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腹腔镜辅助根治性近端胃切除双通道重建的临床应用 被引量:1
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作者 黄传江 赵小军 +2 位作者 尤小兰 程之逸 刘贵远 《腹腔镜外科杂志》 2024年第1期22-26,共5页
目的:探讨腹腔镜辅助根治性近端胃切除双通道重建术式的应用价值。方法:回顾分析2019年2月至2023年2月为70例早期近端胃癌患者行腹腔镜辅助近端胃切除术的临床资料。根据消化道重建方式分为食管胃重建组(n=31)与双通道重建组(n=39)。观... 目的:探讨腹腔镜辅助根治性近端胃切除双通道重建术式的应用价值。方法:回顾分析2019年2月至2023年2月为70例早期近端胃癌患者行腹腔镜辅助近端胃切除术的临床资料。根据消化道重建方式分为食管胃重建组(n=31)与双通道重建组(n=39)。观察两组手术时间、消化道重建时间、出血量、术后恢复情况、反流性食管炎情况。结果:两组均成功完成手术,双通道重建组手术时间、消化道重建时间长于食管胃重建组,差异有统计学意义。两组术中出血量、术后通气时间、淋巴结清扫数量、术后住院时间、总并发症发生率差异无统计学意义。双通道重建组术后反流性食管炎发生率低于食管胃重建组。结论:腹腔镜辅助近端胃切除双通道重建术可减少近端胃癌术后反流性食管炎的发生,值得临床推广。 展开更多
关键词 胃肿瘤 腹腔镜检查 近端胃切除术 双通道重建
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Evaluation of Nonbreaking Wave-Induced Mixing Parameterization Schemes Based on a One-Dimensional Ocean Model
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作者 TANG Ran huang chuanjiang +1 位作者 DAI Dejun WANG Gang 《Journal of Ocean University of China》 SCIE CAS CSCD 2024年第3期567-576,共10页
Surface waves have a considerable effect on vertical mixing in the upper ocean.In the past two decades,the vertical mixing induced through nonbreaking surface waves has been used in ocean and climate models to improve... Surface waves have a considerable effect on vertical mixing in the upper ocean.In the past two decades,the vertical mixing induced through nonbreaking surface waves has been used in ocean and climate models to improve the simulation of the upper ocean.Thus far,several nonbreaking wave-induced mixing parameterization schemes have been proposed;however,no quantitative comparison has been performed among them.In this paper,a one-dimensional ocean model was used to compare the performances of five schemes,including those of Qiao et al.(Q),Hu and Wang(HW),Huang and Qiao(HQ),Pleskachevsky et al.(P),and Ghantous and Babanin(GB).Similar to previous studies,all of these schemes can decrease the simulated sea surface temperature(SST),increase the subsurface temperature,and deepen the mixed layer,thereby alleviating the common thermal deviation problem of the ocean model for upper ocean simulation.Among these schemes,the HQ scheme exhibited the weakest wave-induced mixing effect,and the HW scheme exhibited the strongest effect;the other three schemes exhibited roughly the same effect.In particular,the Q and P schemes exhibited nearly the same effect.In the simulation based on observations from the Ocean Weather Station Papa,the HQ scheme exhibited the best performance,followed by the Q scheme.In the experiment with the HQ scheme,the root-mean-square deviation of the simulated SST from the observations was 0.43℃,and the mixed layer depth(MLD)was 2.0 m.As a contrast,the deviations of the SST and MLD reached 1.25℃ and 8.4 m,respectively,in the experiment without wave-induced mixing. 展开更多
