Objective:According to the EAU Guidelines,transurethral resection of the prostate(TURP)has so far still been considered as the gold standard for surgical treatment for patients with obstructing clinical benign prostat...Objective:According to the EAU Guidelines,transurethral resection of the prostate(TURP)has so far still been considered as the gold standard for surgical treatment for patients with obstructing clinical benign prostate hyperplasia(BPH).However,its relatively high rate of complications and postoperative recurrence necessitates further modification and innovation on the surgery technique.We reported the patient outcomes with our technique.Methods:We retrospectively analyzed 52 patients with obstructing clinical BPH who underwent bipolar transurethral enucleation and resection of the prostate(B-TUERP)between March 2015 and September 2015.Pre-and perioperative parameters were obtained from medical charts.Postoperative follow-ups were administrated at 1,3,6,12 and 24 month(s)after surgery,respectively.Results:All the operations were performed successfully with a mean operative time of 43.1 min and an average tissue removal rate of 74.7%.Qmax was significantly improved immediately after surgery,followed by a continuous improvement throughout the follow-ups.Following a steep decrease in mean prostate specific antigen(PSA)and post void residual(PVR)observed within the first half year after surgery,the serum PSA was then maintained at a constant level of 0.61 ng/mL.Temporary urinary retention was found in four cases(7.7%).Stress urinary incontinence occurred in five patients(9.6%),with the condition resolved in 1e2 weeks without extra treatment.Urethral strictures and bladder neck contractures,as the most commonly observed long-term complications,developed in four patients(7.7%).No recurrence was found during 2 years of follow-ups.An improvement in International Index of Erectile Function(IIEF-5)scores was witnessed in 17 patients preoperatively with normal sexual function during the first 6 months after surgery,and sustained throughout the 24-month period.Conclusions:Enucleation reflects an improvement on surgical technique in many ways with a need for surgical equipment that can be broadly accessible in clinical practic展开更多
Bitter gourd(Momordica charantia)is a popular cultivated vegetable in Asian and African countries.To reveal the characteristics of the genomic structure,evolutionary trajectory,and genetic basis underlying the domesti...Bitter gourd(Momordica charantia)is a popular cultivated vegetable in Asian and African countries.To reveal the characteristics of the genomic structure,evolutionary trajectory,and genetic basis underlying the domestication of bitter gourd,we performed whole-genome sequencing of the cultivar Dali-11 and the wild small-fruited line TR and resequencing of 187 bitter gourd germplasms from 16 countries.The major gene clusters(Bi clusters)for the biosynthesis of cucurbitane triterpenoids,which confer a bitter taste,are highly conserved in cucumber,melon,and watermelon.Comparative analysis among cucurbit genomes revealed that the Bi cluster involved in cucurbitane triterpenoid biosynthesis is absent in bitter gourd.Phylogenetic analysis revealed that the TR group,including 21 bitter gourd germplasms,may belong to a new species or subspecies independent from M.charantia.Furthermore,we found that the remaining 166 M.charantia germplasms are geographically differentiated,and we identified 710,412,and 290 candidate domestication genes in the South Asia,Southeast Asia,and China populations,respectively.This study provides new insights into bitter gourd genetic diversity and domestication and will facilitate the future genomics-enabled improvement of bitter gourd.展开更多
