目的 分析完全腹腔镜近端胃切除食管残胃吻合的临床疗效,为治疗早期近端胃癌提供新的手术方法。方法 回顾性分析2019年1月-2021年6月于解放军总医院第一医学中心普通外科医学部行近端胃切除术的80例早期胃癌患者的临床资料。根据手术方...目的 分析完全腹腔镜近端胃切除食管残胃吻合的临床疗效,为治疗早期近端胃癌提供新的手术方法。方法 回顾性分析2019年1月-2021年6月于解放军总医院第一医学中心普通外科医学部行近端胃切除术的80例早期胃癌患者的临床资料。根据手术方式不同分为完全腹腔镜近端胃癌切除术组(n=36)与腹腔镜辅助近端胃癌切除术组(n=44)。比较两组围手术期情况、远期并发症发生情况及生存状况。结果 完全腹腔镜近端胃癌切除术组腹部切口长度[(59.9±4.7) mm vs.(119.7±8.3) mm,P<0.001]、首次排气时间[(58.2±15.3) h vs.(66.8±16.4) h,P=0.019]及术后住院时间[(7.6±1.1) d vs.(9.2±1.3) d,P<0.001]均短于腹腔镜辅助近端胃癌切除术组,手术时间[(186.9±16.4) min vs.(154.0±17.2) min,P<0.001]长于腹腔镜辅助近端胃癌切除术组。两组术中出血量、淋巴结清扫数目和首次进流食时间差异无统计学意义(P>0.05),且均未发生需外科干预的早期并发症。随访期间两组无患者死亡,未出现复发或转移。完全腹腔镜近端胃癌切除术组反流性食管炎发生率低于腹腔镜辅助近端胃癌切除术组,差异有统计学意义[16.7%(6/36) vs.38.6%(17/44),P=0.031]。两组胃动力不足、残胃炎、吻合口狭窄、吻合口溃疡发生率差异无统计学意义(P>0.05)。结论 完全腹腔镜近端胃切除食管残胃吻合具有安全性好、术后恢复快、抗反流等特点,值得临床应用推广。展开更多
目的旨在探讨着丝粒蛋白U(centromere protein U,CENPU)在结直肠癌患者肠组织中的表达情况,并结合生物信息学分析其表达水平对结直肠癌患者预后的影响。方法通过实时荧光定量聚合酶链反应(quantitative real time polymerase chain reac...目的旨在探讨着丝粒蛋白U(centromere protein U,CENPU)在结直肠癌患者肠组织中的表达情况,并结合生物信息学分析其表达水平对结直肠癌患者预后的影响。方法通过实时荧光定量聚合酶链反应(quantitative real time polymerase chain reaction,qRT-PCR)、蛋白质免疫印迹(Western blot,WB)法以及免疫组织化学染色(immunohistochemistry,IHC)实验验证CENPU在组织中的表达情况。结合患者临床病例资料,通过单因素和多因素Cox回归分析CENPU的表达与结直肠癌患者临床病例参数的相关性;然后通过绘制受试操作者操作特征(receiver operating characteristic,ROC)曲线和Kaplan-Meier生存曲线,探究CENPU的表达对结直肠癌患者预后的预测作用。最后,通过生物信息学分析CENPU的表达对结直肠癌疾病进展影响的可能分子机制。结果通过qRT-PCR、WB法以及IHC实验均发现,与正常组织比较,CENPU在结直肠癌患者癌组织中表达显著升高。Cox回归分析表明CENPU的表达与患者的年龄和TNM分期显著相关,是影响患者预后的危险因素。Kaplan-Meier生存曲线分析表明:CENPU高表达的结直肠癌患者的生存率显著降低。ROC曲线结果表明:基于CENPU的表达建立的模型具有较高的预测结直肠癌患者预后的能力。生物信息学分析结果表明:CENPI、CENPN、CENPD、CENPK、CENPP、CENPM、CENPQ、CENPH、NDC80以及ITGB3BP这10个基因与CENPU基因具有相互作用关系;CENPU参与DNA修复、MYC/TARGETS/V1以及PI3K/AKT/MTOR等信号通路。结论结直肠癌患者癌组织中高表达的CENPU与患者的不良预后显著相关,提示CENPU有望成为结直肠癌患者早期诊断及预测预后的潜在靶点。展开更多
To address the low accuracy and stability when applying classical control theory in distribution networks with distributed generation,a control method involving flexible multistate switches(FMSs)is proposed in this st...To address the low accuracy and stability when applying classical control theory in distribution networks with distributed generation,a control method involving flexible multistate switches(FMSs)is proposed in this study.This approach is based on an improved double-loop recursive fuzzy neural network(DRFNN)sliding mode,which is intended to stably achieve multiterminal power interaction and adaptive arc suppression for single-phase ground faults.First,an improved DRFNN sliding mode control(SMC)method is proposed to overcome the chattering and transient overshoot inherent in the classical SMC and reduce the reliance on a precise mathematical model of the control system.To improve the robustness of the system,an adaptive parameter-adjustment strategy for the DRFNN is designed,where its dynamic mapping capabilities are leveraged to improve the transient compensation control.Additionally,a quasi-continuous second-order sliding mode controller with a calculus-driven sliding mode surface is developed to improve the current monitoring accuracy and enhance the system stability.The stability of the proposed method and the convergence of the network parameters are verified using the Lyapunov theorem.A simulation model of the three-port FMS with its control system is constructed in MATLAB/Simulink.The simulation result confirms the feasibility and effectiveness of the proposed control strategy based on a comparative analysis.展开更多
