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Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience
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作者 Yu-Hong Liu Tzu-Chiao Lin +1 位作者 Chao-Yang Chen Ta-Wei Pu 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第9期2787-2795,共9页
BACKGROUND Stapled hemorrhoidopexy(SH)is currently a widely accepted method for treating the prolapse of internal hemorrhoids.Postoperative anal stenosis is a critical complication of SH.A remedy for this involves the... BACKGROUND Stapled hemorrhoidopexy(SH)is currently a widely accepted method for treating the prolapse of internal hemorrhoids.Postoperative anal stenosis is a critical complication of SH.A remedy for this involves the removal of the circumferential staples of the anastomosis,followed by the creation of a hand-sewn anastomosis.Numerous studies have reported modified SH procedures to improve outcomes.We hypothesized that our modified SH technique may help reduce complications of anal stenosis after SH.AIM To compare outcomes of staple removal at the 3-and 9-o’clock positions during modified SH in patients with mixed hemorrhoids.METHODS This was a single-center,retrospective,observational study.Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015,and January 1,2020,were included.The operation time,blood loss,length of hospital stay,and incidence of minor or major complic-ations were recorded.RESULTS Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015 and January 1,2020,were included.Operation time,blood loss,length of hospital stay,and incidence of minor or major complications were recorded.We investigated 187 patients(mean age,50.9 years)who had undergone our modified SH and 313 patients(mean age,53.0 years)who had undergone standard SH.In the modified SH group,54%of patients had previously undergone surgical intervention for hemorrhoids,compared with the 40.3%of patients in the standard SH group.The modified SH group included five(2.7%)patients with anal stenosis,while 21(6.7%)patients in the standard SH group had complications of anal stenosis.There was a significant relationship between the rate of postoperative anal stenosis and the modified SH:0.251(0.085-0.741)and 0.211(0.069-0.641)in multiple regression analysis.The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.CONCLUSION The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH. 展开更多
关键词 Anal canal HEMORRHOIDS PROLAPSE stapled hemorrhoidopexy Postoperative anal stenosis Modified stapled hemorrhoidopexy
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Simulation and Experimental Study of Staple Line Reinforcement Surgery
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作者 Chengjie Hu Jian Zhang 《Journal of Biomedical Science and Engineering》 2024年第4期83-95,共13页
The aim of this study was to evaluate the effectiveness of BM (basement membrane) and SIS (small intestine submucosa) composite extracellular matrix staple line reinforcement in surgical procedures through finite elem... The aim of this study was to evaluate the effectiveness of BM (basement membrane) and SIS (small intestine submucosa) composite extracellular matrix staple line reinforcement in surgical procedures through finite element modelling simulations and leak-proof performance experiments. The mechanical analyses of soft tissues with and without staple line reinforcement were performed by establishing finite element models of three tissues, namely, stomach, intestine and lungs, under the use scenarios of different anastomosis staple models;and the leak-proof performance of the staple line reinforcement was evaluated by simulating leak-proof experiments of gastric incision margins, intestinal sections, and lung incision margins in vitro. The results showed that the equivalent average stresses of the staple line reinforcement were increased by 20 kPa-68 kPa in gastric and intestinal tissues, and 8 kPa-22 kPa in lung tissues. and that the BM and SIS composite extracellular matrix staple line reinforcement could strengthen the anastomotic structure, and at the same time disperse the high stresses of the anastomosed tissues, which could effectively reduce the postoperative complications such as anastomotic bleeding and anastomotic leakage, and provide a safer and more effective optimized design for surgical mechanical anastomosis. It can effectively reduce postoperative complications such as anastomotic bleeding and anastomotic leakage, and provide a safer and more effective optimized design for surgical mechanical anastomosis. 展开更多
关键词 staple Line Reinforcement Surgical Anastomosis Soft Tissue Damage Finite Element Analysis Leak-Proof Performance Experimentsstaple cartridge
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Magnetic resonance imaging-based deep learning model to predict multiple firings in double-stapled colorectal anastomosis 被引量:3
