Tongji University Research Articles

KAIUS: National Key Laboratory of Autonomous Intelligent Unmanned Systems [Institutes in Control

Shanghai, the biggest city in China, is known for its skyscrapers and contemporary lifestyle at the heart of a booming economy. Shanghai is a leading industrial and manufacturing center in China. It is also a national leading center of higher education and scientific research, and there are numerous universities and institutions of higher learning. Tongji University, one of China’s earliest national key universities, is a prestigious institution of higher education, with distinctive features and an international reputation. The university is among the 36 Class A universities in the list of the Double First Class University Plan. According to the 2019 Global Universities Rankings by <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">US News &amp; World Report</i> , Tongji University ranks 11th in China and 35th in Best Global Universities in Asia.

Consistency evaluation of exercise target heart rate determined by resting heart rate and anaerobic threshold in chronic heart failure patients

PurposeTo evaluate the consistency on the target heart rate for exercise determined by simple target heart rate (sTHR) based on resting heart rate (HRrest) and heart rate at anaerobic threshold (HRAT) in cardiopulmonary exercise test (CPET) for patients with chronic heart failure. MethodsThis is a retrospective cohort study, in which CHF patients who underwent CPET in Tongji Hospital Cardiac Rehabilitation Center Affiliated to Tongji University from March 2007 to December 2018 were enrolled. The clinical data of the patients from the electronic medical record system, HRrest and HRAT measured by CPET were collected. Patients were further divided into subgroups according to gender, age (<60 years group and ≥ 60 years group), with or without beta-blocker therapy and subgroup of heart failure (heart failure with reduced, mid-range and preserved ejection fraction). The sTHR (HRrest plus 10, 15, 20, 25 and 30 bpm) and HRAT were all calculated in each patient. Paired t-test was used for the difference between the two methods, correlation analysis was shown by pearson analysis and intraclass correlation coefficient (ICC) was calculated for consistency test. ResultsA total of 547 CHF patients were enrolled, including 447 males (81.7%), aged 63 (56,69) years, with BMI of 25.2 (23.5,26.4) kg/m2 and LVEF of 45.0 (36.0, 52.0) %. The target heart rate determined by HRAT method was (93.59 ± 13.95) bpm, and its counterpart determined by HRrest plus 20 bpm (HRrest+20) was (93.16 ± 7.69) bpm. There was no significant difference between the two methods (P>0.05). However, it was statistically different between HRrest plus 10, 15, 25, 30 bpm and HRAT respectively (P<0.001). And HRrest+20 was positively correlated with HRAT (r = 0.418, P<0.001). Therefore, HRrest+20 below was regarded as sTHR. The ICC of the consistency test between sTHR and HRAT was 0.523,95%CI 0.435–0.596 (P < 0.001) in all patients (n = 547). In patients with beta-blocker therapy (n = 464), the ICC of sTHR and HRAT consistency test was 0.534,95%CI 0.441–0.612, P < 0.001; The ICC of the consistency test between sTHR and HRAT of patients without beta-blocker therapy (n = 83) was 0.407,95%CI 0.083–0.616, P < 0.05. In the sinus rhythm group (n = 466), the ICC of sTHR and HRAT consistency test was 0.527,95%CI 0.433–0.606, P < 0.001; The ICC of the consistency test between sTHR and HRAT of atrial fibrillation patients in group (n = 81) was 0.482,95%CI 0.195–0.667, P < 0.05.The ICC of the consistency test between sTHR and HRAT was 0.501,95%CI 0.338–0.623 (P < 0.001) in patients under 60 years old (n = 195); The ICC of the consistency test between sTHR and HRAT in patients ≥60 years old (n = 352) was 0.533,95%CI 0.424–0.621, P < 0.001. In the male group (n = 447), the ICC of sTHR and HRAT consistency test was 0.577,95%CI 0.491–0.649, P < 0.001; The ICC of the consistency test between sTHR and HRAT of female patients in group (n = 100) was 0.344,95%CI 0.025–0.559, P < 0.05. The ICC of sTHR and HRAT consistency test in HFrEF group (n = 170) was 0.395,95%CI 0.181–0.553, P < 0.01; The ICC values of the consistency test between sTHR and HRAT was 0.543, 95%CI 0.405–0.649 (P < 0.001) in patients with HFmrEF (n = 222); In HFpEF group (n = 155), the ICC of sTHR and HRAT consistency test was 0.620,95%CI 0.478–0.723, P < 0.001. ConclusionThe exercise target heart rate calculated by HRrest is consistent with that determined by HRAT in patients with CHF. For primary hospitals without CPET, exercise prescription equivalent to AT intensity for patients with CHF can be determined by HRrest. However, the target heart rate calculated by HRrest can't replace that determined by HRAT in this patient cohort completely.