目的比较先天性高位肛门直肠畸形新生儿期结肠袢式造瘘术、乙状结肠分离式造瘘术及其改良术式的优缺点。方法回顾性分析复旦大学附属儿科医院2007年6月至2017年6月收治的148例先天性高位肛门直肠畸形肠造瘘患儿的临床资料,其中男童115例...目的比较先天性高位肛门直肠畸形新生儿期结肠袢式造瘘术、乙状结肠分离式造瘘术及其改良术式的优缺点。方法回顾性分析复旦大学附属儿科医院2007年6月至2017年6月收治的148例先天性高位肛门直肠畸形肠造瘘患儿的临床资料,其中男童115例,女童33例,平均出生体重为(3 240±572)g,平均胎龄(38.07±1.1)周,根据造瘘方式分为3组:A组采取结肠袢式造瘘(A1组:横结肠袢式造瘘术;A2组:乙状结肠袢式造瘘术);B组采取乙状结肠分离、远端缩窄式造瘘;C组采取单纯乙状结肠分离式造瘘。对各组手术时间、造瘘口脱垂、造瘘口内陷、远端粪石残留、Ⅱ期术前评估及手术难易等资料进行总结。结果3组患儿出生体重、胎龄、手术时间比较差异无统计学意义( P > 0.05 )。A1组术前行远端肠造影成功仅3例(20.0%),A2组术前远端造影成功4例(66.7%),B组术前行远端肠造影成功46例(79.3%),C组术前行远端肠造影成功20例(62.5%),差异有统计学意义(χ^ 2 =18.834, P <0.001)。B组出现远端造瘘口闭塞3例,A、C组未出现远端闭塞病例。所有患儿于二期肛门成形术中发现直肠盲端积粪扩张16例,其中A1组13例,A2组3例;B组和C组均未发现直肠盲端积粪扩张,3组远端肠管积粪扩张发生率比较差异有统计学意义(χ^ 2 =45.276, P < 0.05 )。A组中有5例发生腹壁伤口感染,而B、C组各有1例发生腹壁伤口感染,3组腹壁伤口感染率比较,差异有统计学意义(χ^2 =6.745, P <0.05)。A组有1例出现造瘘口肠管脱垂,该例无肠管内陷;B组有3例出现造瘘口肠管脱垂,脱垂肠管为近端;C组有2例出现造瘘口肠管脱垂,均为造瘘近端肠管。3组肠管脱垂发生率比较差异无统计学意义(χ^ 2 =0.426, P =0.808)。结论新生儿期先天性肛门闭锁单纯乙状结肠分离式造瘘效果优于结肠袢式造瘘及乙状结肠分离远端缩窄的造瘘方式。乙状结肠近降结肠处造瘘,可降低二期�展开更多
A logistic model was employed to correlate the outbreak of highly pathogenic avian influenza (HPAI) with related environmental factors and the migration of birds. Based on MODIS data of the normalized difference veget...A logistic model was employed to correlate the outbreak of highly pathogenic avian influenza (HPAI) with related environmental factors and the migration of birds. Based on MODIS data of the normalized difference vegetation index, environmental factors were considered in generating a probability map with the aid of logistic regression. A Bayesian maximum entropy model was employed to explore the spatial and temporal correlations of HPAI incidence. The results show that proximity to water bodies and national highways was statistically relevant to the occurrence of HPAI. Migratory birds, mainly waterfowl, were important infection sources in HPAI transmission. In addition, the HPAI outbreaks had high spatiotemporal autocorrelation. This epidemic spatial range fluctuated 45 km owing to different distribution patterns of cities and water bodies. Furthermore, two outbreaks were likely to occur with a period of 22 d. The potential risk of occurrence of HPAI in China's Mainland for the period from January 23 to February 17, 2004 was simulated based on these findings, providing a useful meta-model framework for the application of environmental factors in the prediction of HPAI risk.展开更多
目的探讨十二指肠镜治疗无明显胆管扩张型胰胆管合流异常(pancreaticobiliary maljunction without obvious biliary dilatation,PBM-nonOBD)患儿的手术疗效及预后不良相关因素。方法回顾性分析复旦大学附属儿科医院自2020年1月至2022...目的探讨十二指肠镜治疗无明显胆管扩张型胰胆管合流异常(pancreaticobiliary maljunction without obvious biliary dilatation,PBM-nonOBD)患儿的手术疗效及预后不良相关因素。方法回顾性分析复旦大学附属儿科医院自2020年1月至2022年12月收治的内镜治疗PBM-nonOBD患儿的临床资料(包括人口学资料、临床症状、实验室检查及影像学资料),并对患儿进行随访。采用单因素分析及多因素Logistic回归分析十二指肠镜治疗PBM-nonOBD患儿不良预后的危险因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析相关危险因素的预测价值。结果本研究共纳入44例患儿,随访时间(19.7±8.6)个月,治愈率为54.5%(24/44),其中治疗有效24例(为治疗有效组),治疗无效20例(为治疗无效组)。术后不良事件以十二指肠镜逆行性胆胰管造影术后胰腺炎最常见(7/44,15.9%),其中27.3%(12/44)的患儿最终需接受根治术,15.9%(7/44)的患儿需接受再次内镜治疗。治疗有效组胰胆管合流异常(pancreaticobiliary maljunction,PBM)分型以B型和D型为主,占比分别为41.7%(10/24)和37.5%(9/24)。单因素分析结果显示,年龄偏小、胰胆共同管直径较长、胆总管最宽直径较宽是PBM-nonOBD患儿内镜手术后预后不良的相关因素(P<0.05);多因素Logistic回归分析发现,年龄偏小(OR=1.645,95%CI:1.645~2.309)及胰胆共同管直径较长(OR=0.720,95%CI:0.720~0.968)是PBM-nonOBD患儿预后不良的独立危险因素(P<0.05),曲线下面积(area under the ROC curve,AUC)分别为0.838(95%CI:0.719~0.958)和0.731(95%CI:0.567~0.894),最佳截断值分别为4.9岁和8.8 mm。结论十二指肠镜手术创伤小,不会导致严重并发症,可有效缓解部分PBM-nonOBD患儿症状;年龄偏小和胰胆共同管长度较长可能与十二指肠镜治疗PBM-nonOBD预后不良相关。展开更多
