Laparoscopic right radical hemicolectomy: Central vascular ligation and complete mesocolon excision vs D3 lymphadenectomy - How I do it?

In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.

Donor ductal anomaly is not a contraindication to right liver lobe donation

Background:Data of living-donor liver transplantation(LDLT)suggested that donor ductal anomaly may contribute to postoperative biliary complications in recipients and in donors.This retrospective study aimed to determine if the occurrence of postoperative biliary stricture in donors or recipients in rightlobe LDLT(RLDLT)is related to donor biliary anatomy type.Methods:We analyzed our RLDLT recipients’clinical data and those of their graft donors.The recipients were divided into 2 groups:with and without postoperative biliary stricture.The 2 groups were compared.The primary endpoints were donor biliary anatomy type and postoperative biliary complication incidence;the secondary endpoints were 1-,3-and 5-year graft and patient survival rates.Results:Totally 127 patients were included in the study;25(19.7%)of them developed biliary anastomotic stricture.In these 25 patients,16 had type A biliary anatomy,3 had type B,2 had type C,3 had type D,and 1 had type E.In the 127 donors,96(75.6%)had type A biliary anatomy,13(10.2%)had type B,6(4.7%)had type C,10(7.9%)had type D,and 2(1.6%)had type E.Biliary stricture was seen in 2 donors,who had type A biliary anatomy.None of the recipients or donors developed bile leakage.No association between the occurrence of postoperative biliary stricture and donor biliary anatomy type was found(P=0.527).Conclusions:The incidence of biliary stricture in donors or recipients after RLDLT was not related to donor biliary anatomy type.As postoperative complications were similar in whatever type of donor bile duct anatomy,donor ductal anomaly should not be considered a contraindication to donation of right liver lobe.

Right ventricle dysfunction does not predict mortality in patients with SARS-CoV-2-related acute respiratory distress syndrome on extracorporeal membrane oxygenation support

BACKGROUND The prognostic role of right ventricle dilatation and dysfunction(RVDD)has not been elucidated in patients with coronavirus disease(COVID)-related respiratory failure refractory to standard treatment needing extracorporeal membrane oxygenation(ECMO)support.AIM To assess whether pre veno-venous(VV)ECMO RVDD were related to inintensive care unit(ICU)mortality.METHODS We enrolled 61 patients with COVID-related acute respiratory distress syndrome refractory to conventional treatment submitted to VV ECMO and consecutively admitted to our ICU(an ECMO referral center)from 31th March 2020 to 31th August 2021.An echocardiographic exam was performed immediately before VV ECMO implantation.RESULTS Males were prevalent(73.8%)and patients with a body mass index>30 kg/m^(2) were the majority(46/61,75%).The overall in-ICU mortality rate was 54.1%(33/61).RVDD was detectable in more than half of the population(34/61,55.7%)and associated with higher simplified organ functional assessment(SOFA)values(P=0.029)and a longer mechanical ventilation duration prior to ECMO support(P=0.046).Renal replacement therapy was more frequently needed in RVDD patients(P=0.002).A higher in-ICU mortality(P=0.024)was observed in RVDD patients.No echo variables were independent predictors of in-ICU death.CONCLUSION In patients with COVID-related respiratory failure on ECMO support,RVDD(dilatation and dysfunction)is a common finding and identifies a subset of patients characterized by a more severe disease(as indicated by higher SOFA values and need of renal replacement therapy)and by a higher in-ICU mortality.RVDD(also when considered separately)did not result independently associated with in-ICU mortality in these patients.

“A Prospective Randomized Case-Control Study To Evaluate Mini Right Thoracotomy versus Conventional Sternotomy For Mitral Valve Repair In Rheumatic Heart Disease.”

