腹主动脉球囊阻断术在复杂盆腔肿瘤手术中的应用

目的:探讨腹主动脉球囊阻断术在复杂盆腔肿瘤手术中的安全性及临床应用价值。通过分析术中阻断时间、次数、失血量、术前术后血红蛋白、pH值等指标的变化,评估该技术在复杂盆腔肿瘤手术中应用的安全性及有效性,分析阻断次数和时间对手术出血等方面的影响,为该技术推广应用提供依据。方法:收集2013年3月至2019年11月间在湖北省肿瘤医院经腹主动脉球囊阻断术介导行骨盆、骶骨等盆腔肿瘤切除术患者的病例资料;按照阻断时间(≤60 min或>60 min)和阻断次数分成2组。A组(21例):阻断时间(≤60 min)、阻断次数1次,B组(9例):阻断时间(>60 min)、阻断次数1次或以上。其中A组10例、B组4例因瘤体较大或血供丰富行术前经皮造影瘤体栓塞;统计分析术中阻断时间、次数、失血量,手术前后血红蛋白及pH值等数据,比较阻断时间、次数等对失血量、血红蛋白等指标的的影响。结果:所有患者均完成肿瘤整块或分块切除及重建,重建方式包括3D打印半骨盆假体置换、普通假体和钉棒系统固定,所有病例中阻断次数最多达3次,最长累计阻断时间达140 min,平均阻断时间(57.30±26.88)min,手术出血量400~7500 mL,所有患者手术及术后恢复顺利。阻断时限在≤60 min的患者在术中出血量、血红蛋白降低等指标上明显优于阻断时间在>60 min和多次阻断的患者,差异具有统计学意义(P<0.05),阻断超过60 min以及多次阻断的患者手术平均出血量是阻断时限在≤60 min患者的1.5倍以上(P<0.05)。结论:腹主动脉球囊阻断术在骨盆环手术中有良好的安全性及可操作性,把握好阻断时间及阻断次数,尽量将累计阻断时间控制在60 min以内对于减少术中出血,降低出血相关风险有重要意义,应重视术前筛查、术中充分止血和血液相关指标的监测和管理,该技术具有良好的安全性,临床应用价值较高,值得推广。

Effects of amygdale heterogeneity and sample size on the mechanical properties of basalt

Due to the complex diagenesis process,basalt usually contains defects in the form of amygdales formed by diagenetic bubbles,which affect its mechanical properties.In this study,a synthetic rock mass method(SRM)based on the combination of discrete fracture network(DFN)and finite-discrete element method(FDEM)is applied to characterizing the amygdaloidal basalt,and to systematically exploring the effects of the development characteristics of amygdales and sample sizes on the mechanical properties of basalt.The results show that with increasing amygdale content,the elastic modulus(E)increases linearly,while the uniaxial compressive strength(UCS)shows an exponential or logarithmic decay.When the orientation of amygdales is between 0°and 90°,basalt shows a relatively pronounced strength and stiffness anisotropy.Based on the analysis of the geometric and mechanical properties,the representative element volume(REV)size of amygdaloidal basalt blocks is determined to be 200 mm,and the mechanical properties obtained on this scale can be regarded as the properties of the equivalent continuum.The results of this research are of value to the understanding of the mechanical properties of amygdaloidal basalt,so as to guide the formulation of engineering design schemes more accurately.

Pedestrian and Vehicle Detection Based on Pruning YOLOv4 with Cloud-Edge Collaboration

Nowadays,the rapid development of edge computing has driven an increasing number of deep learning applications deployed at the edge of the network,such as pedestrian and vehicle detection,to provide efficient intelligent services to mobile users.However,as the accuracy requirements continue to increase,the components of deep learning models for pedestrian and vehicle detection,such as YOLOv4,become more sophisticated and the computing resources required for model training are increasing dramatically,which in turn leads to significant challenges in achieving effective deployment on resource-constrained edge devices while ensuring the high accuracy performance.For addressing this challenge,a cloud-edge collaboration-based pedestrian and vehicle detection framework is proposed in this paper,which enables sufficient training of models by utilizing the abundant computing resources in the cloud,and then deploying the well-trained models on edge devices,thus reducing the computing resource requirements for model training on edge devices.Furthermore,to reduce the size of the model deployed on edge devices,an automatic pruning method combines the convolution layer and BN layer is proposed to compress the pedestrian and vehicle detection model size.Experimental results show that the framework proposed in this paper is able to deploy the pruned model on a real edge device,Jetson TX2,with 6.72 times higher FPS.Meanwhile,the channel pruning reduces the volume and the number of parameters to 96.77%for the model,and the computing amount is reduced to 81.37%.

Clinical analysis of 45 cases of surgical treatment for inner thigh primary soft tissue sarcoma

Objective: We aimed to study the relationship between clinical effect and surgical methods of inner thigh primary soft tissue sarcomas. Methods: Wide or radical resection were performed in 45 cases of soft tissue sarcomas, including 20 cases of postoperative recurrence after radiation therapy, 7 cases of first treatment. Thirty-six cases received 4–6 cycles of postoperative chemotherapy. Results: Thirty-eight of 45 cases were followed up for 1–5 years, with 5 case of recurrence and 6 cases of distant metastasis. Conclusion: The inner thigh primary soft tissue sarcoma can be effectively treated with wide or radical resection.

Insights into influence of aging processes on zero-valent iron modified biochar in copper(II) immobilization: from batch solution to pilot-scale investigation

The zero-valent iron modified biochar materials are widely employed for heavy metals immobilization.However,these materials would be inevitably aged by natural forces after entering into the environment,while there are seldom studies reported the aging effects of zero-valent iron modified biochar.In this work,the hydrogen peroxide and hydrochloric acid solution were applied to simulate aging conditions of zero-valent iron modified biochar.According to the results,the adsorption capacity of copper(II)contaminants on biochar,zero-valent iron modified biochar-1,and zero-valent iron modified biochar-2 after aging was decreased by 15.36%,22.65%and 23.26%,respectively.The surface interactions were assigned with chemisorption occurred on multi-molecular layers,which were proved by the pseudo-second-order and Langmuir models.After aging,the decreasing of capacity could be mainly attributed to the inhibition of ion-exchange and zero-valent iron oxidation.Moreover,the plant growth and soil leaching experiments also proved the effects of aging treatment,the zero-valent iron modified biochar reduced the inhibition of copper(II)bioavailability and increased the mobility of copper(II)after aging.All these results bridged the gaps between bio-adsorbents customization and their environmental behaviors during practical agro-industrial application.