Neutrinos from core-collapse supernovae are essential for understanding neutrino physics and stellar evolution.Dual-phase xenon dark matter detectors can be used to track explosions of galactic supernovae by detecting...Neutrinos from core-collapse supernovae are essential for understanding neutrino physics and stellar evolution.Dual-phase xenon dark matter detectors can be used to track explosions of galactic supernovae by detecting neutrinos through coherent elastic neutrino-nucleus scatterings.In this study,a variation of progenitor masses and explosion models are assumed to predict neutrino fluxes and spectra,which result in the number of expected neutrino events ranging from 6.6 to 13.7 at a distance of 10 kpc over a 10-s duration with negligible backgrounds at PandaX-4T.Two specialized triggering alarms for monitoring supernova burst neutrinos are built.The efficiency of detecting supernova explosions at various distances in the Milky Way is estimated.These alarms will be implemented in the real-time supernova monitoring system at PandaX-4T in the near future,which will provide supernova early warnings for the astronomical community.展开更多
文摘Objective:According to the EAU Guidelines,transurethral resection of the prostate(TURP)has so far still been considered as the gold standard for surgical treatment for patients with obstructing clinical benign prostate hyperplasia(BPH).However,its relatively high rate of complications and postoperative recurrence necessitates further modification and innovation on the surgery technique.We reported the patient outcomes with our technique.Methods:We retrospectively analyzed 52 patients with obstructing clinical BPH who underwent bipolar transurethral enucleation and resection of the prostate(B-TUERP)between March 2015 and September 2015.Pre-and perioperative parameters were obtained from medical charts.Postoperative follow-ups were administrated at 1,3,6,12 and 24 month(s)after surgery,respectively.Results:All the operations were performed successfully with a mean operative time of 43.1 min and an average tissue removal rate of 74.7%.Qmax was significantly improved immediately after surgery,followed by a continuous improvement throughout the follow-ups.Following a steep decrease in mean prostate specific antigen(PSA)and post void residual(PVR)observed within the first half year after surgery,the serum PSA was then maintained at a constant level of 0.61 ng/mL.Temporary urinary retention was found in four cases(7.7%).Stress urinary incontinence occurred in five patients(9.6%),with the condition resolved in 1e2 weeks without extra treatment.Urethral strictures and bladder neck contractures,as the most commonly observed long-term complications,developed in four patients(7.7%).No recurrence was found during 2 years of follow-ups.An improvement in International Index of Erectile Function(IIEF-5)scores was witnessed in 17 patients preoperatively with normal sexual function during the first 6 months after surgery,and sustained throughout the 24-month period.Conclusions:Enucleation reflects an improvement on surgical technique in many ways with a need for surgical equipment that can be broadly accessible in clinical practic