关键词 wave-induced mixing surface waves sea surface temperature mixed layer depth General Ocean Turbulence Model
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合并大脑后动脉受累的烟雾病患者脑梗死部位与预后情况分析 被引量:1
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作者 刘儒斌 李盛杰 +1 位作者 黄传江 崔友强 《中国现代医生》 2023年第2期1-5,共5页
目的 分析合并大脑后动脉(posterior cerebral artery,PCA)受累的烟雾病患者脑梗死部位分布特点与预后情况。方法 选取2014年4月至2022年3月于山东省千佛山医院就诊的110例梗死型烟雾病患者作为研究对象,通过CT或MRI检查确定患者脑梗死... 目的 分析合并大脑后动脉(posterior cerebral artery,PCA)受累的烟雾病患者脑梗死部位分布特点与预后情况。方法 选取2014年4月至2022年3月于山东省千佛山医院就诊的110例梗死型烟雾病患者作为研究对象,通过CT或MRI检查确定患者脑梗死半球数量(n=136)和梗死部位,根据大脑后动脉是否受累将梗死半球分为受累组(n=40)和非受累组(n=96),并对两组大脑半球梗死部位进行比较分析;记录患者一般基线资料,通过电话方式对患者进行随访,采用改良Rankin评分(modified Rankin scale,mRs)量表对患者神经功能恢复情况进行评估,根据mRs评分将随访患者分为预后良好组(mRs≤2分)和预后不良组(mRs≥3分),并对两组患者的预后情况进行比较分析。结果 与非受累组相比,受累组合并颞叶和枕叶梗死的概率更高,且受累组预后相对更差,差异有统计学意义(P<0.05)。结论 合并大脑后动脉受累的烟雾病患者更容易出现颞叶和枕叶梗死,且预后相对更差。 展开更多
关键词 烟雾病 大脑后动脉 梗死部位 预后
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烟雾病血运重建术后脑梗死的相关因素研究进展 被引量:1
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作者 刘儒斌 李盛杰 +1 位作者 黄传江 崔友强 《中国实用神经疾病杂志》 2023年第6期774-779,共6页
烟雾病是一种颅内血管进行性狭窄以致闭塞的慢性脑血管疾病,目前血运重建术越来越成为烟雾病患者的主要治疗方式,然而烟雾病术后并发症的发生率相对较高,尤以术后脑梗死为甚,这严重影响了患者的手术治疗效果和临床结局,也成了目前临床... 烟雾病是一种颅内血管进行性狭窄以致闭塞的慢性脑血管疾病,目前血运重建术越来越成为烟雾病患者的主要治疗方式,然而烟雾病术后并发症的发生率相对较高,尤以术后脑梗死为甚,这严重影响了患者的手术治疗效果和临床结局,也成了目前临床工作者所面临的较为棘手的问题和治疗的关注焦点,因此本文主要综述了近几年有关烟雾病血运重建术后导致脑梗死的相关影响因素及其作用机制,以期为烟雾病相关治疗方案提供参考。 展开更多
关键词 烟雾病 血运重建术 脑梗死 影响因素
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Sea level rise projection in the South China Sea from CMIP5 models 被引量:5
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作者 huang chuanjiang QIAO Fangli 《Acta Oceanologica Sinica》 SCIE CAS CSCD 2015年第3期31-41,共11页
Future potential sea level change in the South China Sea (SCS) is estimated by using 24 CMIP5 models under different representative concentration pathway (RCP) scenarios. By the end of the 21st century (2081–210... Future potential sea level change in the South China Sea (SCS) is estimated by using 24 CMIP5 models under different representative concentration pathway (RCP) scenarios. By the end of the 21st century (2081–2100 relative to 1986–2005), the multimodel ensemble mean dynamic sea level (DSL) is projected to rise 0.9, 1.6, and 1.1 cm under RCP2.6, RCP4.5, and RCP8.5 scenarios, respectively, resulting in a total sea level rise (SLR) of 40.9, 48.6, and 64.1 cm in the SCS. It indicates that the SCS will experience a substantial SLR over the 21st century, and the rise is only marginal larger than the global mean SLR. During the same period, the steric sea level (SSL) rise is estimated to be 6.7, 10.0, and 15.3 cm under the three scenarios, respectively, which accounts only for 16%, 21% and 24% of the total SLR in this region. The changes of the SSL in the SCS are almost out of phase with those of the DSL for the three scenarios. The central deep basin has a slightly weak DSL rise, but a strong SSL rise during the 21st century, compared with the north and southwest shelves. 展开更多