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作者 Zheng-Hao Cai Qun Zhang +7 位作者 Zhan-Wei Fu Abraham Fingerhut Jing-Wen Tan Lu Zang Feng Dong Shu-Chun Li Shi-Lin Wang Jun-Jun Ma 《World Journal of Gastroenterology》 SCIE CAS 2023年第3期536-548,共13页
BACKGROUND Multiple linear stapler firings during double stapling technique(DST)after laparoscopic low anterior resection(LAR)are associated with an increased risk of anastomotic leakage(AL).However,it is difficult to... BACKGROUND Multiple linear stapler firings during double stapling technique(DST)after laparoscopic low anterior resection(LAR)are associated with an increased risk of anastomotic leakage(AL).However,it is difficult to predict preoperatively the need for multiple linear stapler cartridges during DST anastomosis.AIM To develop a deep learning model to predict multiple firings during DST anastomosis based on pelvic magnetic resonance imaging(MRI).METHODS We collected 9476 MR images from 328 mid-low rectal cancer patients undergoing LAR with DST anastomosis,which were randomly divided into a training set(n=260)and testing set(n=68).Binary logistic regression was adopted to create a clinical model using six factors.The sequence of fast spin-echo T2-weighted MRI of the entire pelvis was segmented and analyzed.Pure-image and clinical-image integrated deep learning models were constructed using the mask region-based convolutional neural network segmentation tool and three-dimensional convolutional networks.Sensitivity,specificity,accuracy,positive predictive value(PPV),and area under the receiver operating characteristic curve(AUC)was calculated for each model.RESULTS The prevalence of≥3 linear stapler cartridges was 17.7%(58/328).The prevalence of AL was statistically significantly higher in patients with≥3 cartridges compared to those with≤2 cartridges(25.0%vs 11.8%,P=0.018).Preoperative carcinoembryonic antigen level>5 ng/mL(OR=2.11,95%CI 1.08-4.12,P=0.028)and tumor size≥5 cm(OR=3.57,95%CI 1.61-7.89,P=0.002)were recognized as independent risk factors for use of≥3 linear stapler cartridges.Diagnostic performance was better with the integrated model(accuracy=94.1%,PPV=87.5%,and AUC=0.88)compared with the clinical model(accuracy=86.7%,PPV=38.9%,and AUC=0.72)and the image model(accuracy=91.2%,PPV=83.3%,and AUC=0.81).CONCLUSION MRI-based deep learning model can predict the use of≥3 linear stapler cartridges during DST anastomosis in laparoscopic LAR surgery.This model might help determine the best anastomosis strategy by avoiding DST when there is a high probability of the need for≥3 linear stapler cartridges. 展开更多
关键词 Deep learning Image-reading artificial intelligence Magnetic resonance imaging Predictive model Double stapling technique Linear stapler Rectal cancer Laparoscopic surgery Low anterior resection Anastomotic leakage
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Potential Probiotic Tiger Nut-Cashew Nut-Milk Production by Fermentation with Two Lactic Bacteria Isolated from Ivorian Staple Foods
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作者 Allah Antoine Assamoi Koua Atobla +1 位作者 Djeneba H. Ouattara Raïssa Thénéthio Koné 《Agricultural Sciences》 CAS 2023年第4期584-600,共17页
Probiotification of plant milk can improve its sensory and health-promoting properties. As traditional fermented foods where lactic acid bacteria (LAB) are present have been associated with beneficial effects on human... Probiotification of plant milk can improve its sensory and health-promoting properties. As traditional fermented foods where lactic acid bacteria (LAB) are present have been associated with beneficial effects on human health, the beneficial effects of two LAB recently isolated from two current Ivorian staple foods (a pepper and a traditional beer) were screened. These two strains LAC 1 (Lactobacillus plantarum) and LAC 2 (Pediococcus acidilactici) which presented probiotic, exopolysaccharides, inflammatory and anti-oxidant activities, were used to ferment a composite plant milk of tiger-nut and cashew (80/20) compared to two starters of a commercial yogourt. The obtained plant milks SCT 2 and SCT 3 with a significant increase in their antioxidant and/or anti-inflammatory activities and lactic bacteria contents were more preferred by consumers than SCT 1 obtained by fermentation of the commercial yogourt starters. The mixing of LAC 1 and LAC 2 was not beneficial. SCT 2 (with an anti-inflammatory activity of 31.38% and an anti-oxidant activity of 17.30%) and SCT 3 (with an anti-oxidant activity of 22.28) could be further tested in animal models to verify their nutrition-health claims. 展开更多
关键词 Probiotic staple Food Lactic Acid ANTI-OXIDANT ANTI-INFLAMMATORY
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Using shape-memory alloy staples to treat comminuted manubrium sterni fractures: A case report
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作者 Min Zhang Wei Jiang +1 位作者 Ze-Xue Wang Zhi-Ming Zhou 《World Journal of Clinical Cases》 SCIE 2023年第30期7386-7392,共7页
