BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require furt...BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.展开更多
The problem of tiling rectangles by polyominoes generated large interest. A related one is the problem of tiling parallelograms by twisted polyominoes. Both problems are related with tilings of (skewed) quadrants by p...The problem of tiling rectangles by polyominoes generated large interest. A related one is the problem of tiling parallelograms by twisted polyominoes. Both problems are related with tilings of (skewed) quadrants by polyominoes. Indeed, if all tilings of a (skewed) quadrant by a tile set can be reduced to a tiling by congruent rectangles (parallelograms), this provides information about tilings of rectangles (parallelograms). We consider a class of tile sets in a square lattice appearing from arbitrary dissections of rectangles in two L-shaped polyominoes and from symmetries of these tiles about the first bisector. Only translations of the tiles are allowed in a tiling. If the sides of the dissected rectangle are coprime, we show the existence of tilings of all (skewed) quadrants that do not follow the rectangular (parallelogram) pattern. If one of the sides of the dissected rectangle is 2 and the other is odd, we also show tilings of rectangles by the tile set that do not follow the rectangular pattern. If one of the sides of the dissected rectangle is 2 and the other side is even, we show a new infinite family of tile sets that follows the rectangular pattern when tiling one of the quadrants. For this type of dis-section, we also show a new infinite family that does not follow the rectangular pattern when tiling rectangles. Finally, we investigate more general dissections of rectangles, with. Here we show infinite families of tile sets that follow the rectangular pattern for a quadrant and infinite families that do not follow the rectangular pattern for any quadrant. We also show, for infinite families of tile sets of this type, tilings of rectangles that do not follow the rectangular pattern.展开更多
A Chebyshev fitting way for a propeller atlas across four quadrants is discussed. As an example, Chebyshev polynomial fitting results and its error analysis are given. Because it’s difficult generally to get a propel...A Chebyshev fitting way for a propeller atlas across four quadrants is discussed. As an example, Chebyshev polynomial fitting results and its error analysis are given. Because it’s difficult generally to get a propeller atlas across four quadrants, a way is used to construct an alternative with higher accuracy based on the properties. As an application example, an alternative for the propeller property of a Deep Submergence Vehicle across four quadrants is given practically and a simulation model of the four quadrants propeller for dynamic condition is set up. The model lays a foundation for DSV full operating-condition movement simulation. A lot of simulation work shows that the results are very close to the practical data and, therefore, are effective.展开更多
目的比较三种工作通道下治疗腰5/骶1椎间盘突出症的疗效。方法回顾分析2017年3月至2020年3月空军军医大学西京医院收治的113例腰椎间盘突出症患者的临床资料,其中37例行传统单纯髓核摘除术(传统组),42例行Quadrant通道下单纯髓核摘除术(...目的比较三种工作通道下治疗腰5/骶1椎间盘突出症的疗效。方法回顾分析2017年3月至2020年3月空军军医大学西京医院收治的113例腰椎间盘突出症患者的临床资料,其中37例行传统单纯髓核摘除术(传统组),42例行Quadrant通道下单纯髓核摘除术(Quadrant组),34例行Zista固定通道下精确开窗髓核摘除术(Zista组)。所有患者均随访1年,比较三组患者手术切口长度、术中出血量、术后引流量、腰痛、腿痛视觉模拟量表(VAS)评分、腰椎Oswestry功能障碍指数(ODI)分析。结果Zista组手术切口长度、术中出血量、术后引流量均小于Quadrant组及传统组(P<0.05),而Quadrant组进一步优于传统组(P<0.05)。腰痛VAS评分术后7 d Zista组及Quadrant组优于传统组(P<0.05),术后1年Zista组优于Quadrant组(P<0.05),而Quadrant组与传统组相当(P>0.05)。腿痛VAS评分三组术后7 d、术后1年均相当(P>0.05)。ODI评分Zista组术后7 d优于Quadrant组及传统组(P<0.05),而Quadrant组及传统组相当(P>0.05),术后1年Zista组优于Quadrant组(P<0.05),且进一步优于传统组(P<0.05)。结论三种手术方式均可以达到相对满意的临床疗效,而Quadrant组较传统组术后短期内改善更佳,而Zista组整体治疗效果优于Quadrant组和传统组,值得推广。展开更多
基金Supported by Health Research Program of Anhui,No.AHWJ2022b032。
文摘BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.