以内燃机典型摩擦副缸套-活塞系统为研究对象,设计和搭建内燃机缸套-活塞系统状态监测试验台。针对传统最大熵方法分析润滑油中磨粒监测数据存在的缺点,提出改进的分数矩最大熵方法(Fractional Moment Maximum Entropy Method, FM-MEM)...以内燃机典型摩擦副缸套-活塞系统为研究对象,设计和搭建内燃机缸套-活塞系统状态监测试验台。针对传统最大熵方法分析润滑油中磨粒监测数据存在的缺点,提出改进的分数矩最大熵方法(Fractional Moment Maximum Entropy Method, FM-MEM),并结合食肉植物优化算法(Carnivorous Plant Algorithm, CPA)对关键参数进行寻优求解。对润滑油中磨粒监测数据进行阈值划分,实现内燃机健康状态评估,然后将理论与试验相结合,以在线磨粒监测为主,从润滑油磨粒、理化指标以及表面形貌3个方面对内燃机缸套-活塞系统的运行状态进行监测,分析低速工况下缸套-活塞系统各个时间段的磨损健康状态及磨粒含量变化趋势,通过内燃机整机的在线磨粒监测试验,证明该方法可实现对内燃机缸套-活塞系统的实时状态监测。展开更多
Depression,a prevalent and complex mental health condition,presents a significant global health burden.Depression is one of the most frequent mental disorders;deaths from it account for 14.3%of people worldwide.In rec...Depression,a prevalent and complex mental health condition,presents a significant global health burden.Depression is one of the most frequent mental disorders;deaths from it account for 14.3%of people worldwide.In recent years,the integration of complementary and alternative medicine,including traditional Chinese medicine(TCM),has gained attention as a potential avenue for addressing depression.This comprehensive review critically assesses the efficacy of TCM interventions in alleviating depressive symptoms.An in-depth look at different research studies,clinical trials,and meta-analyses is used in this review to look into how TCM practices like herbal formulations,acupuncture,and mindbody practices work.The review looks at the quality of the evidence,the rigor of the methods,and any possible flaws in the current studies.This gives us an idea of where TCM stands right now in terms of treating depression.This comprehensive review aims to assess the efficacy of TCM interventions in alleviating depressive symptoms.In order to learn more about their possible healing effects,the study also looks into how different types of TCM work,such as herbal formulas,acupuncture,and mind-body practices.展开更多
文摘目的 分析完全腹腔镜近端胃切除食管残胃吻合的临床疗效,为治疗早期近端胃癌提供新的手术方法。方法 回顾性分析2019年1月-2021年6月于解放军总医院第一医学中心普通外科医学部行近端胃切除术的80例早期胃癌患者的临床资料。根据手术方式不同分为完全腹腔镜近端胃癌切除术组(n=36)与腹腔镜辅助近端胃癌切除术组(n=44)。比较两组围手术期情况、远期并发症发生情况及生存状况。结果 完全腹腔镜近端胃癌切除术组腹部切口长度[(59.9±4.7) mm vs.(119.7±8.3) mm,P<0.001]、首次排气时间[(58.2±15.3) h vs.(66.8±16.4) h,P=0.019]及术后住院时间[(7.6±1.1) d vs.(9.2±1.3) d,P<0.001]均短于腹腔镜辅助近端胃癌切除术组,手术时间[(186.9±16.4) min vs.(154.0±17.2) min,P<0.001]长于腹腔镜辅助近端胃癌切除术组。两组术中出血量、淋巴结清扫数目和首次进流食时间差异无统计学意义(P>0.05),且均未发生需外科干预的早期并发症。随访期间两组无患者死亡,未出现复发或转移。完全腹腔镜近端胃癌切除术组反流性食管炎发生率低于腹腔镜辅助近端胃癌切除术组,差异有统计学意义[16.7%(6/36) vs.38.6%(17/44),P=0.031]。两组胃动力不足、残胃炎、吻合口狭窄、吻合口溃疡发生率差异无统计学意义(P>0.05)。结论 完全腹腔镜近端胃切除食管残胃吻合具有安全性好、术后恢复快、抗反流等特点,值得临床应用推广。
文摘目的旨在探讨着丝粒蛋白U(centromere protein U,CENPU)在结直肠癌患者肠组织中的表达情况,并结合生物信息学分析其表达水平对结直肠癌患者预后的影响。方法通过实时荧光定量聚合酶链反应(quantitative real time polymerase chain reaction,qRT-PCR)、蛋白质免疫印迹(Western blot,WB)法以及免疫组织化学染色(immunohistochemistry,IHC)实验验证CENPU在组织中的表达情况。结合患者临床病例资料,通过单因素和多因素Cox回归分析CENPU的表达与结直肠癌患者临床病例参数的相关性;然后通过绘制受试操作者操作特征(receiver operating characteristic,ROC)曲线和Kaplan-Meier生存曲线,探究CENPU的表达对结直肠癌患者预后的预测作用。最后,通过生物信息学分析CENPU的表达对结直肠癌疾病进展影响的可能分子机制。结果通过qRT-PCR、WB法以及IHC实验均发现,与正常组织比较,CENPU在结直肠癌患者癌组织中表达显著升高。Cox回归分析表明CENPU的表达与患者的年龄和TNM分期显著相关,是影响患者预后的危险因素。Kaplan-Meier生存曲线分析表明:CENPU高表达的结直肠癌患者的生存率显著降低。ROC曲线结果表明:基于CENPU的表达建立的模型具有较高的预测结直肠癌患者预后的能力。生物信息学分析结果表明:CENPI、CENPN、CENPD、CENPK、CENPP、CENPM、CENPQ、CENPH、NDC80以及ITGB3BP这10个基因与CENPU基因具有相互作用关系;CENPU参与DNA修复、MYC/TARGETS/V1以及PI3K/AKT/MTOR等信号通路。结论结直肠癌患者癌组织中高表达的CENPU与患者的不良预后显著相关,提示CENPU有望成为结直肠癌患者早期诊断及预测预后的潜在靶点。