BACKGROUND Comminuted manubrium sterni fractures are rare,and internal fixation methods are limited.This report explored a practical and feasible method of internal fixation for comminuted manubrium sterni fractures.C... BACKGROUND Comminuted manubrium sterni fractures are rare,and internal fixation methods are limited.This report explored a practical and feasible method of internal fixation for comminuted manubrium sterni fractures.CASE SUMMARY A 17-year-old female was injured in a car accident for which she underwent debridement and suturing of her head and anterior chest wounds in another hospital.Eight days later,the patient was transferred to our hospital for surgical treatment.The manubrium sterni was found intraoperatively to be split into three irregular fragments with obvious overlap and separation displacement.Meanwhile,a manubriosternal joint dislocation and left first rib cartilage fracture were observed.The retraction force of the shape-memory alloy staples was used to pull the fracture fragments together.Two more titanium locking plates were then used to fix the manubrium sterni and corpus sterni longitudinally,and the left first rib cartilage fracture was repositioned and fixed with a titanium locking plate.A postoperative computed tomography scan showed reduced and rigid fixation of the comminuted manubrium sterni fractures.The patient recovered well with no significant complaints of discomfort.The patient was discharged 10 days postoperatively after the stitches had been removed.CONCLUSION Shape-memory alloy staples had the advantage of being safe and effective during the repositioning and internal fixation of comminuted manubrium sterni fractures.Therefore,they provided a new surgical option for comminuted manubrium sterni fractures. 展开更多
关键词 Shape-memory alloy staples Fracture fixation Manubrium sterni Internal fixation Manubriosternal joint dislocation Case report
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The Advantages and Disadvantages of Skin Staple Suture Compared with Traditional Suture in Brain Surgery in Primary Hospital:A Randomized Controlled Study
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作者 Wanyin Ren Xiaofen Zhao +3 位作者 Xuming Yang Haoran Zhang Jian Xie Yao Qian 《Journal of Clinical and Nursing Research》 2023年第5期111-117,共7页
Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patie... Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group used disposable skin stapler to suture the scalp incision,and the control group used conventional silk suture to suture the incision.Statistical analysis was carried out on 6 indicators including suturing speed,healing under-scab,incision necrosis,incision cerebrospinal fluid(CSF)leakage,incision infection,and postoperative“centipede-shaped”scar incidence rate of the two suture methods.Results:There was no significant difference between the groups in terms of postoperative healing under-scab,incision necrosis,incision CSF leakage,and intracranial infection(P>0.05).The suturing speed in the observation group was 15.2±0.7 cm/min,which was significantly faster than 7.4±0.3 cm/min in the control group(P<0.05).The incidence of“centipede-shaped”scars in the observation group was significantly lower than that in the control group at 1 to 6 months after operation(P<0.05).Conclusion:Compared with traditional silk suture,skin staple suture has obvious advantages in suture speed and cosmetic effect. 展开更多
关键词 Brain surgery SUTURE Skin staples Postoperative complications
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Gastroenteroanastomosis Techniques for Laparoscopic Gastric Bypass: Linear vs Circular Stapler
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作者 Matheus Netto Augusto Tinoco +1 位作者 Igor Fonte Bôa Ivana Duval-Araújo 《Surgical Science》 2023年第7期474-485,共12页
Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective and well-accepted procedure for the treatment of morbid obesity but has complications such as stenosis of the gastroenteroanastomosis (GE), GE ... Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective and well-accepted procedure for the treatment of morbid obesity but has complications such as stenosis of the gastroenteroanastomosis (GE), GE leak, surgical site infection, and stapling malfunction. This study evaluated the efficiency of weight loss and the incidence of short- and mid-term postoperative complications in patients undergoing LRYGB in which anastomosis was performed using a linear stapler (LSA) or a circular stapler (CSA). Methods: Prospective observational study conducted between April 2016 and March 2019. The data were extracted from a hospital database that includes patients undergoing LRYGB in two different GE techniques, assessing postoperative complications and excess body weight loss. Results: Data from 457 patients were analyzed, of which 216 were in the LSA group and 241 were in the CSA group. There were four cases (1.7%) of GE stenosis in the CSA group and only one (0.5%) in the LSA group. Stapler malfunction occurred in both groups: CSA (0.4%) and LSA (0.5%), and a GE leak developed only in the CSA group (0.4%). Surgical site infection was found in five patients in the CSA group (2.1%) and two in the LSA group (0.9%). No statistical difference was found between the two groups in any of the variables analyzed (p > 0.05). Conclusions: Both stapling techniques resulted in a similar loss of excess body weight during the follow-up period. Although the LSA group had fewer total complications, these were not statistically significant, which substantiates the fact that both techniques are safe and feasible, provided they are performed by a surgeon with a long learning curve in laparoscopic bariatric surgery. 展开更多