Purpose: Right mini thoracotomy has been evaluated in many studies for mitral valve repair mainly in degenerative valvular disease but not in rheumatic heart disease. Mitral valve repair is more challenging in rheumatic etiology due to complexity of lesions. This prospective randomized case control study was designed to evaluate repair through mini right thoracotomy and to compare the clinical and echocardiographic outcomes with sternotomy in rheumatic patients. Methods: 25 patients of rheumatic heart disease underwent mitral valve repair through mini right thoracotomy (group I). Various clinical and functional parameters were compared with 25 patients of mitral valve repair through sternotomy (group II). On follow up the results were compared in both groups for clinical and echocardiographic parameters. Results: The various pre-operative demographic parameters were comparable in two groups. Equal rate of mitral valve repair (group I-21/25, 84% and group II-21/25, 84%) was achieved in both groups. The various intra-operative and post-operative clinical parameters were better in group I .There were equivalent functional and valve related outcomes in both groups in term of NYHA class (1.28 ± 0.613 vs 1.08 ± 0.276, P = 0.144), post-operative mitral valve area (2.43 ± 0.891 vs 2.82 ± 0.662, P = 0.090), incidence of more than mild mitral regurgitation (0) and mean pressure gradient across mitral valve (4.98 ± 3.33 vs 4.23 ± 1.5, P = 0.309). Conclusion: Mitral valve repair through mini right thoracotomy approach in rheumatic etiology is feasible and safe with equivalent rate of successful repair as compared to median sternotomy. It is associated with lesser morbidity, cosmetic advantage and lesser resource utilization.

An Evidence-Based CoCoSo Framework with Double Hierarchy Linguistic Data for Viable Selection of Hydrogen Storage Methods

Hydrogen is the new age alternative energy source to combat energy demand and climate change.Storage of hydrogen is vital for a nation’s growth.Works of literature provide different methods for storing the produced hydrogen,and the rational selection of a viable method is crucial for promoting sustainability and green practices.Typically,hydrogen storage is associated with diverse sustainable and circular economy(SCE)criteria.As a result,the authors consider the situation a multi-criteria decision-making(MCDM)problem.Studies infer that previous models for hydrogen storage method(HSM)selection(i)do not consider preferences in the natural language form;(ii)weights of experts are not methodically determined;(iii)hesitation of experts during criteria weight assessment is not effectively explored;and(iv)three-stage solution of a suitable selection of HSM is unexplored.Driven by these gaps,in this paper,authors put forward a new integrated framework,which considers double hierarchy linguistic information for rating,criteria importance through inter-criteria correlation(CRITIC)for expert weight calculation,evidence-based Bayesian method for criteria weight estimation,and combined compromise solution(CoCoSo)for ranking HSMs.The applicability of the developed framework is testified by using a case example of HSM selection in India.Sensitivity and comparative analysis reveal the merits and limitations of the developed framework.

The Historical Position and Value Dimensions of Human Rights Civilization

Human beings are the mainstay and the ultimate goal of civilization.The history of human civilization is a continuous struggle to realize the respect,liberation,protection,and development of humanity.Human rights are an achievement of humanity and a symbol of progress,and the human rights civilization is an important component of human civilization.Understanding and interpreting human rights from the perspective of human rights civilization means that human rights are not only a concept or an idea but also a grand historical and long-term social practice.Up to now,the development of human rights civilization has roughly experienced four awakening eras:initialization,revolution,popularization,and globalization.In terms of its value dimensions,it has the characteristics of progressiveness,diversity,commonality,inclusiveness,indivisibility,openness,and so on.The historical position of human rights civilization and the development of its value dimensions have shown to the world that human rights are the common wealth of humanity,and human rights belong to all mankind;human rights are historical,concrete,and developmental;the concept of human rights is constantly evolving,and its connotations and categories are constantly expanding;achieving the free and well-rounded development of every person is the highest value realm of human rights civilization.The Chinese modernization endows Chinese civilization with modern strength and opens up new horizons for human rights civilization.The new pattern of human rights civilization to be created by Chinese modernization not only possesses the common characteristics of human rights civilization but also enjoys Chinese characteristics based on its own national conditions,enriching and developing the diversity of human rights civilization for all mankind.