The Association between Deoxyribonucleic Acid Hypermethylation in Intron VII and Human Leukocyte Antigen-C∗07 Expression in Patients with Endometriosis.

Endometriosis, which is a common disease affecting approximately 10% of women of reproductive age, usually causes dysmenorrhea and infertility, thus seriously harming the patients' physical and mental health. However, there is a mean delay of 6.7 years between the onset of the symptoms and the surgical diagnosis of endometriosis. There is an increasing amount of evidence that suggests that epigenetic aberrations, including deoxyribonucleic acid (DNA) methylation, play a definite role in the pathogenesis of endometriosis. This study aimed to explore the noninvasive or minimally invasive biomarkers of this disease. Six patients with surgically confirmed ovarian endometriosis and six patients who received IUD implantation for contraception without endometriosis were recruited in the East Hospital of Tongji University in 2018. The genome methylation profiling of the eutopic and ectopic endometrium of ovarian endometriosis patients and normal endometrial specimens from healthy women was determined using a methylation microarray test. The test screened methylation-differentiated 5'-C-phosphate-G-3' (CpG) sites and then located the target genes affected by these sites following sequence alignment. Then, an additional 22 patients and 26 healthy controls were enrolled to further verify the difference in the selected genes between endometriosis patients and healthy women. The differential DNA methylation of the selected genes was validated via direct bisulfite sequencing and analysis of their messenger ribonucleic acid (mRNA) levels using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Fifteen differentially methylated CpG sites were found among the patients and healthy women, and five CpG sites were mapped to the introns of the human leukocyte antigen-C (HLA-C) gene; these were highly polymorphic between different HLA-C alleles and were HLA-C∗07 specific. The results indicated that the HLA-C∗07 carrier patients exhibited significantly higher DNA methylation levels at the intron VII of HLA-C compared to the HLA-C∗07 carrier healthy controls. High HLA-C∗07 mRNA levels were also observed using qRT-PCR with HLA-C∗07-specific primers, which indicated that the hypermethylation of CpG in intron VII might suppress a silencer that regulates HLA-C∗07 expressions. Deoxyribonucleic acid hypermethylation in the intron VII of the HLA-C∗07 gene appears to regulate the expression of HLA-C∗07. The aberrant DNA methylation in this region was positively correlated with the occurrence of endometriosis.

Outcome comparison of pyrotinib with current standard of care in the second/third line setting in advanced non-small cell lung cancer patients with HER2 mutation.

Outcome comparison of pyrotinib with current standard of care in the second/third line setting in advanced non-small cell lung cancer patients with HER2 mutation.

Characteristics of autonomic neuropathy in patients with vestibular migraine

Objective: To investigate the characteristics of autonomic neuropathy in patients with vestibular migraine (VM) by sympathetic skin reflex (SSR) and R-R interval variation (RRIV). Methods: Seventy-three patients with interseizure VM and 36 healthy controls in the Department of Neurology affiliated to Shanghai Fourth People's Hospital of Tongji University from November 1, 2019 to December 31, 2021 were prospectively enrolled. SSR and RRIV were performed and relevant parameters were recorded, including SSR latency, SSR amplitude, RRIV during calm breathing (R%), RRIV during deep breathing (D%), RRIV difference between deep breathing and calm breathing (D%-R%), RRIV ratio between deep breathing and calm breathing (D%/R%), and the difference and correlation of various parameters between VM patients and healthy controls were analyzed. Results: Among the 73 patients with VM, there were 12 males and 61 females, and aged (46±13) years. While among 36 healthy controls, there were 6 males and 30 females, and aged (46±7) years. Among the 73 VM patients, abnormal SSR, abnormal RRIV, abnormal SSR and RRIV, and abnormal SSR or RRIV was detected in 38 cases (52%), 17 cases (23%), 11 cases (15%) and 44 cases (60%), respectively. Compared with healthy controls, the lower extremity SSR latency [(1 719±289) ms] in VM patients was longer than that in control group [(1 500±349) ms] (P=0.001), but the upper extremity SSR amplitude [1.6 (0.8, 3.0) mV] was lower than that in control group [2.6 (1.8, 4.2) mV] (P=0.006). SSR amplitude, R% and D% were negatively correlated with age in VM patients (rs=-0.311, P=0.007; rs=-0.237, P=0.043; rs=-0.263, P=0.024, respectively). SSR of lower extremity in VM patients was longer than that of upper extremity [(1 719±289) ms vs (1 244±185) ms, P<0.001], but the amplitude of lower extremity was lower than that of upper extremity [0.8 (0.3, 1.7) mV vs 1.6 (0.8, 3.0) mV, P<0.001]. SSR latency of upper limb was positively correlated with SSR latency of lower limb (r=0.436, P<0.001), the amplitude of upper limb was positively correlated with amplitude of lower limb (rs=0.456, P<0.001), and D% was positively correlated with R% (rs=0.357, P=0.002). Conclusion: The autonomic neuropathy during VM interphase features with imbalance between sympathetic and parasympathetic nervous system, and the sympathetic nerve function is mainly impaired.