关键词 Gastric Bypass ROUX-EN-Y OBESITY Bariatric Surgery Surgical Stapling Postoperative Complications
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Nutritional Value and Application of Broad Bean Nutrition Flour as a Combination of Staple Food 被引量:4
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作者 吴春芳 林晶晶 +2 位作者 卞晓春 陈惠 夏礼如 《Agricultural Science & Technology》 CAS 2015年第6期1280-1285,共6页
This paper introduced the definition and importance of combination of sta-ple food. With broad bean nutrition flour as a sample, the preparation of the combi-nation of staple food was also described. In addition, the ... This paper introduced the definition and importance of combination of sta-ple food. With broad bean nutrition flour as a sample, the preparation of the combi-nation of staple food was also described. In addition, the main nutritional value of broad bean nutrition flour was introduced. Compared with those of other single flours, the nutritional value of broad bean nutrition flour was improved. Moreover, the nutrients in the broad bean nutrition flour would not be destroyed during the processing and preparation of staple food, and the processed steamed bread and raw noodle are more characteristic. The application value and prospects of broad bean nutrition flour, as a combination of staple food, were further discussed. 展开更多
关键词 Broad bean nutrition flour Combination of staple food APPLICATION
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Staple半侧加压造成山羊胸椎不平衡发展的组织学观察
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作者 张巍 张永刚 +3 位作者 郑国权 张如意 赵斌 王岩 《解放军医学院学报》 CAS 2014年第1期89-91,共3页
目的通过对Staple固定、加压生长期山羊胸椎的组织学观察,探讨加压侧对脊柱生长发育的影响。方法 9只未成年雌性山羊随机分为实验组(n=6)和对照组(n=3);实验组采用单侧多节段(T6-T11)跨椎间隙Staple固定;对照组只作相同切口暴露,不进行... 目的通过对Staple固定、加压生长期山羊胸椎的组织学观察,探讨加压侧对脊柱生长发育的影响。方法 9只未成年雌性山羊随机分为实验组(n=6)和对照组(n=3);实验组采用单侧多节段(T6-T11)跨椎间隙Staple固定;对照组只作相同切口暴露,不进行固定。4个月后获取T8、T9间隙(对照组相应节段)椎间盘及生长板,采用HE、Giemsa染色,镜下观察生长板及椎间盘情况。结果对照组未出现脊柱侧凸畸形,两侧生长板高度以及生长板肥大层细胞和终板软骨细胞形态无明显差异。实验组出现轻度脊柱侧凸畸形,术后4个月Cobb角为17.9°±5.6°;椎间隙上方生长板高度:加压侧(1.27±0.34)mm低于非加压侧的(2.05±0.19)mm,椎间隙下方生长板高度加压侧(0.77±0.31)mm也低于非加压侧的(2.1±0.29)mm;加压侧生长板肥大层细胞数量少、形态异常、排列不规则,非加压侧生长板肥大层细胞排列整齐,细胞形态饱满,胞质丰富,细胞核完整,与对照组无差别;终板软骨细胞也呈同样变化,加压侧与非加压侧软骨细胞数量明显减少,排列不紧密,细胞体积小,胞质较少,胞核扁平。结论半侧固定、加压抑制了固定侧脊柱生长板及终板软骨细胞的发育,可造成脊柱两侧不平衡发展。 展开更多
关键词 staple 脊柱侧凸 生长板 组织学
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Analysis on the Production Advantages of USA Pima Extra Long Staple Cotton
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作者 田立文 徐志武 +7 位作者 郑子漂 宁新民 崔建平 朱斌 徐海江 郭仁松 林涛 刘志清 《Agricultural Science & Technology》 CAS 2017年第5期892-903,共12页
This paper defines the following advantages of ELS (Extra Long Staple) also known as Pima cotton planted in the United States: first, the only variety which is concentrated in the planting area with good soil moist... This paper defines the following advantages of ELS (Extra Long Staple) also known as Pima cotton planted in the United States: first, the only variety which is concentrated in the planting area with good soil moisture and fertilizer retention performances and abundant light and heat resources; second; advanced and practi- cal material equipment and technology; third; high yield and good quality, significant planting scale benefit; fourth, feasible and reliable modernized intensive farm man- agement mode with large-scale agricultural machinery operation; fifth, high-efficient social services and policy support system, as well as reasonable planting layout, good brand influence, synchronization of high yield and good quality with large-scale benefits. Although the production capability of Pima cotton in the United States is considered to be the largest and most powerful country in the world, compared with the ELS production in China, both have their own advantages and characteristics. Therefore, it is suggested that by using the ELS production experience ol the Unit- ed Stages for reference, China should make use of the modern breeding technJques to accelerate the modification of synthetic genetic features of ELS variety, try its best to breed the ELS variety which is suitable for mechanical plucking as soon as possible, actively develop new technology to simplify the whole cost saving cultiva- tion, reform ELS production organization, vigorously develop the social service sys- tem, and adjust and optimize the ELS industry support policies, so as to fundamen- tally improve the competitiveness of China's ELS in international market. 展开更多
