Rare combined variations of accessory left hepatic artery and accessory right hepatic artery: a case report and literature review.

Variations in the hepatic artery are commonly described in the literature, which is vital for the success procedure of all hepatobiliary surgery. Usually a variation occurs in either the accessory right hepatic artery (aRHA) or the accessory left hepatic artery (aLHA). However, we report an extremely rare case where the variation occurs in both simultaneously. We over served the aRHA arising from the gastroduodenal artery and branching into the superior pancreatic duodenum artery, while the aLHA arose from the common hepatic artery and branched into right gastric artery. This situation has never been reported in literature. We will discuss the meaning of this hepatic artery variation in a clinical setting.

The effectiveness of serious games on undergraduate nursing students' knowledge and skills: A systematic review and meta-analysis.

AIM: To determine the effect of serious games on undergraduate nursing students by the meta-analysis method. BACKGROUND: There is a need for greater focus on enhancing the knowledge and skills of undergraduate nursing students. Generation Z students desire active engagement in the learning process. When compare with conventional learning approaches, serious games can enhance pupil interest by making the learning process more captivating. DESIGN: Systematic review and meta-analysis. METHOD: A total of nine databases were systematically searched from inception to April 2024. The Cochrane RoB-2 tool and the Joanna Brigg's Institute Critical Appraisal Tool for quasi-experimental designs were used to undertake quality appraisal. A narrative synthesis, a meta-analysis and subgroup analysis were conducted to analyze the study outcomes. RESULTS: In the study, 19 experimental studies included 14 randomized controlled trials and five quasi-experimental studies. When compare with control groups, serious games in RCTs showed significant improvements in knowledge (SMD 1.24, 95 % CI 0.52-1.96; P<0.001) and skills (SMD 0.50, 95 % CI 0.13-0.87; P<0.01). Subgroup analysis for technical skills outcomes demonstrated that serious games in RCTs were more effective than control groups (SMD 0.62, 95 % CI 0.20-1.05; P<0.001). CONCLUSION: Serious games had a beneficial impact on the knowledge and skills of undergraduate nursing students. In the context of serious game intervention, it is imperative to carefully consider the approach.

The emerging role of circulating tumor cells in cancer management.

Circulating tumor cells (CTCs) are cells that are shed from the primary tumor and circulate in the blood, and their metastasis and formation of a secondary tumor are closely associated with cancer-related death. Therefore, regulating tumor metastasis through CTCs can be a novel strategy to fight cancer. It has been demonstrated that CTCs can reflect the profile of the primary tumor and provide valuable information about intratumoral heterogeneity and their evolution over time. Moreover, the revelation of the relationship between metastasis and CTCs suggests that CTC regulation represents a promising novel anticancer strategy. Above all, at the molecular level, genetic analysis might be vital in the new era of gene-targeted cancer therapies and contribute to personalized anti-metastasis tumor treatments. In this review, we will focus on the biological significance of CTCs in the peripheral blood and discuss their potential clinical implications in cancer management.