The elaboration of multinutritional blocs (MB) is an alternative that allows supplement energy, protein, vitamins and minerals, and additionally, it can be administered and take natural resources as protein banks, mai...The elaboration of multinutritional blocs (MB) is an alternative that allows supplement energy, protein, vitamins and minerals, and additionally, it can be administered and take natural resources as protein banks, mainly in the dry season, raising their cost and the concentrates decreasing profitability to producers. An aid is green or dried foliage of the tree-shrub of the Mixteca Poblana that drop their leaves to the ground (dry hay) in the dry season, thus becomes valuable forage consumed by goats, being great for your protein content and low cost in diets of small ruminants in silvopastoral production systems, at the dwindle the foliage of woody perennials in a time of the year. The aim of this study was to develop and meet production costs multinutrient blocks with goatee sheets (Pithecellobium acatlense) consumed by goats in the Mixteca Puebla. The study was done in the community of Tehuaxtla, belonging to the municipality Piaxtla in the Mixteca Poblana, which shows a secondary vegetation (arboreal, shrubby) that is consumed by goats in that region. 8 multinutritional blocks were used with Pithecellobium acatlense into two groups of 30 goats. Chemical analysis threw goatee 11.7% CP during the dry season and 14.8% CP for rains regarding consumption of BM group A showed 20% less compared to Group B, with respect to consumption of the block multinutrient the group A was 56 g/day/goat, whilst the group B has consumed 73 g/day/goat, where he converted ±0.14 g/goat/day for this preparation (MB), with a cost /goat when consuming block/8 days 0.14 USD.展开更多
BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require furt...BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.展开更多
BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to ...BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab therapy.CASE SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor.After emergency TES,the patient's spinal cord function recovered,and permanent paralysis was avoided.The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT.Unfortunately,the tumor recurred 9 months after the first surgery.After 12 months of denosumab therapy,the tumor size was reduced,and tumor calcification.To prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed again.The patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last follow-up.CONCLUSION This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic results.TES in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.展开更多
With the identification of more than a dozen novel Hermansky-Pudlak Syndrome (HPS) proteins in vesicle trafficking in higher eukaryotes, a new class of trafficking pathways has been described. It mainly consists of ...With the identification of more than a dozen novel Hermansky-Pudlak Syndrome (HPS) proteins in vesicle trafficking in higher eukaryotes, a new class of trafficking pathways has been described. It mainly consists of three newly-defined protein com- plexes, BLOC-l, -2, and -3. Compelling evidence indicates that these complexes together with two other well-known complexes, AP3 and HOPS, play important roles in endosomal transport. The interactions between these complexes form a network in protein trafficking via endosomes and cytoskeleton. Each node of this network has intra-complex and extra-complex interactions. These complexes are connected by direct interactions between the subunits from different complexes or by indirect interactions through coupling nodes that interact with two or more subunits from different complexes. The dissection of this network facilitates the understanding of a dynamic but elaborate transport machinery in protein/membrane trafficking. The disruption of this network may lead to abnormal trafficking or defective organellar development as described in patients with Hermansky-Pudlak syndrome.展开更多
在3D混合虚拟场景的构建过程中,信号的传输和接收非常重要.确保信号的传输和接收达到要求的关键是信号接收模块React building block的建立.文中主要讨论如何使用Microsoft Visual studio2005和Virtools 4.0进行信号接收模块React build...在3D混合虚拟场景的构建过程中,信号的传输和接收非常重要.确保信号的传输和接收达到要求的关键是信号接收模块React building block的建立.文中主要讨论如何使用Microsoft Visual studio2005和Virtools 4.0进行信号接收模块React building block(或简称BB)的创建.展开更多
This study examines the use of the geographic information systems (GIS) in structural geomorphology to build the model of the crust based on fractal analysis of relief. Fractal theory, developed by B. Mandelbrot, us...This study examines the use of the geographic information systems (GIS) in structural geomorphology to build the model of the crust based on fractal analysis of relief. Fractal theory, developed by B. Mandelbrot, used to determination morpho-bloc divisibility of the Earth's surface. There is the traceable statistically recurring relief structure indicate the appropriate tiered hierarchy of crustal blocks forming the tectonic and kinematic layers. This hypothesis tested on a digital elevation model (DEM) of the White Sea-Kuloi Plateau -- an area of tectonic and magmatic activity of the Paleozoic era. Found the correlation of position the kimberlite magmatic bodies with the tectonic blocks certain depth according to a flactal analysis.展开更多
AIM: To compare the efficacy and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the treatment of colorectal tumors.