关键词 ELS (Extra Long staple or Pima cotton Natural Ecology Planting lay-out and scale Fiber quality Material equipment
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基于背景直方图的Staple目标跟踪算法
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作者 孟令军 尚桠朝 《电子技术应用》 2021年第9期20-24,38,共6页
针对Staple算法在由于相机运动出现模糊情况下跟踪精度下降的问题,提出一种基于背景权重直方图的改进Staple目标跟踪算法。首先,针对传统颜色直方图忽略空间性的问题,提出对直方图引入位置权重;其次,利用背景区域颜色直方图抑制背景信... 针对Staple算法在由于相机运动出现模糊情况下跟踪精度下降的问题,提出一种基于背景权重直方图的改进Staple目标跟踪算法。首先,针对传统颜色直方图忽略空间性的问题,提出对直方图引入位置权重;其次,利用背景区域颜色直方图抑制背景信息对目标区域直方图的影响,提出引入背景权重直方图,并完成直方图分类器的构建。该算法在OTB2015测试集上与其他5个先进算法进行实验比较,结果表明在距离精度和成功率上总体效果相对Staple分别提升了3.7%和2%。 展开更多
关键词 背景权重直方图 目标跟踪 staple 运动模糊 相关滤波
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Comparison of a modified anoscope and the purse-string anoscope in stapled haemorrhoidopexy
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作者 Ali Dogan Bozdag Ismail Yaman +2 位作者 Hayrullah Derici Tugrul Tansug Vedat Deniz 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第44期5573-5578,共6页
AIM: To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS: The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 an... AIM: To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS: The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed. The purse-string suture anoscope in the PPH kit was used on 15 patients (Group 1), and the modified anoscope was used on 22 patients (Group 2). Demographic characteristics of the patients, operation time, surgeon's performance, analgesic requirement, and complications were compared. RESULTS: Operation time was significantly longer in Group 1 (42.0 4- 8.4 min vs 27.7 4- 8.0 min, P = 0.039). The surgeons reported their operative performance as significantly better in Group 2 (the results of the assessments were poor in ten, medium in four and good in one in Group 1, while good in all patients in Group 2, P 〈 0.001). The need for haemostatic sutures was significantly higher in Group 1 (six cases) and was needed in two cases in Group 2 (P = 0.034). CONCLUSION: Operation time decreased and the surgeon's satisfaction increased with use of the modified anoscope, and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler. 展开更多
关键词 Haemorrhoidal disease Modified anoscope Purse-string suture stapled haemorrhoidopexy stapled anopexy
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联姻OA365跨国巨头Staples进军中国
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作者 戈晶晶 詹义杰 《新经济导刊》 北大核心 2004年第21期12-15,共4页
位居世界500强的办公用品零售巨鳄,来自美国的Staples公司(NASDAQ代码:SPLS),在关注中国这个全球最具潜力的市场许久之后,终于来到了中国,这次与他们携手的是中国最大的网上办公用品销售企业--上海上信电子商务有限公司(OA365).
关键词 上海上信电子商务有限公司 美国staples公司 经营理念 办公用品超市 市场开拓 中国市场
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Progress of potato staple food research and industry development in China 被引量:49
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作者 ZHANG Hong XU Fen +2 位作者 WU Yu HU Hong-hai DAI Xiao-feng 《Journal of Integrative Agriculture》 SCIE CAS CSCD 2017年第12期2924-2932,共9页
Potato is the largest non-cereal food crop worldwide and ranked as the world's fourth most important food crop after rice, wheat, and maize. Potato is a vital food-security crop and substitute for cereal crop conside... Potato is the largest non-cereal food crop worldwide and ranked as the world's fourth most important food crop after rice, wheat, and maize. Potato is a vital food-security crop and substitute for cereal crop considering its high yield and great nutritive value. Therefore, by replacing wheat, rice or maize in traditional staple foods partly by potato, the nutritional value of traditional foods and the utilization of potato are expected to be improved. China is the largest potato producer worldwide in terms of either volume or area. However, majority of potatoes are consumed as fresh vegetables for cuisine, and the industrial processing rate is much lower than the global average. Thus, research and development for nutritional potato stable food suitable for the dietary habits of Chinese residents are of great significance. However, we still confronted plenty of constraints in the development of potato staple food. In order to develop potato staple food suitable for Chinese residents' dietary habit like noodles, Mantou(steamed bread), rice and rice noodles, also to industrialize production of potato staple foods, some transformations need to be realized. Independent innovation is the only choice to realize the potato staple food processing and industrial development strategy on the technical level. Thus a lot of researches have been done to promote the development of potato staple food in China. Up to now, we already developed a series kinds of potato staple foods and some of these staple foods have already been widely promoted in Chinese markets. 展开更多
关键词 POTATO staple food RESEARCH INDUSTRY China