文摘Bitter gourd(Momordica charantia)is a popular cultivated vegetable in Asian and African countries.To reveal the characteristics of the genomic structure,evolutionary trajectory,and genetic basis underlying the domestication of bitter gourd,we performed whole-genome sequencing of the cultivar Dali-11 and the wild small-fruited line TR and resequencing of 187 bitter gourd germplasms from 16 countries.The major gene clusters(Bi clusters)for the biosynthesis of cucurbitane triterpenoids,which confer a bitter taste,are highly conserved in cucumber,melon,and watermelon.Comparative analysis among cucurbit genomes revealed that the Bi cluster involved in cucurbitane triterpenoid biosynthesis is absent in bitter gourd.Phylogenetic analysis revealed that the TR group,including 21 bitter gourd germplasms,may belong to a new species or subspecies independent from M.charantia.Furthermore,we found that the remaining 166 M.charantia germplasms are geographically differentiated,and we identified 710,412,and 290 candidate domestication genes in the South Asia,Southeast Asia,and China populations,respectively.This study provides new insights into bitter gourd genetic diversity and domestication and will facilitate the future genomics-enabled improvement of bitter gourd.
文摘目的比较先天性高位肛门直肠畸形新生儿期结肠袢式造瘘术、乙状结肠分离式造瘘术及其改良术式的优缺点。方法回顾性分析复旦大学附属儿科医院2007年6月至2017年6月收治的148例先天性高位肛门直肠畸形肠造瘘患儿的临床资料,其中男童115例,女童33例,平均出生体重为(3 240±572)g,平均胎龄(38.07±1.1)周,根据造瘘方式分为3组:A组采取结肠袢式造瘘(A1组:横结肠袢式造瘘术;A2组:乙状结肠袢式造瘘术);B组采取乙状结肠分离、远端缩窄式造瘘;C组采取单纯乙状结肠分离式造瘘。对各组手术时间、造瘘口脱垂、造瘘口内陷、远端粪石残留、Ⅱ期术前评估及手术难易等资料进行总结。结果3组患儿出生体重、胎龄、手术时间比较差异无统计学意义( P > 0.05 )。A1组术前行远端肠造影成功仅3例(20.0%),A2组术前远端造影成功4例(66.7%),B组术前行远端肠造影成功46例(79.3%),C组术前行远端肠造影成功20例(62.5%),差异有统计学意义(χ^ 2 =18.834, P <0.001)。B组出现远端造瘘口闭塞3例,A、C组未出现远端闭塞病例。所有患儿于二期肛门成形术中发现直肠盲端积粪扩张16例,其中A1组13例,A2组3例;B组和C组均未发现直肠盲端积粪扩张,3组远端肠管积粪扩张发生率比较差异有统计学意义(χ^ 2 =45.276, P < 0.05 )。A组中有5例发生腹壁伤口感染,而B、C组各有1例发生腹壁伤口感染,3组腹壁伤口感染率比较,差异有统计学意义(χ^2 =6.745, P <0.05)。A组有1例出现造瘘口肠管脱垂,该例无肠管内陷;B组有3例出现造瘘口肠管脱垂,脱垂肠管为近端;C组有2例出现造瘘口肠管脱垂,均为造瘘近端肠管。3组肠管脱垂发生率比较差异无统计学意义(χ^ 2 =0.426, P =0.808)。结论新生儿期先天性肛门闭锁单纯乙状结肠分离式造瘘效果优于结肠袢式造瘘及乙状结肠分离远端缩窄的造瘘方式。乙状结肠近降结肠处造瘘,可降低二期�
基金supported by the National Basic Research Program of China (2007CB714404)the National Natural Science Foundation of China (40871173)the Spe-cial Grant for the Prevention and Treatment of Infectious Diseases (2008ZX10004-012)
文摘A logistic model was employed to correlate the outbreak of highly pathogenic avian influenza (HPAI) with related environmental factors and the migration of birds. Based on MODIS data of the normalized difference vegetation index, environmental factors were considered in generating a probability map with the aid of logistic regression. A Bayesian maximum entropy model was employed to explore the spatial and temporal correlations of HPAI incidence. The results show that proximity to water bodies and national highways was statistically relevant to the occurrence of HPAI. Migratory birds, mainly waterfowl, were important infection sources in HPAI transmission. In addition, the HPAI outbreaks had high spatiotemporal autocorrelation. This epidemic spatial range fluctuated 45 km owing to different distribution patterns of cities and water bodies. Furthermore, two outbreaks were likely to occur with a period of 22 d. The potential risk of occurrence of HPAI in China's Mainland for the period from January 23 to February 17, 2004 was simulated based on these findings, providing a useful meta-model framework for the application of environmental factors in the prediction of HPAI risk.