Meet the First Authors.

Meet the First Authors.

Diagnosis, treatment, and potential causative mutations of cryptogenic plastic bronchitis.

Diagnosis, treatment, and potential causative mutations of cryptogenic plastic bronchitis.

Challenges of carbon emission reduction by the workshop education pattern

The COVID-19 pandemic has forced many conferences and educational events to shift from in-person to online, significantly reducing the carbon footprint associated with these activities. Workshops are a common pattern of thematic learning at the university level, usually involving a series of activities, such as gathering, learning, and dining, for participants from different regions. However, unlike a three-day conference, workshops usually last for seven days or more, resulting in a non-negligible carbon footprint. To resolve this challenge, we have developed a model that provides recommendations for minimizing the carbon footprint of workshops. Using data from the DigitalFUTURES International Workshop on architecture education at Tongji University in China, we calculated the carbon footprint of scenarios with varying workshop durations, participation modes, and transportation methods. Our results show that online workshops can reduce the carbon footprint by up to 88% compared to in-person workshops. Hybrid workshops, which combine online and in-person participation, can also lead to significant carbon reductions, with a 46% online participation rate resulting in an 82% reduction in carbon footprint. However, we recommend that in-person participation be maintained to ensure efficient learning and effective communication. Our work provides a sustainable solution for organizing future workshops with a reduced carbon footprint.

Pulmonary granular cell tumors: a clinicopathological analysis of five cases

Objective: To investigate the clinicopathological features of pulmonary granular cell tumors (pGCTs) and to improve the diagnostic accuracy of the tumor. Methods: A total of 5 pGCTs were diagnosed from February 2016 to January 2022 at Shanghai Pulmonary Hospital, Tongji University School of Medicine and Fudan University Shanghai Cancer Center, China. Immunohistochemical staining, and analysis of the clinicopathological characteristics were performed. Results: The average age of the pGCTs patients was 46 years (ranging from 24 to 54 years), with 3 females and 2 males. One case occurred in the bronchus with multiple nodules in the lung, 2 cases occurred in the bronchial opening, and 2 cases were solitary nodules in the lung. The maximum diameter of the tumors ranged from 12 to 15 mm (mean size 14 mm). Microscopically, the tumor showed infiltrative growth and consisted of round, oval or polygonal cells. Abundant eosinophilic cytoplasm was noted, and the nucleoli were prominent. None of the 5 cases showed any mitosis or necrosis. Immunohistochemical and histochemical study showed positive staining for S-100 (5/5), SOX10 (5/5), Vimentin (5/5), TFE3 (4/5), PAS (3/5), and amylase-digested-PAS (3/5), while 4 cases were negative for CD68. TFE3 FISH analyses on 2 cases showed that no signal abnormality was detected in these 2 cases. The average proliferation index of Ki-67 was 2.2% (range 0-5%). There was no recurrence in 4 cases of pGCTs with a follow-up time ranging from 2 months to 60 months. Conclusions: pGCTs are very rare tumors, most likely originating from Schwann cells. Immunohistochemical staining is the conventional diagnostic tool for pGCTs diagnosis. Recognition of this entity is essential for pathologists to avoid misdiagnosis and unnecessary treatments.