关键词 sea level rise South China Sea dynamic sea level steric sea level CMIP5 models
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Effects of the surface wave-induced mixing on circulation in an isopycnal-coordinate oceanic circulation model 被引量:1
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作者 huang chuanjiang QIAO Fangli WEI Zexun 《Acta Oceanologica Sinica》 SCIE CAS CSCD 2013年第5期7-14,共8页
The influence of the nonbreaking surface wave-induced mixing under the mixed layer on the oceanic cir- culation was investigated using an isopycnal-coordinate oceanic circulation model. The effect of the wave- induced... The influence of the nonbreaking surface wave-induced mixing under the mixed layer on the oceanic cir- culation was investigated using an isopycnal-coordinate oceanic circulation model. The effect of the wave- induced mixing within the mixed layer was eliminated via a bulk mixed layer model. The results show that the wave-induced mixing can penetrate through the mixed layer and into the oceanic interior. The wave- induced mixing under the mixed layer has an important effect on the distribution of temperature of the upper ocean at middle and high latitudes in summer, especially the structure of the seasonal thermocline. Moreover, the wave-induced mixing can affect the oceanic circulation, such as western boundary currents and the North Equatorial Currents through changes of sea surface height associated with the variation of the thermal structure of the upper ocean. 展开更多
关键词 wave-induced mixing oceanic interior seasonal thermocline oceanic circulation geostrophicadjustment
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Contribution of surface wave-induced vertical mixing to heat content in global upper ocean 被引量:1
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作者 CHEN Siyu QIAO Fangli +1 位作者 huang chuanjiang SONG Zhenya 《Journal of Oceanology and Limnology》 SCIE CAS CSCD 2020年第2期307-313,共7页
Compared with observations,the simulated upper ocean heat content(OHC)determined from climate models shows an underestimation bias.The simulation bias of the average annual water temperature in the upper 300 m is 0.2... Compared with observations,the simulated upper ocean heat content(OHC)determined from climate models shows an underestimation bias.The simulation bias of the average annual water temperature in the upper 300 m is 0.2℃lower than the observational results.The results from our two numerical experiments,using a CMIP5 model,show that the non-breaking surface wave-induced vertical mixing can reduce this bias.The enhanced vertical