AIM To compare endoscopic submucosal dissection(ESD) outcomes between Eastern and Western countries.METHODS A systematic review and meta-analysis was performed using Pub Med,MEDLINE,Web of Science,CINAHL and EBM revie...AIM To compare endoscopic submucosal dissection(ESD) outcomes between Eastern and Western countries.METHODS A systematic review and meta-analysis was performed using Pub Med,MEDLINE,Web of Science,CINAHL and EBM reviews to identify studies published between 1990 and February 2016. The primary outcome was the efficacy of ESD based on information about either curative resection,en bloc or R0 resection rates. Secondary outcomes were complication rates,local recurrence rates and procedure times. RESULTS Overall,238 publications including 84318 patients and 89512 gastrointestinal lesions resected using ESD were identified. 90% of the identified studies reporting ESDon 87296 lesions were conducted in Eastern countries and 10% of the identified studies reporting ESD outcomes in 2216 lesions were from Western countries. Meta-analyses showed higher pooled percentage of curative,en bloc,and R0 resection in the Eastern studies; 82%(CI: 81%-84%),95%(CI: 94%-96%) and 89%(CI: 88%-91%) compared to Western studies; 71%(CI: 61%-81%),85%(CI: 81%-89%) and 74%(CI: 67%-81%) respectively. The percentage of perforation requiring surgery was significantly greater in the Western countries(0.53%; CI: 0.10-1.16) compared to Eastern countries(0.01%; CI: 0%-0.05%). ESD procedure times were longer in Western countries(110 min vs 77 min).CONCLUSION Eastern countries show better ESD outcomes compared to Western countries. Availability of local ESD expertise and regional outcomes should be considered for decision making to treat gastrointestinal lesions with ESD.展开更多
AIM: To investigate factors related to recurrence following en bloc resection using endoscopic submucosal dissection(ESD) in patients with early gastric cancer(EGC). METHODS: A total of 1121 patients(1215 lesions) who...AIM: To investigate factors related to recurrence following en bloc resection using endoscopic submucosal dissection(ESD) in patients with early gastric cancer(EGC). METHODS: A total of 1121 patients(1215 lesions) who had undergone ESD for gastric neoplasia between April 2003 and May 2010 were retrospectively reviewed. Data from 401 patients(415 lesions) were analyzed, following the exclusion of those who underwent piecemeal resection, with deep resection margin invasion or lateral margin infiltration, and diagnosed with benign lesions. RESULTS: Local recurrence after en bloc ESD was found in 36 cases(8.7%). Unclear resection margins, long procedure times, and narrow safety margins were identified as risk factors for recurrence. Lesions located in the upper third of the stomach showed a higher rate of recurrence than those located in the lower third of the stomach(OR = 2.9, P = 0.03). The probability of no recurrence for up to 24 mo was 79.9% in those with a safety resection margin ≤ 1 mm and 89.5% in those with a margin > 1 mm(log-rank test, P = 0.03). CONCLUSION: Even in cases in which en bloc ESD is performed for EGC, local recurrence still occurs. To reduce local recurrences, more careful assessment will be needed prior to the implementation of ESD in casesin which the tumor is located in the upper third of the stomach. In addition, clear identification of tumor boundaries as well as the securing of sufficient safety resection margins will be important.展开更多
Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the co...Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.展开更多
文摘The elaboration of multinutritional blocs (MB) is an alternative that allows supplement energy, protein, vitamins and minerals, and additionally, it can be administered and take natural resources as protein banks, mainly in the dry season, raising their cost and the concentrates decreasing profitability to producers. An aid is green or dried foliage of the tree-shrub of the Mixteca Poblana that drop their leaves to the ground (dry hay) in the dry season, thus becomes valuable forage consumed by goats, being great for your protein content and low cost in diets of small ruminants in silvopastoral production systems, at the dwindle the foliage of woody perennials in a time of the year. The aim of this study was to develop and meet production costs multinutrient blocks with goatee sheets (Pithecellobium acatlense) consumed by goats in the Mixteca Puebla. The study was done in the community of Tehuaxtla, belonging to the municipality Piaxtla in the Mixteca Poblana, which shows a secondary vegetation (arboreal, shrubby) that is consumed by goats in that region. 8 multinutritional blocks were used with Pithecellobium acatlense into two groups of 30 goats. Chemical analysis threw goatee 11.7% CP during the dry season and 14.8% CP for rains regarding consumption of BM group A showed 20% less compared to Group B, with respect to consumption of the block multinutrient the group A was 56 g/day/goat, whilst the group B has consumed 73 g/day/goat, where he converted ±0.14 g/goat/day for this preparation (MB), with a cost /goat when consuming block/8 days 0.14 USD.
基金Supported by Health Research Program of Anhui,No.AHWJ2022b032。
文摘BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.
基金Supported by The Shanghai Municipal Health Commission Clinical Research Project,No.202140140.
文摘BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab therapy.CASE SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor.After emergency TES,the patient's spinal cord function recovered,and permanent paralysis was avoided.The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT.Unfortunately,the tumor recurred 9 months after the first surgery.After 12 months of denosumab therapy,the tumor size was reduced,and tumor calcification.To prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed again.The patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last follow-up.CONCLUSION This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic results.TES in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.