Effect of Motion Cues on Highway Driving Performance in Simulated Driving

The motion system is a major component of a driving simulator. It provides motion cues in various directions with different degrees of freedom (DOF). Different DOF could influence response variables widely used in highway design safety evaluation conducted in simulators. Few studies, though, have comprehensively explored the effect of driving simulator motion cues on driving performance. The high-fidelity Tongji University Driving Simulator (TUDS) was used to separately compare five dependent variables: speed, speed change, lane deviation, longitudinal acceleration, and lateral acceleration. The Wilcoxon signed-rank test was used to examine the difference for each variable using 8-DOF and fixed-base motion system configurations for nine types of combined highway alignments. A subjective assessment of participants’ driving experience was conducted, and the chi-square test for each term was used to compare the difference in motion system fidelity and adverse reactions between the two configurations. Results show that: (1) speed and lateral acceleration are more likely to be significantly affected by motion cues than speed change, lane deviation, and longitudinal acceleration; (2) the horizontal curve with up-grade is the type of combined alignment where speed and lateral acceleration are mostly affected; (3) characteristics of the five variables in different combined alignments vary between the two simulators; (4) the 8-DOF motion system provides better perceived motion fidelity than the fixed-base system does, and the 8-DOF simulator causes less discomfort and tiredness in simulator sickness; and (5) the presence of motion cues is suggested for highways with complex combined curves when focusing on speed and lateral acceleration.

Sample Size Study of Driving Simulator Experiment for Freeway Design Safety Evaluations

Driving Simulator, a powerful simulation tool, has already been used in safety evaluation of roadway geometric design during the pre-construction design stage. Conventional ways of estimating proper sample size include the empirical method, the resource equation, power analysis, and the Bayesian method. However, significant boundaries and prior distributions of operational indices are hard to identify in simulator studies, which makes it difficult to use conventional ways in choosing the acceptable sample size. This study proposes an empirical method to infer proper sample size. The Tongji University eight-degree-of-freedom driving simulator was utilized to collect continuous driving behavior data from a simulated mountainous freeway. Vehicle speed and lane departure events were selected as the indices to measure the influence of geometric design features on operational efficiency and safety. A mixed linear model and a mixed logistic regression model were used to assess the relationships between geometric design features and vehicle speed and lane departure. Random sampling was used to choose 10 samples of 5 to 50 drivers from a total of 55 drivers. Acceptable sample size was determined based on the parameter coefficient convergence elbow points of the mean squared error (MSE) curves of significant variables. The clear elbow points of the MSE curves indicate that 30 is an acceptable sample size.

A Stress Index-based Tendon Optimization Method for Prestressed Concrete Continuous Girder Bridges

PDF HTML XML Export Cite reminder A Stress Index-based Tendon Optimization Method for Prestressed Concrete Continuous Girder Bridges DOI: 10.59238/j.pt.2023.01.001 Author: Affiliation: (1. Department of Bridge Engineering, Tongji University, Shanghai 200092, China; 2. Anhui Transport consulting & Design Institute Co., Ltd. Anhui 230088, China) Clc Number: Fund Project: Article | Figures | Metrics | Reference | Related | Cited by | Materials | Comments Abstract:Traditional tendon design methods for prestressed concrete (PC) continuous girder bridges are tedious since they obtain feasible solutions based on trial calculation, and the existing optimization methods that can obtain the optimal solution have deficiencies regarding structural stress. In this study, based on research on the refined bridge design conducted in the Department of Bridge Engineering at Tongji University in recent years, a stress index-based tendon optimization method for PC continuous girder bridges is pro-posed. First, various tendon layouts are summarized, and a reasonable tendon layout is selected. Then, a mathematical tendon optimization model is established. After meeting the specifications and construction feasibility requirements, a genetic algorithm is used to find the optimal solution. This method not only realizes tendon forward design but also obtains a satisfactory solution. Finally, this method is used to successfully optimize the tendons of a three-span PC continuous girder bridge, which verifies the ration-ality of the method. Reference Related Cited by

Experimental Study on Steel‒Concrete Composite Beams Strengthened by Externally Prestressed CFRP Strips

