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Objective: Laparoendoscopic single-site myomectomy (LESS-M) is widely applied for the treatment of uterine leiomyoma. The purposes of this study were to investigate differences in hidden blood loss between LESS-M and conventional laparoscopic myomectomy (CLM) during treatment of uterine leiomyoma and to identify the associated risk factors. Design: This is a retrospective study. Participants: The participants of this study were patients who underwent laparoscopic myomectomy (114 and 156 for LESS-M and CLM, respectively) between July 1, 2019, and October 10, 2020, at the Second Affiliated Hospital of Wenzhou Medical University. Setting: The study was conducted at the Second Affiliated Hospital of Wenzhou Medical University. Methods: We enrolled a total of 114 and 156 patients who were treated with LESS-M and CLM, respectively, between July 1, 2019, and October 10, 2020. We collected clinical data, then applied the Nadler and Gross formula and multiple linear regression analysis to calculate the HBL and identify the associated risk factors, respectively. Results: Patients in the LESS-M group had a VBL of 115.4 ± 180.6 mL and an HBL of 364.3 ± 252.6 mL, accounting for 74.4 ± 22.4% of true TBL. On the other hand, patients in the CLM group had VBL of 187.9 ± 198.5 mL, and HBL of 306.8 ± 304.7 mL, accounting for 58.9 ± 30.2% of true TBL. HBL was significantly higher in the LESS-M than the CLM group (p = 0.000). Limitations: This study was the small sample size used. Conclusions: HBL accounted for a significant percentage of TBL in laparoscopic myomectomy, especially in patients treated with LESS-M. Paying attention to perioperative blood changes coupled with fully understanding HBL might promote postoperative recovery of patients. [ABSTRACT FROM AUTHOR]

Climate warming profoundly affects the vegetative growth, flowering phenology and sexual reproduction of plants; therefore, it affects the ornamental value of wild flowers. Despite this, the extent and mechanism of the impact remain unclear. Here, we conducted a warming experiment for two growing seasons (increases of 1.89 °C in 2017 and 2.37 °C in 2018) with infrared heaters to examine the effects of warming on the ornamental value of the wild flower Impatiens oxyanthera, endemic to China, in Mount Emei. We evaluated the comprehensive ornamental value based on plant morphology and flowering characteristics using the analytic hierarchy process (AHP) and disentangled the impact of the two traits on ornamental value using principal component analysis (PCA) and the partial least squares structural equation model (PLS-SEM) under ambient and warming treatments. We hypothesized that warming would reduce the ornamental value of I. oxyanthera in terms of plant morphology and flowering traits. Our results showed that warming significantly decreased plant height and crown width and increased branch number and single-leaf area. Warming also decreased vexillum length, corolla tube length, nectar spur length and pedicel length. In addition, warming shortened flowering duration per plant and reduced flower number, while there was no significant effect on flower longevity and flower color at full-bloom stage between the control and warming treatment. Therefore, the comprehensive ornamental value under warming was lower than that under the control. Pedicel length, flower color, flower longevity and flowering duration per plant were the main factors affecting the comprehensive ornamental value. The PLS-SEM showed that warming had an indirect negative effect on ornamental value via direct negative effects on flowering traits. Collectively, these results indicate that, although promoting vegetative growth, short-term warming significantly decreased the ornamental value of I. oxyanthera due to warming-caused smaller flowers and shorter flowering duration. [ABSTRACT FROM AUTHOR]