肝尾状叶的复杂解剖结构以及其独特的生理机制使得手术的难度和危险性大大提高。近年来,随着肝脏解剖学以及外科手术技术和微创技术的发展,已经成功地完成了各种肝尾状叶肿瘤的手术,并将加速康复外科(enhanced recovery after surgery,E...肝尾状叶的复杂解剖结构以及其独特的生理机制使得手术的难度和危险性大大提高。近年来,随着肝脏解剖学以及外科手术技术和微创技术的发展,已经成功地完成了各种肝尾状叶肿瘤的手术,并将加速康复外科(enhanced recovery after surgery,ERAS)和肝脏保护作为目标,以达到最优的治疗效果。该文将结合最近的研究文献对肝尾状叶的最新解剖知识及手术技术进展要点进行介绍。展开更多
目的介绍并探讨专利超微创一体化器械辅助两孔腹腔镜胆囊切除术(LC)的临床应用价值。方法回顾性分析2023年3月至9月上海市浦东新区人民医院施行手术的100例胆囊疾病患者的临床资料,其中一体化器械辅助两孔组采用超微创一体化器械辅助两...目的介绍并探讨专利超微创一体化器械辅助两孔腹腔镜胆囊切除术(LC)的临床应用价值。方法回顾性分析2023年3月至9月上海市浦东新区人民医院施行手术的100例胆囊疾病患者的临床资料,其中一体化器械辅助两孔组采用超微创一体化器械辅助两孔LC(n=50),传统三孔组采用传统三孔LC(n=50),比较两组手术时间、术中出血量、术后6 h和24 h疼痛评分、术后镇痛药的使用、住院时间、住院费用、手术并发症率以及患者对手术切口的满意程度等多个方面。结果两组患者均手术成功,与传统三孔组比较,一体化器械辅助两孔组手术时间缩短[(37.56±3.89)min vs(42.74±6.45)min,P<0.001],术后6 h VAS疼痛评分[(2.96±0.73)vs(3.37±0.81),P<0.05]及术后镇痛药的使用[5(10%)vs 13(26%),P<0.05]均降低,两组在术中出血量、术后24 h VAS疼痛指数、住院费用、术后引流量以及住院时间等各项指标上,差异无统计学意义(P>0.05),而术后患者对切口的满意度[(97.52±1.72)vs(95.30±1.93),P<0.001]明显升高。随访2~3个月,未发现任何胆汁渗漏、出血、腹水积聚或伤口感染等并发症。结论专利超微创一体化器械辅助两孔LC术具有切口小、损伤低、术后恢复快和疼痛轻等优势,与单通道腹腔镜胆囊切除术和2.4 mm的Minilap器械相比在成本上更具优势,并且有更好的安全性和操控性。展开更多
The Laizhou Bay(LB)represents a substantial ecological area that is vulnerable to human activities and confronts diverse environmental challenges.This study provides a comprehensive characterization of nutrients,petro...The Laizhou Bay(LB)represents a substantial ecological area that is vulnerable to human activities and confronts diverse environmental challenges.This study provides a comprehensive characterization of nutrients,petroleum,heavy metals,and phytoplankton community structure across seven distinct areas in LB.The results indicate relatively high concentrations of NO_(2)-N,SiO_(4)-Si,and NO_(3)-N in the Southwest Laizhou Bay(SWLB)and Huanghe River Estuary(HRE).In contrast,the East Laizhou bay(ELB)and the North of Huanghe River Estuary(NHRE)exhibit the highest concentrations of heavy metals(As,Cr and Hg).The areas with high phytoplankton density and community diversity are mainly located in the SWLB.After adjusting for basic environmental factors,phytoplankton density and Margalef richness index D are significantly associated with nutrients(NO_(3)-N,NO_(2)-N,NH_(4)-N,SiO_(4)-Si),and heavy metal(Cr)concentrations.We highlight that,in addition to Xiaoqinghe River,nutrients brought by the Mihe River in the SWLB and heavy metal(Cr)pollution in the ELB resulting from industrial and mining activities along the coast significantly influence phytoplankton growth and community structure.Therefore,it is recommended that more monitoring and management efforts be focused on these regions in the future.展开更多
为解决RFID领域中多标签识别存在的信息泄露和信息碰撞问题,提出了一种基于预约机制的防碰撞安全认证协议(reservation mechanism for authentication protocol,RMAP)。RMAP可有效抵御窃听、重放、欺骗等攻击,且采用精简杂凑运算次数的...为解决RFID领域中多标签识别存在的信息泄露和信息碰撞问题,提出了一种基于预约机制的防碰撞安全认证协议(reservation mechanism for authentication protocol,RMAP)。RMAP可有效抵御窃听、重放、欺骗等攻击,且采用精简杂凑运算次数的方法,有效地简化了计算量。同时,采用载波监听多点接入技术,通过重传随机数进行帧序号的二次预约和重排,实现标签的无碰撞有序通信和识别效率的最优,解决了现有协议为避免信息碰撞而对标签进行循环性识别导致的识别效率低、读取时间长的问题。对RMAP识别效率的数值分析表明,当待识别标签数量少于1024时,RMAP的最低识别效率为95.15%,高于常用防碰撞协议。展开更多
