Research on the prognostic value of adjusting intraperitoneal threedimensional quality evaluation mode in laparoscopic cholecystectomy patients

BACKGROUND Benign gallbladder diseases have become a high-prevalence condition not only in China but also worldwide.The main types of benign gallbladder diseases include gallbladder polyps,acute and chronic cholecystitis,and gallstones,with gallstones being the most common,accounting for over 70%of cases.Although the mortality rate of benign gallbladder diseases is low,they carry obvious potential risks.Studies have shown that an increased incidence of benign gallbladder diseases can increase the risk of cardiovascular diseases and gallbladder cancer,resulting in a substantial disease burden on patients and their families.AIM To assess the medical utility of the Configuration-Procedure-Consequence(CPC)three-dimensional quality evaluation model in modulating the prognosis of laparoscopic cholecystectomy patients.METHODS A total of 98 patients who underwent laparoscopic cholecystectomy in our hospital from February 2020 to January 2022 were selected as the subjects.According to the random number table method,they were divided into a study group and a control group,with 49 patients in each group.The control group received routine perioperative care,while the study group had the addition of the CPC three-dimensional quality evaluation.The postoperative recovery-related indicators(time to first flatus,time to oral intake,time to ambulation,hospital stay),stress indicators(cortisol and adrenaline levels),distinctions in anxiety and RESULTS The time to first flatus,time to oral intake,time to ambulation,and hospital stay of the study group patients were obviously lower than those of the control group patients,with statistical significance(P<0.05).On the 1st day after admission,there were no obvious distinctions in cortisol and adrenaline levels in blood samples,as well as in the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores between the study group and the control group(P>0.05).However,on the 3rd day after surgery,the cortisol and adrenaline levels,as well as SAS and SDS scores of the study group patients,were obviously lower than those of the control group patients(P<0.05).The study group had 2 cases of incisional infection and 1 case of pulmonary infection,with a total incidence of complications of 6.12%(3/49),which was obviously lower than the 20.41%(10/49)in the control group(P<0.05).CONCLUSION Implementing the CPC three-dimensional quality evaluation model for patients undergoing laparoscopic cholecystectomy can help accelerate their perioperative recovery process,alleviate perioperative stress symptoms,mitigate anxiety,depression,and other adverse emotions,and to some extent,reduce the incidence of perioperative complications.

Experimental study on the type change of liquid flow in broken coal samples

A test system of the permeability of broken coal samples mainly consists of a CMT5305 electronic universal test machine, crushed rock compaction containing cylinder and a self-designed seepage circuit, which is composed of a gear pump, a reversing valve, a relief valve and other components. By using the steady penetration method, the permeability and non-Darcy flow β factor of broken coal samples under five different porosity levels were measured, the grain diameters of the coal samples were selected as 2.5-5 mm, 5-10 mm, 10-15 mm, 15-20 mm, 20-25 mm and 2.5-25 ram, respectively. After measuring the permeability under each porosity, the overfall pressure of the relief valve continuously increased until the coal sample was broken down. In this way, the flow type of liquid inside the broken coal samples changed from seepage to pipe flow. The correlation between breakdown pressure gradient （BPG） and porosity was analyzed, and the BPG was compared with the pressure gradient when seepage instability occurred. The results show that, ①the non-Darcy flow β factor was negative before broken coal samples with six kinds of diameters were broken down; ②the BPG of coal samples with a grain size of 2.5-25 mm was lower than that of the others; ③ the BPG of coal samples with a single diameter under the same porosity increased as the grain size increased; ④ the BPG could be fitted by an exponential function with porosity, and the exponent decreased as the grain size increased for coal samples with a single diameter; ⑤ the BPG was slightly less than the seepage instability pressure gradient. The change in liquid flow type from seepage to pipe flow could be regarded as the performance of the seepage instability.