mixing increases the OHC in the global upper ocean(65°S–65°N).Using non-breaking surface wave-induced vertical mixing reduced the disparity by 30%to 0.14℃.The heat content increase is not directly induced by air-sea heat fluxes during the simulation period,but is the legacy of temperature increases in the first 150 years.During this period,additional vertical mixing was initially included in the climate model.The non-breaking surface wave-induced vertical mixing improves the OHC by increasing the air-sea heat fluxes in the first 150 years.This increase in air-sea heat fluxes warms the upper ocean by 0.05–0.06℃.The results show that the incorporation of vertical mixing induced by nonbreaking surface waves in our experiments can improve the simulation of OHC in the global upper ocean. 展开更多
关键词 surface wave-induced vertical mixing upper ocean heat content air-sea heat fluxes climate model
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Can Langmuir Circulations Solve the Problem of Insufficient Upper-Ocean Mixing? 被引量:1
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作者 huang chuanjiang QIAO Fangli DAI Dejun 《Journal of Ocean University of China》 SCIE CAS CSCD 2020年第4期761-771,共11页
Insufficient vertical mixing in the upper ocean during summer is a common problem of oceanic circulation and climate models.The turbulence associated with non-breaking waves is widely believed to effectively solve thi... Insufficient vertical mixing in the upper ocean during summer is a common problem of oceanic circulation and climate models.The turbulence associated with non-breaking waves is widely believed to effectively solve this problem.In many studies,non-breaking surface wave processes are attributed to the effects of Langmuir circulations(LCs).In the present work,the influences of LCs on the upper-ocean thermal structure are examined by using one-and three-dimensional ocean circulation,as well as climate,models.The results indicated that the effect of vertical mixing enhanced by LCs is limited to the upper ocean.The models evaluated,including those considering LC effects alone and the combined effects of LCs and wave breaking,failed to produce a reasonable summertime thermocline,resulting in a large cold bias in the subsurface layer.Therefore,while they can slightly reduce the biases of mixed layer depths and sea surface temperatures in models,LCs are insufficient to solve the problem of insufficient vertical mixing.Moreover,restriction of non-breaking surface wave-induced processes in LCs may be questionable. 展开更多
关键词 Langmuir circulations vertical mixing THERMOCLINE subsurface temperature non-breaking wave processes
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浪致混合对亚热带冬季海洋混合强度的影响 被引量:1
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作者 陈思宇 乔方利 +1 位作者 黄传江 宋振亚 《海洋学报》 CAS CSCD 北大核心 2020年第5期22-30,共9页