基金the Natural Science Foundation of Fujian,China(No.2021J01633).
文摘To address the low accuracy and stability when applying classical control theory in distribution networks with distributed generation,a control method involving flexible multistate switches(FMSs)is proposed in this study.This approach is based on an improved double-loop recursive fuzzy neural network(DRFNN)sliding mode,which is intended to stably achieve multiterminal power interaction and adaptive arc suppression for single-phase ground faults.First,an improved DRFNN sliding mode control(SMC)method is proposed to overcome the chattering and transient overshoot inherent in the classical SMC and reduce the reliance on a precise mathematical model of the control system.To improve the robustness of the system,an adaptive parameter-adjustment strategy for the DRFNN is designed,where its dynamic mapping capabilities are leveraged to improve the transient compensation control.Additionally,a quasi-continuous second-order sliding mode controller with a calculus-driven sliding mode surface is developed to improve the current monitoring accuracy and enhance the system stability.The stability of the proposed method and the convergence of the network parameters are verified using the Lyapunov theorem.A simulation model of the three-port FMS with its control system is constructed in MATLAB/Simulink.The simulation result confirms the feasibility and effectiveness of the proposed control strategy based on a comparative analysis.
文摘以内燃机典型摩擦副缸套-活塞系统为研究对象,设计和搭建内燃机缸套-活塞系统状态监测试验台。针对传统最大熵方法分析润滑油中磨粒监测数据存在的缺点,提出改进的分数矩最大熵方法(Fractional Moment Maximum Entropy Method, FM-MEM),并结合食肉植物优化算法(Carnivorous Plant Algorithm, CPA)对关键参数进行寻优求解。对润滑油中磨粒监测数据进行阈值划分,实现内燃机健康状态评估,然后将理论与试验相结合,以在线磨粒监测为主,从润滑油磨粒、理化指标以及表面形貌3个方面对内燃机缸套-活塞系统的运行状态进行监测,分析低速工况下缸套-活塞系统各个时间段的磨损健康状态及磨粒含量变化趋势,通过内燃机整机的在线磨粒监测试验,证明该方法可实现对内燃机缸套-活塞系统的实时状态监测。
基金Supported by the 2022 Hunan Provincial Department of Education Scientific Research Project,No.22C0188the 2022 Key R&D Projects in Hunan Province,No.2020SK2123.
文摘Depression,a prevalent and complex mental health condition,presents a significant global health burden.Depression is one of the most frequent mental disorders;deaths from it account for 14.3%of people worldwide.In recent years,the integration of complementary and alternative medicine,including traditional Chinese medicine(TCM),has gained attention as a potential avenue for addressing depression.This comprehensive review critically assesses the efficacy of TCM interventions in alleviating depressive symptoms.An in-depth look at different research studies,clinical trials,and meta-analyses is used in this review to look into how TCM practices like herbal formulations,acupuncture,and mindbody practices work.The review looks at the quality of the evidence,the rigor of the methods,and any possible flaws in the current studies.This gives us an idea of where TCM stands right now in terms of treating depression.This comprehensive review aims to assess the efficacy of TCM interventions in alleviating depressive symptoms.In order to learn more about their possible healing effects,the study also looks into how different types of TCM work,such as herbal formulas,acupuncture,and mind-body practices.