文摘肝尾状叶的复杂解剖结构以及其独特的生理机制使得手术的难度和危险性大大提高。近年来,随着肝脏解剖学以及外科手术技术和微创技术的发展,已经成功地完成了各种肝尾状叶肿瘤的手术,并将加速康复外科(enhanced recovery after surgery,ERAS)和肝脏保护作为目标,以达到最优的治疗效果。该文将结合最近的研究文献对肝尾状叶的最新解剖知识及手术技术进展要点进行介绍。
文摘目的介绍并探讨专利超微创一体化器械辅助两孔腹腔镜胆囊切除术(LC)的临床应用价值。方法回顾性分析2023年3月至9月上海市浦东新区人民医院施行手术的100例胆囊疾病患者的临床资料,其中一体化器械辅助两孔组采用超微创一体化器械辅助两孔LC(n=50),传统三孔组采用传统三孔LC(n=50),比较两组手术时间、术中出血量、术后6 h和24 h疼痛评分、术后镇痛药的使用、住院时间、住院费用、手术并发症率以及患者对手术切口的满意程度等多个方面。结果两组患者均手术成功,与传统三孔组比较,一体化器械辅助两孔组手术时间缩短[(37.56±3.89)min vs(42.74±6.45)min,P<0.001],术后6 h VAS疼痛评分[(2.96±0.73)vs(3.37±0.81),P<0.05]及术后镇痛药的使用[5(10%)vs 13(26%),P<0.05]均降低,两组在术中出血量、术后24 h VAS疼痛指数、住院费用、术后引流量以及住院时间等各项指标上,差异无统计学意义(P>0.05),而术后患者对切口的满意度[(97.52±1.72)vs(95.30±1.93),P<0.001]明显升高。随访2~3个月,未发现任何胆汁渗漏、出血、腹水积聚或伤口感染等并发症。结论专利超微创一体化器械辅助两孔LC术具有切口小、损伤低、术后恢复快和疼痛轻等优势,与单通道腹腔镜胆囊切除术和2.4 mm的Minilap器械相比在成本上更具优势,并且有更好的安全性和操控性。
基金the National Natural Science Foundation of China(Nos.42176234 and 42130403)the Chinese Arctic and Antarctic Creative Program(No.JDXT2018-01)the Key Special Project for Introduced Talents Team of Southern Marine Science and Engineering Guangdong Laboratory(Guangzhou)(No.GML2019ZD0402).
文摘The Laizhou Bay(LB)represents a substantial ecological area that is vulnerable to human activities and confronts diverse environmental challenges.This study provides a comprehensive characterization of nutrients,petroleum,heavy metals,and phytoplankton community structure across seven distinct areas in LB.The results indicate relatively high concentrations of NO_(2)-N,SiO_(4)-Si,and NO_(3)-N in the Southwest Laizhou Bay(SWLB)and Huanghe River Estuary(HRE).In contrast,the East Laizhou bay(ELB)and the North of Huanghe River Estuary(NHRE)exhibit the highest concentrations of heavy metals(As,Cr and Hg).The areas with high phytoplankton density and community diversity are mainly located in the SWLB.After adjusting for basic environmental factors,phytoplankton density and Margalef richness index D are significantly associated with nutrients(NO_(3)-N,NO_(2)-N,NH_(4)-N,SiO_(4)-Si),and heavy metal(Cr)concentrations.We highlight that,in addition to Xiaoqinghe River,nutrients brought by the Mihe River in the SWLB and heavy metal(Cr)pollution in the ELB resulting from industrial and mining activities along the coast significantly influence phytoplankton growth and community structure.Therefore,it is recommended that more monitoring and management efforts be focused on these regions in the future.
文摘为解决RFID领域中多标签识别存在的信息泄露和信息碰撞问题,提出了一种基于预约机制的防碰撞安全认证协议(reservation mechanism for authentication protocol,RMAP)。RMAP可有效抵御窃听、重放、欺骗等攻击,且采用精简杂凑运算次数的方法,有效地简化了计算量。同时,采用载波监听多点接入技术,通过重传随机数进行帧序号的二次预约和重排,实现标签的无碰撞有序通信和识别效率的最优,解决了现有协议为避免信息碰撞而对标签进行循环性识别导致的识别效率低、读取时间长的问题。对RMAP识别效率的数值分析表明,当待识别标签数量少于1024时,RMAP的最低识别效率为95.15%,高于常用防碰撞协议。