基金This work was supported in part by the National Science Fund for Distinguished Young Scholars (No. 30525007)National Basic Research Program of China (No. 2006CB504103+1 种基金 No. 2006CB500704)Hi-Tech Research and Development Program of China (No. 2006AA02Z322)
文摘With the identification of more than a dozen novel Hermansky-Pudlak Syndrome (HPS) proteins in vesicle trafficking in higher eukaryotes, a new class of trafficking pathways has been described. It mainly consists of three newly-defined protein com- plexes, BLOC-l, -2, and -3. Compelling evidence indicates that these complexes together with two other well-known complexes, AP3 and HOPS, play important roles in endosomal transport. The interactions between these complexes form a network in protein trafficking via endosomes and cytoskeleton. Each node of this network has intra-complex and extra-complex interactions. These complexes are connected by direct interactions between the subunits from different complexes or by indirect interactions through coupling nodes that interact with two or more subunits from different complexes. The dissection of this network facilitates the understanding of a dynamic but elaborate transport machinery in protein/membrane trafficking. The disruption of this network may lead to abnormal trafficking or defective organellar development as described in patients with Hermansky-Pudlak syndrome.
文摘在3D混合虚拟场景的构建过程中,信号的传输和接收非常重要.确保信号的传输和接收达到要求的关键是信号接收模块React building block的建立.文中主要讨论如何使用Microsoft Visual studio2005和Virtools 4.0进行信号接收模块React building block(或简称BB)的创建.
文摘This study examines the use of the geographic information systems (GIS) in structural geomorphology to build the model of the crust based on fractal analysis of relief. Fractal theory, developed by B. Mandelbrot, used to determination morpho-bloc divisibility of the Earth's surface. There is the traceable statistically recurring relief structure indicate the appropriate tiered hierarchy of crustal blocks forming the tectonic and kinematic layers. This hypothesis tested on a digital elevation model (DEM) of the White Sea-Kuloi Plateau -- an area of tectonic and magmatic activity of the Paleozoic era. Found the correlation of position the kimberlite magmatic bodies with the tectonic blocks certain depth according to a flactal analysis.
文摘AIM: To compare the efficacy and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the treatment of colorectal tumors.
文摘AIM To compare endoscopic submucosal dissection(ESD) outcomes between Eastern and Western countries.METHODS A systematic review and meta-analysis was performed using Pub Med,MEDLINE,Web of Science,CINAHL and EBM reviews to identify studies published between 1990 and February 2016. The primary outcome was the efficacy of ESD based on information about either curative resection,en bloc or R0 resection rates. Secondary outcomes were complication rates,local recurrence rates and procedure times. RESULTS Overall,238 publications including 84318 patients and 89512 gastrointestinal lesions resected using ESD were identified. 90% of the identified studies reporting ESDon 87296 lesions were conducted in Eastern countries and 10% of the identified studies reporting ESD outcomes in 2216 lesions were from Western countries. Meta-analyses showed higher pooled percentage of curative,en bloc,and R0 resection in the Eastern studies; 82%(CI: 81%-84%),95%(CI: 94%-96%) and 89%(CI: 88%-91%) compared to Western studies; 71%(CI: 61%-81%),85%(CI: 81%-89%) and 74%(CI: 67%-81%) respectively. The percentage of perforation requiring surgery was significantly greater in the Western countries(0.53%; CI: 0.10-1.16) compared to Eastern countries(0.01%; CI: 0%-0.05%). ESD procedure times were longer in Western countries(110 min vs 77 min).CONCLUSION Eastern countries show better ESD outcomes compared to Western countries. Availability of local ESD expertise and regional outcomes should be considered for decision making to treat gastrointestinal lesions with ESD.
文摘AIM: To investigate factors related to recurrence following en bloc resection using endoscopic submucosal dissection(ESD) in patients with early gastric cancer(EGC). METHODS: A total of 1121 patients(1215 lesions) who had undergone ESD for gastric neoplasia between April 2003 and May 2010 were retrospectively reviewed. Data from 401 patients(415 lesions) were analyzed, following the exclusion of those who underwent piecemeal resection, with deep resection margin invasion or lateral margin infiltration, and diagnosed with benign lesions. RESULTS: Local recurrence after en bloc ESD was found in 36 cases(8.7%). Unclear resection margins, long procedure times, and narrow safety margins were identified as risk factors for recurrence. Lesions located in the upper third of the stomach showed a higher rate of recurrence than those located in the lower third of the stomach(OR = 2.9, P = 0.03). The probability of no recurrence for up to 24 mo was 79.9% in those with a safety resection margin ≤ 1 mm and 89.5% in those with a margin > 1 mm(log-rank test, P = 0.03). CONCLUSION: Even in cases in which en bloc ESD is performed for EGC, local recurrence still occurs. To reduce local recurrences, more careful assessment will be needed prior to the implementation of ESD in casesin which the tumor is located in the upper third of the stomach. In addition, clear identification of tumor boundaries as well as the securing of sufficient safety resection margins will be important.
文摘Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.