文摘目的探讨十二指肠镜治疗无明显胆管扩张型胰胆管合流异常(pancreaticobiliary maljunction without obvious biliary dilatation,PBM-nonOBD)患儿的手术疗效及预后不良相关因素。方法回顾性分析复旦大学附属儿科医院自2020年1月至2022年12月收治的内镜治疗PBM-nonOBD患儿的临床资料(包括人口学资料、临床症状、实验室检查及影像学资料),并对患儿进行随访。采用单因素分析及多因素Logistic回归分析十二指肠镜治疗PBM-nonOBD患儿不良预后的危险因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析相关危险因素的预测价值。结果本研究共纳入44例患儿,随访时间(19.7±8.6)个月,治愈率为54.5%(24/44),其中治疗有效24例(为治疗有效组),治疗无效20例(为治疗无效组)。术后不良事件以十二指肠镜逆行性胆胰管造影术后胰腺炎最常见(7/44,15.9%),其中27.3%(12/44)的患儿最终需接受根治术,15.9%(7/44)的患儿需接受再次内镜治疗。治疗有效组胰胆管合流异常(pancreaticobiliary maljunction,PBM)分型以B型和D型为主,占比分别为41.7%(10/24)和37.5%(9/24)。单因素分析结果显示,年龄偏小、胰胆共同管直径较长、胆总管最宽直径较宽是PBM-nonOBD患儿内镜手术后预后不良的相关因素(P<0.05);多因素Logistic回归分析发现,年龄偏小(OR=1.645,95%CI:1.645~2.309)及胰胆共同管直径较长(OR=0.720,95%CI:0.720~0.968)是PBM-nonOBD患儿预后不良的独立危险因素(P<0.05),曲线下面积(area under the ROC curve,AUC)分别为0.838(95%CI:0.719~0.958)和0.731(95%CI:0.567~0.894),最佳截断值分别为4.9岁和8.8 mm。结论十二指肠镜手术创伤小,不会导致严重并发症,可有效缓解部分PBM-nonOBD患儿症状;年龄偏小和胰胆共同管长度较长可能与十二指肠镜治疗PBM-nonOBD预后不良相关。
基金the National Natural Science Foundation of China(12090060,12090063,12105052,12005131,11905128,11925502)the Office of Science and Technology,Shanghai Municipal Government,China(22JC1410100)。
文摘Neutrinos from core-collapse supernovae are essential for understanding neutrino physics and stellar evolution.Dual-phase xenon dark matter detectors can be used to track explosions of galactic supernovae by detecting neutrinos through coherent elastic neutrino-nucleus scatterings.In this study,a variation of progenitor masses and explosion models are assumed to predict neutrino fluxes and spectra,which result in the number of expected neutrino events ranging from 6.6 to 13.7 at a distance of 10 kpc over a 10-s duration with negligible backgrounds at PandaX-4T.Two specialized triggering alarms for monitoring supernova burst neutrinos are built.The efficiency of detecting supernova explosions at various distances in the Milky Way is estimated.These alarms will be implemented in the real-time supernova monitoring system at PandaX-4T in the near future,which will provide supernova early warnings for the astronomical community.