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Hand-sewn vs linearly stapled esophagogastric anastomosis for esophageal cancer:A meta-analysis 被引量:14
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作者 Xu-Feng Deng Quan-Xing Liu +2 位作者 Dong Zhou Jia-Xin Min Ji-Gang Dai 《World Journal of Gastroenterology》 SCIE CAS 2015年第15期4757-4764,共8页
AIM: To compare the outcomes of hand-sewn(HS) and linearly stapled(LS) esophagogastric anastomosis for esophageal cancer.METHODS: Before beginning this study, a rigorous protocol was established according to the recom... AIM: To compare the outcomes of hand-sewn(HS) and linearly stapled(LS) esophagogastric anastomosis for esophageal cancer.METHODS: Before beginning this study, a rigorous protocol was established according to the recommendations of the Cochrane Collaboration. Databases and references were searched for all randomizedcontrolled trials and comparative clinical studies that compared LS with HS esophagogastric anastomosis for esophageal cancer. The primary outcomes compared were anastomotic leak and stricture. Subgroup analyses were performed according to site of anastomosis.RESULTS: Fifteen studies were used, comprising 3203 patients(n = 2027 LS and 1176 HS). Primary outcome analysis revealed a significant decrease in anastomotic leakage(RR = 0.51, 95%CI: 0.41-0.65; P < 0.00001) a s s o c i a t e d w i t h L S a n a s t o m o s i s. A s i g n i f i c a n t l y reduced rate of anastomotic stricture associated with LS was also found(RR = 0.56, 95%CI: 0.49-0.64; P < 0.00001). A subgroup analysis according to the site of anastomosis revealed a significantly reduced rate of anastomotic stricture(P < 0.00001). Although there was no significant difference in the decrease in thoracic anastomotic leakage, there was a significant decrease in cervical anastomotic leakage associated with LS(P < 0.00001).CONCLUSION: This meta-analysis indicates that the LS technique contributes to a reduced rate of leakage and stricture compared with the HS method. 展开更多
关键词 Anastomotic leakage Anastomotic stricture Hand-sewn ANASTOMOSIS LINEARLY stapled ANASTOMOSIS META-ANALYSIS
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Stapled transanal rectal resection for obstructed defecation syndrome associated with rectocele and rectal intussusception 被引量:23
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作者 Zhang, Bin Ding, Jian-Hua +2 位作者 Yin, Shu-Hui Zhang, Meng Zhao, Ke 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第20期2542-2548,共7页
AIM:To evaluate the safety and efficacy of stapled transanal rectal resection(STARR),and to analyze the outcome of the patients 12-mo after the operation.METHODS:From May 2007 to October 2008,50 female patients with r... AIM:To evaluate the safety and efficacy of stapled transanal rectal resection(STARR),and to analyze the outcome of the patients 12-mo after the operation.METHODS:From May 2007 to October 2008,50 female patients with rectocele and/or rectal intussusception underwent STARR.The preoperative status,perioperative and postoperative complications at baseline,3,6 and 12-mo were assessed.Data were collected prospectively from standardized questionnaires for the assessment of constipation[constipation scoring system,Longo’s obstructed defecation syndrome(ODS)score system,symptom severity score],patient satisfaction (visual analogue scale),and quality of life(Patient Assessment of Constipation-Quality of Life Questionnaire).RESULTS:At a 12-mo follow-up,significant improvement in the constipation scoring system,ODS score system,symptom severity score,visual analog scale and quality of life(P<0.0001)was observed.The symptoms of constipation improved in 90%of patients at 12 mo after surgery.The self-reported definitive outcome was excellent in 15(30%)patients,fairly good in 8(16%),good in 22(44%),and poor in 5(10%).CONCLUSION:STARR can be performed safely without major morbidity.Moreover,the procedure seems to be effective for patients with obstructed defecation associated with symptomatic rectocele and rectal intussusception. 展开更多
关键词 stapled transanal rectal resection Obstructed defecation syndrome RECTOCELE Rectal intussusception
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Meta-analysis of stapled hemorrhoidopexy vs LigaSure hemorrhoidectomy 被引量:12
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作者 Jun Yang Pei-Jing Cui +1 位作者 Hua-Zhong Han Da-Nian Tong 《World Journal of Gastroenterology》 SCIE CAS 2013年第29期4799-4807,共9页