PDF HTML XML Export Cite reminder Experimental Study on Steel‒Concrete Composite Beams Strengthened by Externally Prestressed CFRP Strips DOI: 10.59238/j.pt.2023.01.004 Author: Affiliation: (Department of Construction Engineering, School of Civil Engineering, Tongji University, shanghai 200092, China) Clc Number: Fund Project: Article | Figures | Metrics | Reference | Related | Cited by | Materials | Comments Abstract:This paper mainly studies the mechanical properties of simply supported bridges of steel?concrete composite structures strengthened with externally prestressed CFRP plates. The introduction of the prestress of the CFRP plate from the support rods can not only apply prestress to the main beam but also provide an upward lifting force at the bottom end of the main beam to reduce the deflection of the original structure. Therefore, the CFRP board is prestressed by the support rods, which can improve the speed and efficiency of rein-forcement construction. The effects of the CFRP amount, prestress size, support rods amount and other parameters on the stiffness and bearing capacity of composite beams were studied by a static test of the scaled model. In the flexural test of the tensioned combination beam, by increasing the prestressing level and the number of CFRP plates, the flexural moment of inertia of the combination beam section was effectively improved, the reinforcement effect on the yield bearing capacity and ultimate flexural bearing capacity of the combination beam was obvious, and the reinforced specimens still had good ductility. For the third com-bination beam, a CFRP plate with a 15% prestressing level and 3 mm thickness was used for reinforcement. The ultimate load carrying capacity of the combined beam was increased by 47.9%; the yield load of the lower flange was increased by 39.8%; and the stiffness in the elastic phase was increased by 21.66%. Reference Related Cited by

A Study on the Present Situation of After-class Service of Physical Education in Universities —Take Tongji University as an Example

A Study on the Present Situation of After-class Service of Physical Education in Universities —Take Tongji University as an Example

Preface

2022 3rd International Conference on Mechanical Engineering and Materials (ICMEM 2022) has been held online on 18th November 2022 due to Covid-19. Organized by Hubei Zhongke Institute of Geology and Environment Technology, ICMEM 2022 intends to invite worldwide famous scientists, experts, scholars, and researchers for academic presentations. ICMEM 2022 proceeding covers all aspects of mechanical engineering and material sciences, such as Dynamics, Vibration and Sound Engineering, Materials and Technology, Fluids Engineering, Solid Mechanics and Design, Micro/Nano Engineering and Technology, Production Engineering, Robotics and Control, Thermal and Power Engineering, Vehicle Technology, Machine Fault Diagnostics and Prognostics, Intelligent Transport System, Intelligent Monitoring Technology, Metallic Alloys, Tool Materials, Ceramics and Glasses, Composite Materials, Amorphous Materials, Nanomaterials, Biomaterials, Polymers, etc.. Around 120 articles were selected from more than 290 submissions after peer-review, and authors participated in ICMEM 2022 with 19 oral presentations and 51 posters, promoting the communication among researchers and experts from institutes and universities, including Beijing Institute of Space Mechanics & Electricity, China University of Petroleum (Beijing), Tongji University, Jimei University, Harbin Engineering University, University of Science and Technology Beijing, Xiamen University, Fudan University, Chinese Academy of Sciences, etc.We would like to thank all the members of the Technical Program Committee for the success of ICMEM 2022. And we wish to express our sincere gratitude to the authors and reviewers for their valuable scientific contributions and useful feedbacks to ensure a high scientific quality of ICMEM 2022.List of Conference Committee is available in this pdf.

Structural Design and Mechanical Properties of a Plate-Shell Structure Bridge

PDF HTML XML Export Cite reminder Structural Design and Mechanical Properties of a Plate-Shell Structure Bridge DOI: 10.59238/j.pt.2023.01.006 Author: Affiliation: (1.Department of Bridge Engineering, Tongji University, Shanghai 200092, China;2.Tongji Architectural Design (Group) Co., Ltd., Shanghai 200092, China) Clc Number: Fund Project: Article | Figures | Metrics | Reference | Related | Cited by | Materials | Comments Abstract:The main bridge of Quzhou Academy Bridge is a V-shaped rigid frame bridge with a hanging hole, the span arrangement is 75 m+150 m+75 m=300 m, the middle span hanging hole was provided with a 60 m steel box girder, and the V-leg structure and the main beam are all prestressed concrete box girders with variable height. Due to the need for bridge landscapes and pedestrian viewing platforms, the large extension arc V-leg structure extends 6 m to each side of the bridge deck, and the total width is 41 m. It was necessary to consider the stress effect of the shell in the longitudinal and transverse directions. The stress and deformation of the shell in two directions are analyzed by using the finite element method solid model, and the difference between the solid model and the frame model is compared in detail. Finally, the overall structure was analyzed and checked in the modified simplified frame finite element model. Reference Related Cited by

Predicting cardiovascular risk in a Chinese primary Sjögren's syndrome population: development and assessment of a predictive nomogram.