The Way to Optimize the Right to Personal Data Portability in Chinese Practice——Based on Empirical Analysis of the Privacy Policies of 66 Mobile Apps

Although the existing legal norms and judicial practic-es can provide basic guidance for the right to personal data portabili-ty, it can be concluded that there are obstacles to the realization of this right through empirical research of the privacy policies of 66 mobile apps, such as whether they have stipulations on the right to personal data portability, whether they are able to derive copies of personal in-formation automatically, whether there are textual examples, whether ID verification is required, whether the copied documents are encrypt-ed, and whether the scope of personal information involved is consis-tent. This gap in practice, on the one hand, reflects the misunderstand-ing of the right to personal data portability, and on the other hand, is a result of the negative externalities, practical costs and technical lim-itations of the right to personal data portability. Based on rethinking the right to data portability, we can somehow solve practical problems concerning the right to personal data portability through multiple measures such as promoting the fulfillment of this right by legislation, optimizing technology-oriented operations, refining response process mechanisms, and enhancing system interoperability.

Research on the Constitutional,Historical and Practical Logic of the Chinese Path of Human Rights Development——From the Perspective of the Inclusion of Human Rights Clause in the Constitution

The inclusion of the human rights clause in the Chi-nese Constitution is a concern and expression of the spirit of the Con-stitution,which has laid the institutional regulations of the fundamen-tal law for the development of human rights in China,provided the principles and value norms of the highest level of effectiveness for the legal protection of human rights,and built a profound constitutional basis for the formation and improvement of the Chinese path of human rights development.The human rights clause is not only a summariza-tion and affirmation of the historical practice of Chinese human rights development under the leadership of the Communist Party of China,but also a new starting point for the development of human rights in China under the leadership of the Communist Party of China.It marks that the development of human rights in China has entered a new era.The Party and the state have finally embarked on a path of human rights development with Chinese characteristics by formulating and implementing the Human Rights Action Plan of China,eliminating ab-solute poverty through the national poverty alleviation campaign,and promoting human rights protection through the rule of law.

Access to Financial Services——An Analysis from the Human Rights Perspective

There is a broad connection between finance and human rights,with finance having both positive and negative impacts on human rights.Everyone has a need for access to financial services.Documents in both the international human rights and international finance fields address the relationship between financial services and human rights.Among financial services,microcredit and inclusive finance have the closest connection to human rights and potentially the greatest impact on human rights.Access to financial services promotes economic,social,and cultural rights as well as the rights of specific groups.The conditions for access to financial services to promote human rights require the state to assume obligations to recognize,respect,protect,and fulfill the need for individuals to access financial services,and to ensure the availability,accessibility,acceptability,and adaptability of basic financial services.Access to financial services has played a significant role in China’s comprehensive victory in the battle of poverty alleviation,providing valuable experience for the international community in poverty eradication,achieving sustainable development goals,and protecting and promoting human rights.

The Historic Achievements of the Communist Party of China in Respecting and Protecting Human Rights in the New Era

In the new era,the Communist Party of China(CPC)has made historic achievements in respecting and protecting human rights.Building upon the principle of the“two integrations”(integrating the basic tenets of Marxism with China’s specific realities and fine traditional culture),it has nurtured new theories on respecting and protecting human rights in the new era,which can address the fundamental questions of whom and what the human rights protection efforts in the new era are for.Guided by the principle of“taking our own path,”it has charted a distinct course for the development of human rights,diverging from the Western approach.The CPC has maintained the unity between Party leadership and the respect for and protection of human rights,promoting progress in human rights through the pursuit of“high-quality development,”and ensuring various fundamental rights of the people through the rule of law.Building upon the past experience,the CPC has established the“source”of the institutional framework for respecting and protecting human rights in the new era,crafted the“body”of this institutional framework,and introduced its practical“application.”In promoting the comprehensive advancement of human rights protection,the CPC has facilitated the connotative development of human rights protection in China,empowering China in international human rights discourse,and contributing Chinese strength and wisdom to global human rights governance.

Experience of donor right lobe hepatectomy in adult-to-adult live donor liver transplantation: clinical analysis of 89 cases

Objective: To review the experience of donor selec- tion and right lobe hepatectomy in adult-to-adult live donor liver transplantation. Methods: From May 1996 to December 2001, 89 live donor liver transplants using right lobe grafts were performed at Queen Mary Hospital, Hong Kong. All donors had received psychological counseling before donor operations. They were screened by laboratory tests including complete blood cell count, liver and renal biochemistry, and viral serology studies. Com- puted tomography (CT), CT volumetry and hepatic arteriography were routinely performed. All donors underwent the operations using the method designed by us. Results: The median duration of the operations was 8.8 hours. The median blood loss recorded 466 ml. The median intensive care unit and hospital stays were 2 and 10 days, respectively. There was no do- nor mortality. Complications of donor operations in- cluded wound infection, urinary tract infection, bili- ary stricture, cholestasis, subphrenic collection, bowel obstruction and incision hernia, etc. All do- nors have recovered and returned to their previous occupations. Conclusions: Live donation of right lobe grafts for a- dult-to-adult liver transplantation is safe, provided that donor selection is strict and utmost care is exer- cised during the operation.