上层海洋在全球气候系统中起着至关重要的作用。对上层海洋层结及混合的模拟偏差一直是海洋和气候数值模式发展中悬而未决的问题。本文首先评估了CMIP5中45个模式对上层海洋层结模拟的偏差,确认了冬季亚热带地区海洋模式垂向混合偏强。... 上层海洋在全球气候系统中起着至关重要的作用。对上层海洋层结及混合的模拟偏差一直是海洋和气候数值模式发展中悬而未决的问题。本文首先评估了CMIP5中45个模式对上层海洋层结模拟的偏差,确认了冬季亚热带地区海洋模式垂向混合偏强。随后,基于自然资源部第一海洋研究所地球系统模式(FIO-ESM v1.0),分别开展了1986-2005年期间包含和关闭海浪垂向混合情况下的数值实验,分析浪致混合对亚热带冬季海洋混合强度模拟的影响及机制。发现浪致混合使得气候模式中亚热带海域冬季的海洋层结增强,增强的层结使上层海洋更加稳定。首次揭示了增加浪致混合反而降低了海洋总体的垂向混合率:浪致混合使北半球冬季亚热带海域混合率从无浪实验的227 cm^2/s降低到有浪实验的178 cm^2/s,降低了21.6%;南半球冬季亚热带海域混合率从无浪实验的189 cm^2/s降低到有浪实验的165 cm^2/s,降低了12.7%。进一步分析发现,浪致混合主要是通过增加冬季亚热带海域上层海洋的热含量从而强化了海洋的层结,最终改善了气候模式对上层海洋混合的模拟。 展开更多
关键词 混合强度 浪致混合 数值模式 冬季 亚热带
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Effects of horizontal mixing on the upper ocean temperature in the equatorial Pacific Ocean
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作者 huang chuanjiang QIAO Fangli 《Acta Oceanologica Sinica》 SCIE CAS CSCD 2012年第1期16-23,共8页
The influence of horizontal mixing on the thermal structure of the equatorial Pacific Ocean is examined based on a sigma coordinate model. In general, the distributions of the temperature and currents simulated by the... The influence of horizontal mixing on the thermal structure of the equatorial Pacific Ocean is examined based on a sigma coordinate model. In general, the distributions of the temperature and currents simulated by the sigma coordinate model are very close to the climatology. However, the simulated thermocline along the equator is slightly diffusive so that there is a cold bias above the main thermocline, while there is a warm bias under the main thermocline. Both horizontal diffusivity and viscosity have important effects on the upper thermal structure in the equatorial Pacific Ocean, while their detailed dynamics are different. Horizontal diffusivity affects the thermal structure in the upper ocean mainly through regulating the vertical diffusivity, while the horizontal viscosity does mainly through regulating directly the circulate system. A large horizontal diffusivity or a small horizontal viscosity can be in favor of simulating a more realistically thermal structure in the equatorial Pacific Ocean. 展开更多
关键词 horizontal mixing thermal structure equatorial Pacific Ocean
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腹腔镜右半结肠癌根治术中保留胃网膜右静脉的临床研究 被引量:13
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作者 尤小兰 连彦军 +7 位作者 吴健 王元杰 戴佳文 赵小军 程之逸 黄传江 李文琦 周艳 《中华胃肠外科杂志》 CAS CSCD 北大核心 2020年第12期1164-1169,共6页