AIM: To compare outcome of stapled hemorrhoidopexy (SH) vs LigaSure hemorrhoidectomy (LH) by a meta-analysis of available randomized controlled trials (RCTs). METHODS: Databases, including PubMed, EMBASE, the Cochrane... AIM: To compare outcome of stapled hemorrhoidopexy (SH) vs LigaSure hemorrhoidectomy (LH) by a meta-analysis of available randomized controlled trials (RCTs). METHODS: Databases, including PubMed, EMBASE, the Cochrane Library, and the Science Citation Index updated to December 2012, were searched. The main outcomes measured were operating time, early postoperative pain, postoperative urinary retention and bleeding, wound problems, gas or fecal incontinence, anal stenosis, length of hospital stay, residual skin tags, prolapse, and recurrence. The meta-analysis was performed using the free software Review Manager. Differences observed between the two groups were expressed as the odds ratio (OR) with 95%CI. A fixedeffects model was used to pool data when statistical heterogeneity was not present. If statistical heterogeneity was present (P < 0.05), a random-effects model was used. RESULTS: The initial search identified 10 publica-tions. After screening, five RCTs published as full articles were included in this meta-analysis. Among the five studies, all described a comparison of the patient baseline characteristics and showed that there was no statistically significant difference between the two groups. Although most of the analyzed outcomes were similar between the two operative techniques, the operating time for SH was significantly longer than for LH (P < 0.00001; OR= -6.39, 95%CI: -7.68 -5.10). The incidence of residual skin tags and prolapse was significantly lower in the LH group than in the SH group [2/111 (1.8%) vs 16/105 (15.2%); P = 0.0004; OR= 0.17, 95%CI: 0.06-0.45). The incidence of recurrence after the procedures was significantly lower in the LH group than in the SH group [2/173 (1.2%) vs 13/174 (7.5%); P = 0.003; OR= 0.21, 95%CI: 0.07-0.59]. CONCLUSION: Both SH and LH are probably equally valuable techniques in modern hemorrhoid surgery. However, LigaSure might have slightly favorable immediate postoperative results and technical advantages. 展开更多
关键词 stapled HEMORRHOIDOPEXY LIGASURE HEMORRHOIDECTOMY HEMORRHOIDS META-ANALYSIS
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Midterm outcome of stapled transanal rectal resection for obstructed defecation syndrome:A single-institution experience in China 被引量:6
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作者 Bin Zhang Jian-Hua Ding +4 位作者 Yu-Juan Zhao Meng Zhang Shu-Hui Yin Ying-Ying Feng Ke Zhao 《World Journal of Gastroenterology》 SCIE CAS 2013年第38期6472-6478,共7页
AIM:To assess midterm results of stapled transanal rectal resection(STARR)for obstructed defecation syndrome(ODS)and predictive factors for outcome.METHODS:From May 2007 to May 2009,75 female patients underwent STARR ... AIM:To assess midterm results of stapled transanal rectal resection(STARR)for obstructed defecation syndrome(ODS)and predictive factors for outcome.METHODS:From May 2007 to May 2009,75 female patients underwent STARR and were included in the present study.Preoperative and postoperative workup consisted of standardized interview and physical examination including proctoscopy,colonoscopy,anorectal manometry,and defecography.Clinical and functional results were assessed by standardized questionnaires for the assessment of constipation constipation scoring system(CSS),Longo’s ODS score,and symptom severity score(SSS),incontinence Wexner incontinence score(WS),quality of life Patient Assessment of Constipation-Quality of Life Questionnaire(PAC-QOL),and patient satisfaction visual analog scale(VAS).Data were collected prospectively at baseline,12 and 30 mo.RESULTS:The median follow-up was 30 mo(range,30-46 mo).Late postoperative complications occurred in 11(14.7%)patients.Three of these patients required procedure-related reintervention(one diverticulectomy and two excision of staple granuloma).Although the recurrence rate was 10.7%,constipation scores(CSS,ODS score and SSS)significantly improved after STARR(P<0.0001).Significant reduction in ODS symptoms was matched by an improvement in the PAC-QOL and VAS(P<0.0001),and the satisfaction index was excellent in 25(33.3%)patients,good in 23(30.7%),fairly good in 14(18.7%),and poor in 13(17.3%).Nevertheless,the WS increased after STARR(P=0.0169).Incontinence was present or deteriorated in 8(10.7%)patients;6(8%)of whom were new onsets.Univariate analysis revealed that the occurrence of fecal incontinence(preoperative,postoperative or new-onset incontinence;P=0.028,0.000,and 0.007,respectively)was associated with the success of the operation.CONCLUSION:STARR is an acceptable procedure for the surgical correction of ODS.However,its impact on symptomatic recurrence and postoperative incontinence may be problematic. 展开更多
关键词 Colorectal surgery CONSTIPATION stapled TRANSANAL RECTAL RESECTION
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Stapled gastro/duodenojejunostomy shortens reconstruction time during pylorus-preserving pancreaticoduodenectomy 被引量:6
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作者 Norihiro Sato Kei Yabuki +5 位作者 Shiro Kohi Yasuhisa Mori Noritaka Minagawa Toshihisa Tamura Aiichiro Higure Koji Yamaguchi 《World Journal of Gastroenterology》 SCIE CAS 2013年第48期9399-9404,共6页