Analysis of surgical and perioperative complications in seventy-five right hepatectomies for living donor liver transplantation

AIM: To present an analysis of the surgical and perioperative complications in a series of seventy- five right hepatectomies for living-donation (RHLD) performed in our center. METHODS: From January 2002 to September 2007, we performed 75 RHLD, defined as removal of a portion of the liver corresponding to Couinaud segments 5-8, in order to obtain a graft for adult to adult living-related liver transplantation (ALRLT). Surgical complications were stratified according to the most recent version of the Clavien classification of postoperative surgical complications. The perioperative period was defined as within 90 d of surgery. RESULTS: No living donor mortality was present in this series, no donor operation was aborted and no donors received any blood transfusion. Twenty- three (30.6%) living donors presented one or more episodes of complication in the perioperative period. Seven patients (9.33%) out of 75 developed biliary complications, which were the most common complications in our series.CONCLUSION: The need to define, categorize and record complications when healthy individuals, such as living donors, undergo a major surgical procedure, such as a right hepatectomy, reflects the need for prompt and detailed reports of complications arising in this particular category of patient. Perioperative complications and post resection liver regeneration are not influenced by anatomic variations or patient demographic.

Comparison of clinical outcomes and postoperative recovery between two open heart surgeries:minimally invasive right subaxillary vertical thoracomy and traditional median sternotomy

Objective: To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median stemotomy through right atrium in treatment of common congenital heart diseases. Methods: Clinical data of 59 cases of common congenital heart diseases treated with minimally invasive right axillary vertical thoracotomy from May, 2011 to February, 2013 and 77 cases of same diseases with traditional median stemotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventricular septal defect and partial endocardial cushion defect. The results were compared from the two groups, including the time for operation and cardiopulmonary bypass, amount of blood transfusion, postoperative drainage, ventilation time, hospital stay, and prognosis. Results: No severe complications happened in both groups, like deaths or secondary surgery caused by bleeding. No significant differences were in CPB time and postoperative ventilator time between groups (P>0.05), while for all of the operative time, the length of incision, postoperative drainage and hospital stay, minimally invasive right axillary vertical thoracotomy was superior to median stemotomy, with statistically significant differences (P<0.05). In six month followup after operation, no complications of residual deformity and pericardial effusion were found in both groups by doing echocardiography, but mild pectus carinatum was found in 8 patients in the traditional median sternotomy group (traditional group), whereas patients in another group were well recovered. Conclusions: Minimally invasive right subaxillary vertical thoracotomy for common congenital heart diseases is as safe as traditional median stemotomy, without the increasing incidence of postoperative complications. Additionally, compared with traditional median stemotomy, minimally - invasive right subaxillary vertical thoracotomy is better in the aspects of hidden incision, appearance, and postoperative recovery.

Does cranial-medial mixed dominant approach have a unique advantage for laparoscopic right hemicolectomy with complete mesocolic excision?

BACKGROUND Complete mesocolic excision(CME)with central vascular ligation(CVL)was proposed by Hohenberger in 2009.The CME principle has gradually become the technical standard for colon cancer surgery.How to achieve CME with CVL in laparoscopic right hemicolectomy(LRH)is controversial,and a unified standard approach is not yet available.In recent years,the authors’team has integrated the theory of membrane anatomy,tried to combine the cephalic approach with the classic medial approach(MA)for technical optimization,and proposed a cranialmedial mixed dominant approach(CMA).AIM To explore the feasibility of operational approaches for LRH with CME.METHODS In this retrospective cohort study,the clinical data of 57 patients with right-sided colon cancer(TNM stage I,II,or III)who underwent LRH with CME from January 2016 to June 2020 were collected and summarized.There were 31 patients in the traditional MA group and 26 in the CMA group.RESULTS There were no significant differences in baseline data between the two groups.The operation was shorter and the number of lymph nodes dissected was higher in the CMA group than in the MA group,but there was no significant difference in the number of positive lymph nodes,intraoperative blood loss,postoperative exhaust time,feeding time,postoperative hospital stay or postoperative complication incidence.CONCLUSION Our study shows that the CMA is a safe and feasible procedure for LRH with CME and has a unique advantage.