目的腹腔镜右半结肠癌根治手术的入路及手术步骤已程序化并达成专业共识,然而,一些细节问题如手术中Henle干的处理、术中是否保留胃网膜右静脉(RGEV)等仍然存在争议。为此,本研究探讨腹腔镜右半结肠癌根治术中保留RGEV的安全性、可行性... 目的腹腔镜右半结肠癌根治手术的入路及手术步骤已程序化并达成专业共识,然而,一些细节问题如手术中Henle干的处理、术中是否保留胃网膜右静脉(RGEV)等仍然存在争议。为此,本研究探讨腹腔镜右半结肠癌根治术中保留RGEV的安全性、可行性以及近、远期临床疗效。方法采用回顾性队列研究的方法,分析2016年3月至2018年5月期间,在江苏省泰州市人民医院胃肠外科接受腹腔镜右半结肠癌根治术的92例患者的临床资料。所有病例均行右半结肠完整结肠系膜切除术(CME),术后病理数据及随访资料完整。根据肿瘤具体位置决定术中是否保留RGEV,49例为保留RGEV组,43例为不保留RGEV组,分析比较两组患者术后一般情况、肿瘤安全性指标、术后并发症及近、远期疗效。结果保留RGEV组与不保留RGEV组患者基线资料的比较,差异无统计学意义(均P>0.05)。保留RGEV组与不保留RGEV组手术时间、术中出血量、非计划再手术、吻合口漏、清扫淋巴结数目、转移淋巴结数目、术后进食时间比较,差异均无统计学意义(均P>0.05)。与不保留RGEV组相比,保留RGEV组术后缩短了肛门排气时间[(3.1±1.0)d比(4.0±1.7)d,t=-2.787,P=0.007]和住院时间[(11.5±1.5)d比(15.0±7.9)d,t=-2.823,P=0.007];降低了住院费用[(4.6±0.5)万元比(5.7±3.3)万元,t=-2.076,P=0.044]。不保留RGEV组围手术期胃瘫发生率14.0%(6/43),保留RGEV组无胃瘫病例发生(P<0.05)。中位随访时间31.8(5.2~43.7)个月,保留RGEV组与不保留RGEV组总体生存期分别为(35.4±1.8)个月和(37.6±1.7)个月,差异无统计学意义(P=0.336);无病生存期分别为(32.0±2.2)个月和(35.5±2.0)个月,差异也无统计学意义(P=0.201)。结论腹腔镜右半结肠癌根治术中保留RGEV安全、可行,可降低术后胃瘫发生率,缩短术后肠功能恢复时间和住院时间,并减少住院费用。与不保留RGEV相比,疗效相当。 展开更多
关键词 结肠肿瘤 右半结肠癌根治术 胃网膜右静脉 胃瘫
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小切口辅助下腹腔镜直肠癌根治术中双荷包吻合术的应用研究 被引量:8
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作者 尤小兰 吴健 +7 位作者 王元杰 赵小军 周艳 李文琦 徐宁 程之逸 黄传江 刘贵远 《中华胃肠外科杂志》 CAS CSCD 北大核心 2018年第12期1408-1413,共6页
目的探讨小切口辅助下腹腔镜直肠癌根治术中双荷包吻合术的可行性和安全性以及经济学效益。方法对2011年1月至2017年12月期间在江苏省泰州市人民医院胃肠外科接受手术治疗的224例原发性直肠腺癌患者的临床资料进行回顾性分析,病例纳入... 目的探讨小切口辅助下腹腔镜直肠癌根治术中双荷包吻合术的可行性和安全性以及经济学效益。方法对2011年1月至2017年12月期间在江苏省泰州市人民医院胃肠外科接受手术治疗的224例原发性直肠腺癌患者的临床资料进行回顾性分析,病例纳入标准为术前肠镜病理明确诊断,肿瘤距肛缘4~15cm,行耻骨上小切口辅助腹腔镜全直肠系膜切除术(TME)。按术中吻合方式,分为双荷包单吻合器组(双荷包吻合组,108例)和单荷包双吻合器组(单荷包吻合组,116例),对两组患者的手术学指标、肿瘤安全性指标、近期疗效及经济学指标进行分析比较。结果双荷包吻合组与单荷包吻合组患者年龄、性别、腹部手术史、体质指数、美国医师协会评分(ASA评分)、肿瘤大小、肿瘤距肛缘距离、肿瘤病理分化程度、肿瘤TNM分期等基线资料比较,差异无统计学意义(均P>0.05)。两组手术时间、术中出血量、淋巴结清扫数目、切除肿瘤近端和远端肠管平均长度以及术后排尿功能障碍、性功能障碍、排粪功能异常发生率差异均无统计学意义(均P>0.05)。与单荷包吻合组相比,双荷包吻合组术后吻合口继发出血率低[0.9%(1/108)比6.0%(7/116),χ^2=4.238,P=0.040],术后吻合口漏发生率低[1.9%(2/108)比7.8%(9/116),χ^2=4.179,P=0.041],术后吻合口狭窄发生率低[1.9%(2/108)比8.6%(10/116),χ^2=5.054,P=0.025],且住院时间短[(13.4±3.9)d比(15.9±9.8)d,t=2.524,P=0.013],住院费用低[(3.4±0.7)万元比(4.6±2.3)万元,t=5.047,P<0.001]。平均随访33个月,两组患者术后局部复发率、远处转移率、总体生存率差异均无统计学意义(均P>0.05)。结论小切口辅助腹腔镜直肠癌TME术中行双荷包单吻合器吻合术安全、可行,并可降低住院费用。 展开更多
关键词 直肠肿瘤 腹腔镜手术 双荷包吻合
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腹腔镜胃楔形切除术与经脐单孔腔镜胃楔形切除术的临床疗效对比分析 被引量:2
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作者 程之逸 赵小军 +3 位作者 尤小兰 黄传江 刘贵远 毛旭南 《中华普外科手术学杂志(电子版)》 2020年第5期495-498,共4页
目的对比腹腔镜胃楔形切除术与经脐单孔腔镜胃楔形切除术的临床疗效。方法回顾性选取2016年1月至2019年4月确诊为胃间质瘤且行腹腔镜胃楔形切除术的63例患者进行研究。根据手术方式不同36例行腹腔镜胃楔形切除术患者列为五孔组,将27行... 目的对比腹腔镜胃楔形切除术与经脐单孔腔镜胃楔形切除术的临床疗效。方法回顾性选取2016年1月至2019年4月确诊为胃间质瘤且行腹腔镜胃楔形切除术的63例患者进行研究。根据手术方式不同36例行腹腔镜胃楔形切除术患者列为五孔组,将27行经脐单孔腔镜胃楔形切除术患者列为单孔组。采用SPSS 25.0统计学软件进行数据分析,围术期指标、营养指标、生活质量评分等计量资料采用(±s)表示,组间比较采用独立样本t检验;术后并发症等计数资料组间比较卡方χ2检验;等级计数资料采用秩和检验。P<0.05差异有统计学意义。结果两组均顺利完成手术,无死亡、中转开腹或转为开腹手术病例,术后病理证实均为R0切除。单孔组手术时间及术中出血量少于五孔组(P<0.05);术后排气时间、住院时间、术后并发症、术后营养指标等,两组差异均无统计学意义。术后3个月单孔组患者生理职(功)能、躯体疼痛优于五孔组(P<0.05),其他生活质量评分差异均无统计学意义。结论经脐单孔腹腔镜胃楔形切除术疗效较常规腹腔镜胃楔形切除术近似,且具有术时短、出血少、更微创等优势,可在临床中逐步推广应用。 展开更多
关键词 胃肠道间质肿瘤 腹腔镜 胃切除术 疗效比较研究 经脐单孔
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