目的分析腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)分别联合腹腔镜经胆囊管胆总管探查术(laparoscopic transcystic common bile duct exploration,LTCBDE)与内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatog...目的分析腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)分别联合腹腔镜经胆囊管胆总管探查术(laparoscopic transcystic common bile duct exploration,LTCBDE)与内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)治疗胆囊结石合并胆总管结石的临床疗效。方法回顾性分析2016年7月至2021年7月上海市徐汇区中心医院收治的胆总管结石合并胆囊结石病人的临床治疗,采用倾向性评分匹配法将符合入组标准的LTCBDE+LC组病人与同期行ERCP+LC组病人进行匹配,每组纳入30例,比较两组间围手术期并发症、手术时间、检验指标及随访结石复发情况。结果两组病人均无围手术期死亡;同期ERCP+LC组发生1例术后高淀粉酶血症,经保守治疗后好转,术后并发症差异无统计学意义(P>0.05);LTCBDE+LC组与ERCP+LC组比较,所用手术时间[(95.40±21.40)min比(94.01±20.37)min]差异无统计学意义(P>0.05);术后第1天总胆红素[(29.20±4.15)μmol/L比(30.25±3.91)μmol/L]、直接胆红素[(10.55±3.56)μmol/L比(11.40±4.41)μmol/L]、丙氨酸转氨酶[(27.95±5.92)U/L比(28.55±5.71)U/L]差异均无统计学意义(均P>0.05);术后3个月复查磁共振胰胆管造影、超声检查均无结石复发、残留及胆管狭窄。结论LTCBDE+LC与ERCP+LC治疗胆囊结石合并胆总管结石均安全可靠;术前严格选择适应证,LTCBDE+LC在治疗方面是更值得推广的比较好的方法。展开更多
Transcutaneous electrical nerve stimulation(TENS) has been widely used for sensory feedback which is a key consideration of improving the performance of prosthetic hands. Two-electrode discriminability is the key to r...Transcutaneous electrical nerve stimulation(TENS) has been widely used for sensory feedback which is a key consideration of improving the performance of prosthetic hands. Two-electrode discriminability is the key to realize high-spatial-resolution TENS, but the neural firing mechanism is not clear yet. The goal of this research is to investigate the neural firing patterns under two-electrode stimulation and to reveal the potential mechanisms. A three-dimensional(3 D) model is established by incorporating Aβ fiber neuron clusters into a layered forearm structure. The diameters of the stimulating electrodes are selected as 5, 7, 9 and 12 mm, and the two-electrode discrimination distance(TEDD) is quantified. It is found that a distant TEDD is obtained for a relatively large electrode size, and 7 mm is suggested to be the optimal diameter of stimulating electrodes. The present study reveals the neural firing patterns under two-electrode stimulation by the 3 D TENS model. In order to discriminate individual electrodes under simultaneous stimulation, no crosstalk of activated Aβ fibers exists between two electrodes. This research can further guide the optimization of the electrode-array floorplan.展开更多
文摘目的分析腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)分别联合腹腔镜经胆囊管胆总管探查术(laparoscopic transcystic common bile duct exploration,LTCBDE)与内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)治疗胆囊结石合并胆总管结石的临床疗效。方法回顾性分析2016年7月至2021年7月上海市徐汇区中心医院收治的胆总管结石合并胆囊结石病人的临床治疗,采用倾向性评分匹配法将符合入组标准的LTCBDE+LC组病人与同期行ERCP+LC组病人进行匹配,每组纳入30例,比较两组间围手术期并发症、手术时间、检验指标及随访结石复发情况。结果两组病人均无围手术期死亡;同期ERCP+LC组发生1例术后高淀粉酶血症,经保守治疗后好转,术后并发症差异无统计学意义(P>0.05);LTCBDE+LC组与ERCP+LC组比较,所用手术时间[(95.40±21.40)min比(94.01±20.37)min]差异无统计学意义(P>0.05);术后第1天总胆红素[(29.20±4.15)μmol/L比(30.25±3.91)μmol/L]、直接胆红素[(10.55±3.56)μmol/L比(11.40±4.41)μmol/L]、丙氨酸转氨酶[(27.95±5.92)U/L比(28.55±5.71)U/L]差异均无统计学意义(均P>0.05);术后3个月复查磁共振胰胆管造影、超声检查均无结石复发、残留及胆管狭窄。结论LTCBDE+LC与ERCP+LC治疗胆囊结石合并胆总管结石均安全可靠;术前严格选择适应证,LTCBDE+LC在治疗方面是更值得推广的比较好的方法。
基金the National Natural Science Foundation of China(No.81671801)the Innovation Studio Fund from School of Biomedical Engineering at Shanghai Jiao Tong Universitythe Medical-Engineering Cross Project of Shanghai Jiao Tong University(No.YG2017MS53)
文摘Transcutaneous electrical nerve stimulation(TENS) has been widely used for sensory feedback which is a key consideration of improving the performance of prosthetic hands. Two-electrode discriminability is the key to realize high-spatial-resolution TENS, but the neural firing mechanism is not clear yet. The goal of this research is to investigate the neural firing patterns under two-electrode stimulation and to reveal the potential mechanisms. A three-dimensional(3 D) model is established by incorporating Aβ fiber neuron clusters into a layered forearm structure. The diameters of the stimulating electrodes are selected as 5, 7, 9 and 12 mm, and the two-electrode discrimination distance(TEDD) is quantified. It is found that a distant TEDD is obtained for a relatively large electrode size, and 7 mm is suggested to be the optimal diameter of stimulating electrodes. The present study reveals the neural firing patterns under two-electrode stimulation by the 3 D TENS model. In order to discriminate individual electrodes under simultaneous stimulation, no crosstalk of activated Aβ fibers exists between two electrodes. This research can further guide the optimization of the electrode-array floorplan.