Resolving Doubts,Enhancing Mutual Trust and Promoting Cultural Exchanges among Civilizations:The visit of the Delegation of China Society for Human Rights Studies to the UK and Greece

The delegation of China Society for Human Rights Studies visited the UK and Greece from the 30th of June to the 7th of July.During their stay in the UK,the delegation visited the Foreign and Commonwealth Office,the Parliament, research institutes and think tanks,having indepth discussions on human rights issues with people from various circles.

Judicial Protection and Restorative Justice of the Support Rights and Interests for the Elderly Rights——Taking the Sample of Judgement Documents from 2013-2018 as Analysis Object

The support rights and interests of the elderly is one of the core issues of an aging society.Judging from the judgment documents on support dispute cases in recent years,maintenance disputes mainly occur in the kinship structure of parents and children,the support obligators are mainly men,the content of support is mainly material appeals.In the judicial process,there are some characteristics worth studying,such as lawyers,intervention,judges,thinking,reasoning and expression.In view of this,the current development direction of the judicial protection of elderly’s rights and interests in China should be carried out around the goal of"restorative justice"and efforts should be made,such concept renewal,system improvement and spiritual support prospect.

Taking the Path of Poverty Reduction with Chinese Characteristics to Promote New Progress in China's Human Rights——A Keynote Speech at the Opening Ceremony of 2018 Beijing Forum on Human Rights

The 2018 Beijing Forum on Human Rights opens on this wonderful autumn day.On behalf of the China Society for Human Rights Studies, I wish to express warm congratulations on the opening of the forum and a sincere welcome to all guests from home and abroad.

The Rights of Persons Charged with Penal Offences to Access to Lawyers——A comparison between international and domestic laws

I. Getting help from lawyers and its realization according to international standards The right to defense for a person involving in a law suit is a universal human right. Article 11 of the Universal Declaration of Human Rights provides： ＂Everyone charged with a penal offence has the right to be presumed innocent until proved guilty according to law in a public trial at which he has had all the guarantees necessary for his defence.＂ This means （1） the right to defence is a basic human right due to all persons charged with a penal offence; （2） it is a basic requirement for the principle of presumption of innocence and fair trial; and （3） the realization of the fight needs practical and effective guarantees.

The Basis of Requisitional Right of Regulatory Taking

所谓“管制性征收”，是指政府在对经济社会诸领域进行管制时，由于过分限制了公民的财产权而造成对公民财产事实上的征收。管制性征收是一种“反向征收”，它因公民对政府管制行为合法性和合宪性的挑战而出现。请求权基础对于公民面对管制性征收获得救济具有决定意义。美国公民可以基于宪法中的“征收条款”或者“补偿条款”提出对政府管制行为的挑战，德国公民只能依据《基本法》的规定请求法院判决政府管制行为无效。在中国，根据《立法法》和《行政诉讼法》等法律的规定，公民关于管制性征收的请求权基础是相当模糊的。

Construction of Double Right-Border Binary Vector Carrying Non-Host Gene Rxo1 Resistant to Bacterial Leaf Streak of Rice

Rxol cloned from maize is a non-host gene resistant to bacterial leaf streak of rice. pCAMBIA1305-1 with Rxo1 was digested with Sca I and NgoM IV and the double right-border binary vector pMNDRBBin6 was digested with Hpa I and Xma I. pMNDRBBin6 carrying the gene Rxo1 was acquired by ligation of blunt-end and cohesive end. The results of PCR, restriction enzyme analysis and sequencing indicated that the Rxo1 gene had been cloned into pMNDRBBin6. This double right-border binary vector, named as pMNDRBBin6-Rxol, will play a role in breeding marker-free plants resistant to bacterial leaf streak of rice by genetic transformation.