Patients with primary Sjögren's syndrome (pSS) are at increased risk of cardiovascular morbidity as compared with the general population. A retrospective study on 349 Chinese patients with pSS was conducted to identify potential risk factors for cardiovascular events and develop a cardiovascular risk nomogram. This is a retrospective observational study. The study included 349 patients who were diagnosed with pSS at Tongji Hospital, School of Medicine, Tongji University, China from January 2010 to March 2022. The least absolute shrinkage and selection operator (LASSO) was used to select features for the cardiovascular risk model. The features selected in LASSO were used to build the cardiovascular risk model in a multivariate logistic regression analysis. C-index, receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis were used to assess the predictive model. Internal validation was performed by bootstrapping. Sex, joint pain as an initial symptom, dry mouth, oral ulcers, dental caries, Raynaud's phenomenon, fatigue, diabetes, elevated thyroid-stimulating hormone (TSH) level, and elevated systolic blood pressure were included in the nomogram for the prediction of cardiovascular risk. Our model had good discrimination (C-index: 0.824, 95% confidence interval: 0.712-0.936) and good calibration (C-index in the interval validation: 0.8). Decision curve analysis indicated that our nomogram demonstrated clinical usefulness for intervention in a cardiovascular disease possibility threshold of 3%. The cardiovascular risk nomogram incorporating sex, initial joint pain, dry mouth, oral ulcer, dental caries, Raynaud's phenomenon, fatigue, diabetes, elevated TSH, and systolic blood pressure could be used in the prediction of cardiovascular risk in patients with pSS and the guidance of further treatment.

The Largest Space-Asymmetric-Curved-Single Tower Twisted-Cable-Plane Cable-Stayed Bridge—Tuojiang Bridge of Jinjianren Expressway Phase II

PDF HTML XML Export Cite reminder The Largest Space-Asymmetric-Curved-Single Tower Twisted-Cable-Plane Cable-Stayed Bridge—Tuojiang Bridge of Jinjianren Expressway Phase II DOI: 10.59238/j.pt.2023.01.008 Author: Affiliation: (Tongji Architectural Design (Group) Co., Ltd., Shanghai 200092, China) Clc Number: Fund Project: Article | Figures | Metrics | Reference | Related | Cited by | Materials | Comments Abstract:The Tuojiang Bridge of Jinjianren Expressway Phase II is located in Jianyang City and the Eastern New District of Chengdu, all the section length is 4.3 km with a total construction and installation cost of about 1.74 billion yuan. The road is classed as both a first-class highway and an urban expressway, with a design speed of 80 km/h for the main line and 40 km/h for the auxiliary lanes. Tongji University Architectural Design (Group) Co., LTD designed the main bridge which is an urban landscape bridge with a length of 963 m. The main bridge adopts 45+185+238+45m single-tower double-cable-plane cable-stayed span layout, and the approach bridge adopts prestressed small box girder structure. Reference Related Cited by

Book Review of Guide for Travelling in an Uncertain World: What is Risk?

This paper reviews the main contents of the following picture book: Guide for travelling in an uncertain world: what is risk? Zhang, J., and Huang, H.W. 2022. Shanghai: Tongji University Press (ISBN: 978-7-5765-0351-7) (in Chinese). This picture book can help children and their parents become aware of risk, learn the knowledge about risk analysis, and cultivate interests related to the science, technology, engineering, and mathematics behind risk analysis. It is a welcome and successful contribution to the education of risk analysis to the child and the public.

3-Dimensional Laparoscopic Rectal Anterior Resection With Transanal Specimen Extraction For Rectal Prolapse.

Department of Colorectal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, China Funding/Support: None reported Financial Disclosures: None reported Informed Consent: Informed consent was obtained from the patient. Correspondence: Chuangang Fu, M.D., Department of Colorectal Surgery, Shanghai East Hospital, Tongji University, 200120, No. 150 Jimo Road, Pudong District, Shanghai, China. E-mail: [email protected]