that cause a HS to form are not clearly understood,one thing that is clear is that once scar tissue matures,any intervention will not be successful.In this paper,we report on a case where a patient who was known to develop HS was treated with a new combination of ingredients(Phyto-chemicals+Silicone JUMI)to suppress HS formation.CASE SUMMARY A 68-year-old female of African descent presented a severe HS post total knee replacement(TKR),which the patient describes as itchy and painful.Due to complications caused by the scar,she was apprehensive about undergoing TKR on her other knee.However,after the TKR of the contralateral side post-removal of skin clips,JUMI anti-scar cream(JASC)was used to suppress excessive scar formation.CONCLUSION JASC appears potent and efficacious at suppressing excessive scar formation.We believe that this warrants further studies on larger patient groups and on different surgical sites.

BSA联合转录组分析发掘西瓜叶片黄化候选基因

叶片是植物重要的功能器官之一,不仅是植株进行光合作用的主要场所,也可作为重要的形态标记,应用于育种中。叶片颜色作为形态标记,不仅可用于苗期杂种的清除,亦可用于种子纯度的测定。以西瓜全生育期叶片黄化突变体纯合自交系ly104为母本(P_(1))、绿叶自交系w3为父本(P_(2)),通过杂交创制F_(1)代、F_(2)代、BC_(1)代群体。遗传分析结果表明,该突变体的叶片黄化由单隐性基因控制。采用混合分组分析(BSA)进行初定位,通过简化基因组测序(RAD)开发全基因组单核苷酸多态性(SNP)标记构建西瓜高密度遗传图谱,将西瓜叶片黄化基因定位于2号染色体13950306~15517591 bp(大小约为1.57 Mb)。以西瓜97103v2为参考基因组,该区间包含24个注释基因。对P_(1)(P1Y)、P_(2)(P2G)和F 2代群体中黄叶(F2Y)、绿叶(F2G)株系进行转录组水平分析,结果表明,目标区间内基因Cla97C02G035950、Cla97C02G036010、Cla97C02G036020、Cla97C02G036060在黄化叶片与正常绿叶材料中的表达量差异显著,可能是西瓜叶片的黄化候选基因。研究结果可为进一步解析西瓜叶片黄化基因功能和生物学特性奠定重要基础。

Experience in Surgical Coordination of Type III Cesarean Scar Pregnancy Removal with Combined Assistance of Hysteroscopy and Laparoscopy

Objective:This paper aims to summarize the operative nursing coordination essentials of type III cesareans car pregnancy removal.Methods:Six patients were recruited for this study,and the patient’s condition was fully evaluated before the operation.In addition,the personnel,environment,and materials were well prepared before the operation,and the preparation of special intraoperative instruments and equipment was perfected.Results:The operation is successfully performed in all six patients.Each surgery lasted 70 to 120 minutes with an average duration of 90 minutes.Postoperative blood loss was about 100-500 ml.Postoperative recovery was good without complications in all the patients.Conclusion:In summary,laparoscopic removal of gestational tissue from type III cesareans car pregnancy in conjunction with hysteroscopy ensures compete removal of gestational tissue,while avoiding damaging the surrounding organs and tissues,thus greatly avoiding common complications which usually occur during the surgery.Effective surgical coordination is helpful to further improve the success rate of the operation.