AIM:To investigate whether a stapled technique is superior to the conventional hand-sewn technique for gastro/duodenojejunostomy during pylorus-preserving pancreaticoduodenectomy(PpPD).METHODS:In October 2010,we intro... AIM:To investigate whether a stapled technique is superior to the conventional hand-sewn technique for gastro/duodenojejunostomy during pylorus-preserving pancreaticoduodenectomy(PpPD).METHODS:In October 2010,we introduced a mechanical anastomotic technique of gastro-or duodenojejunostomy using staplers during PpPD.We compared clinical outcomes between 19 patients who underwent PpPD with a stapled gastro/duodenojejunostomy(stapled anastomosis group)and 19 patients who underwent PpPD with a conventional hand-sewn duodenojejunostomy(hand-sewn anastomosis group).RESULTS:The time required for reconstruction was significantly shorter in the stapled anastomosis group than in the hand-sewn anastomosis group(186.0±29.4 min vs 219.7±50.0 min,P=0.02).In addition,intraoperative blood loss was significantly less(391.0±212.0 mL vs 647.1±482.1 mL,P=0.03)and the time to oral intake was significantly shorter(5.4±1.7d vs 11.3±7.9 d,P=0.002)in the stapled anastomosis group than in the hand-sewn anastomosis group.There were no differences in the incidences of delayed gastric emptying and other postoperative complications between the groups.CONCLUSION:These results suggest that stapled gastro/duodenojejunostomy shortens reconstruction time during PpPD without affecting the incidence of delayed gastric emptying. 展开更多
关键词 Pylorus-preserving PANCREATICODUODENECTOMY stapled ANASTOMOSIS GASTROJEJUNOSTOMY DUODENOJEJUNOSTOMY Delayed gastric EMPTYING
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Khubchandani's procedure combined with stapled posterior rectal wall resection for rectocele 被引量:5
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作者 Yi Shao Yong-Xing Fu +3 位作者 Qing-Fa Wang Zhi-Qiang Cheng Guang-Yong Zhang San-Yuan Hu 《World Journal of Gastroenterology》 SCIE CAS 2019年第11期1421-1431,共11页
BACKGROUND Obstructed defecation syndrome(ODS) is a widespread disease in the world.Rectocele is the most common cause of ODS in females. Multiple procedures have been performed to treat rectocele and no procedure has... BACKGROUND Obstructed defecation syndrome(ODS) is a widespread disease in the world.Rectocele is the most common cause of ODS in females. Multiple procedures have been performed to treat rectocele and no procedure has been accepted as the gold-standard procedure. Stapled transanal rectal resection(STARR) has been widely used. However, there are still some disadvantages in this procedure and its effectiveness in anterior wall repair is doubtful. Therefore, new procedures are expected to further improve the treatment of rectocele.AIM To evaluate the efficacy and safety of a novel rectocele repair combining Khubchandani's procedure with stapled posterior rectal wall resection.METHODS A cohort of 93 patients were recruited in our randomized clinical trial and were divided into two different groups in a randomized manner. Forty-two patients(group A) underwent Khubchandani's procedure with stapled posterior rectal wall resection and 51 patients(group B) underwent the STARR procedure.Follow-up was performed at 1, 3, 6, and 12 mo after the operation. Preoperative and postoperative ODS scores and depth of rectocele, postoperative complications, blood loss, and hospital stay of each patient were documented. All data were analyzed statistically to evaluate the efficiency and safety of our procedure.RESULTS In group A, 42 patients underwent Khubchandani's procedure with stapled posterior rectal wall resection and 34 were followed until the final analysis. In group B, 51 patients underwent the STARR procedure and 37 were followed until the final analysis. Mean operative duration was 41.47 ± 6.43 min(group A) vs39.24 ± 6.53 min(group B). Mean hospital stay was 3.15 ± 0.70 d(group A) vs 3.14± 0.54 d(group B). Mean blood loss was 10.91 ± 2.52 mL(group A) vs 10.14 ± 1.86 m L(group B). Mean ODS score in group A declined from 16.50 ± 2.06 before operation to 5.06 ± 1.07 one year after the operation, whereas in group B it was17.11 ± 2.57 before operation and 6.03 ± 2.63 one year after the operation. Mean depth of rectocele decreased from 4.32 ± 0.96 cm(group A) vs 4.18 ± 0.95 cm(group B) preoperatively to 1.19 ± 0.43 cm(group A) vs 1.54 ± 0.82 cm(group B)one year after operation. No other serious complications, such as rectovaginal fistula, perianal sepsis, or deaths, were recorded. After 12 mo of follow-up, 30 patients'(30/34, 88.2%) final outcomes were judged as effective and 4(4/34,11.8%) as moderate in group A, whereas in group B, 30(30/37, 81.1%) patients' outcomes were judged as effective, 5(5/37, 13.5%) as moderate, and 2(2/37,5.4%) as poor.CONCLUSION Khubchandani's procedure combined with stapled posterior rectal wall resection is an effective, feasible, and safe procedure with minor trauma to rectocele. 展开更多
关键词 RECTOCELE RECTAL prolapse Obstructed defecation syndrome Khubchandani’s PROCEDURE stapled POSTERIOR RECTAL WALL RESECTION stapled transanal RECTAL RESECTION
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