文摘The problem of tiling rectangles by polyominoes generated large interest. A related one is the problem of tiling parallelograms by twisted polyominoes. Both problems are related with tilings of (skewed) quadrants by polyominoes. Indeed, if all tilings of a (skewed) quadrant by a tile set can be reduced to a tiling by congruent rectangles (parallelograms), this provides information about tilings of rectangles (parallelograms). We consider a class of tile sets in a square lattice appearing from arbitrary dissections of rectangles in two L-shaped polyominoes and from symmetries of these tiles about the first bisector. Only translations of the tiles are allowed in a tiling. If the sides of the dissected rectangle are coprime, we show the existence of tilings of all (skewed) quadrants that do not follow the rectangular (parallelogram) pattern. If one of the sides of the dissected rectangle is 2 and the other is odd, we also show tilings of rectangles by the tile set that do not follow the rectangular pattern. If one of the sides of the dissected rectangle is 2 and the other side is even, we show a new infinite family of tile sets that follows the rectangular pattern when tiling one of the quadrants. For this type of dis-section, we also show a new infinite family that does not follow the rectangular pattern when tiling rectangles. Finally, we investigate more general dissections of rectangles, with. Here we show infinite families of tile sets that follow the rectangular pattern for a quadrant and infinite families that do not follow the rectangular pattern for any quadrant. We also show, for infinite families of tile sets of this type, tilings of rectangles that do not follow the rectangular pattern.
文摘A Chebyshev fitting way for a propeller atlas across four quadrants is discussed. As an example, Chebyshev polynomial fitting results and its error analysis are given. Because it’s difficult generally to get a propeller atlas across four quadrants, a way is used to construct an alternative with higher accuracy based on the properties. As an application example, an alternative for the propeller property of a Deep Submergence Vehicle across four quadrants is given practically and a simulation model of the four quadrants propeller for dynamic condition is set up. The model lays a foundation for DSV full operating-condition movement simulation. A lot of simulation work shows that the results are very close to the practical data and, therefore, are effective.
文摘目的比较三种工作通道下治疗腰5/骶1椎间盘突出症的疗效。方法回顾分析2017年3月至2020年3月空军军医大学西京医院收治的113例腰椎间盘突出症患者的临床资料,其中37例行传统单纯髓核摘除术(传统组),42例行Quadrant通道下单纯髓核摘除术(Quadrant组),34例行Zista固定通道下精确开窗髓核摘除术(Zista组)。所有患者均随访1年,比较三组患者手术切口长度、术中出血量、术后引流量、腰痛、腿痛视觉模拟量表(VAS)评分、腰椎Oswestry功能障碍指数(ODI)分析。结果Zista组手术切口长度、术中出血量、术后引流量均小于Quadrant组及传统组(P<0.05),而Quadrant组进一步优于传统组(P<0.05)。腰痛VAS评分术后7 d Zista组及Quadrant组优于传统组(P<0.05),术后1年Zista组优于Quadrant组(P<0.05),而Quadrant组与传统组相当(P>0.05)。腿痛VAS评分三组术后7 d、术后1年均相当(P>0.05)。ODI评分Zista组术后7 d优于Quadrant组及传统组(P<0.05),而Quadrant组及传统组相当(P>0.05),术后1年Zista组优于Quadrant组(P<0.05),且进一步优于传统组(P<0.05)。结论三种手术方式均可以达到相对满意的临床疗效,而Quadrant组较传统组术后短期内改善更佳,而Zista组整体治疗效果优于Quadrant组和传统组,值得推广。
