BACKGROUND Gastric cancer(GC)is a prevalent malignant tumor worldwide and ranks as the fourth leading cause of cancer-related mortality.Upper gastrointestinal bleeding(UGIB)is a frequent complication of GC.Radical gas...BACKGROUND Gastric cancer(GC)is a prevalent malignant tumor worldwide and ranks as the fourth leading cause of cancer-related mortality.Upper gastrointestinal bleeding(UGIB)is a frequent complication of GC.Radical gastrectomy and palliative therapy are widely used surgical procedures in the clinical management of GC.This study intends to probe the clinical efficacy and safety of radical gastrectomy and palliative therapy on the basis of exploratory laparotomy in patients with GC combined with UGIB,hoping to provide valuable information to aid patients in selecting the appropriate surgical intervention.AIM To investigate the clinical efficacy and safety of exploratory laparotomy^(+)radical gastrectomy and palliative therapy in patients with GC and UGIB combined.METHODS A total of 89 GC patients admitted to the First Affiliated Hospital of the University of South China between July 2018 and July 2020 were selected as participants for this study.The 89 patients were divided into two groups:radical resection group(n=46)treated with exploratory laparotomy^(+)radical gastrectomy and Palliative group(n=43)treated with palliative therapy.The study compared several variables between the two groups,including surgical duration,intraoperative blood transfusion volume,postoperative anal exhaust time,off-bed activity time,length of hospitalization,and incidence of complications such as duodenal stump rupture,anastomotic obstruction,and postoperative incision.Additionally,postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),and CD3^(+)/HLADR^(+)),immunoglobulin(IgG and IgM),tumor markers(CEA,CA199,and CA125),and inflammatory factors(IL-6,IL-17,and TNF-α)were assessed.The surgical efficacy and postoperative quality of life recovery were also evaluated.The patients were monitored for survival and tumor recurrence at 6 mo,1 year,and 2 years post-surgery.RESULTS The results indicated that the duration of operation time and postoperative hospitalization did not differ between the two surgical procedures.However,patients in the radical resection group exhibited shorter intraoperative blood loss,anus exhaust time,off-bed activity time,and inpatient activity time than those in the Palliative group.Although there was no substantial difference in the occurrence of postoperative complications,such as duodenal stump rupture and anastomotic obstruction,between the radical resection group and Palliative group(P>0.05),the radical resection group exhibited higher postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),etc.)and immunoglobulin levels(IgG,IgM)than the Palliative group,while tumor markers and inflammatory factors levels were lower than those in the radical resection group.Additionally,surgical efficacy,postoperative quality of life,and postoperative survival rates were higher in patients who underwent radical gastrectomy than in those who underwent palliative therapy.Moreover,the probability of postoperative tumor recurrence was lower in the radical gastrectomy group compared to the palliative therapy group,and these differences were all statistically significant(P<0.05).CONCLUSION Compared to palliative therapy,exploratory laparotomy^(+)radical gastrectomy can improve immune function,reduce the levels of tumor markers and inflammatory factors,improve surgical efficacy,promote postoperative quality of life recovery,enhance survival rates,and attenuate the probability of tumor recurrence.展开更多
Some attributes are uncertain for evaluation work because of incomplete or limited information and knowledge.It leads to uncertainty in evaluation results.To that end,an evaluation method,uncertainty entropy-based exp...Some attributes are uncertain for evaluation work because of incomplete or limited information and knowledge.It leads to uncertainty in evaluation results.To that end,an evaluation method,uncertainty entropy-based exploratory evaluation(UEEE),is proposed to guide the evaluation activities,which can iteratively and gradually reduce uncertainty in evaluation results.Uncertainty entropy(UE)is proposed to measure the extent of uncertainty.First,the belief degree distributions are assumed to characterize the uncertainty in attributes.Then the belief degree distribution of the evaluation result can be calculated by using uncertainty theory.The obtained result is then checked based on UE to see if it could meet the requirements of decision-making.If its uncertainty level is high,more information needs to be introduced to reduce uncertainty.An algorithm based on the UE is proposed to find which attribute can mostly affect the uncertainty in results.Thus,efforts can be invested in key attribute(s),and the evaluation results can be updated accordingly.This update should be repeated until the evaluation result meets the requirements.Finally,as a case study,the effectiveness of ballistic missiles with uncertain attributes is evaluated by UEEE.The evaluation results show that the target is believed to be destroyed.展开更多
Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical s...Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection(SSI).Although several effor ts are being under taken to determine the proper means to reduce such complications,there is still a high incidence of SSI worldwide.Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site.This study tested the effectiveness of an operating room(OR)bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.Methods:A quasi-experimental pretest and posttest design was utilized to determine its effectiveness.The study was composed of 60 par ticipants divided into two groups:30 subjects were selected to receive the OR bundle of care,while the other 30 subjects received the usual care.The groupings were determined through a systematic random sampling technique.The OR bundle of care had three interventions,namely:(1)maintaining perioperative normothermia,(2)no pre-operative surgical site hair removal,and(3)changing gloves before abdominal wall closure.These patients were evaluated using the standard instrument,Bates–Jensen Wound Assessment Tool(BWAT)in the post-intervention phases of the wound healing process,which are as follows:hemostasis,inflammatory,and proliferative phases.To describe the difference in the patients’wound status after implementation of the OR bundle of care in each post-intervention phase,Friedman’s test was used.To describe the difference in the patients’wound status in both groups after implementation of the OR bundle of care,the Mann–Whitney U test was used.Results:The patient’s wound status was lower,indicating a more healing process.Differences between the wound status of the control and the experimental group were observed on the third postoperative day.This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring.A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.Conclusions:The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital,if there is uniform and consistent implementation of the said intervention.展开更多
Personality widely exists in diverse animal taxa.Such inter-individual variance in behaviour is supposed to be influenced by social context.However,it remains unknown whether the experience of social life has any carr...Personality widely exists in diverse animal taxa.Such inter-individual variance in behaviour is supposed to be influenced by social context.However,it remains unknown whether the experience of social life has any carryover effects on the subsequent expression of personality.Here,we examined exploratory behaviour in caged Java Sparrows(Lonchura oryzivora)using exploration assays.Birds were assigned to live in either a solitary or a social context for four weeks.We compared the expressions of exploration before and after the treatments,and found that birds showed higher exploration tendencies after than before social life,while the isolated birds were consistent in their exploratory behaviours.Different living experience led to differences in the exploration activities for birds without significant differences in exploration before.Our results indicate that social experience can make birds more proactive.展开更多
The cooperative education mode of academy system and undergraduate tutorial system is an important reform mode for cultivating top-notch innovative talents in colleges and universities.However,there is still room for ...The cooperative education mode of academy system and undergraduate tutorial system is an important reform mode for cultivating top-notch innovative talents in colleges and universities.However,there is still room for improvement in the operation of tutorial system.For example,the lack of synergy in the academy system leads to problems such as insufficient understanding between teachers and students and limited guidance effect.Therefore,this study analyzes the implementation status of tutorial system,and puts forward the corresponding strategies for the existing problems.展开更多
桥梁健康监测数据的挖掘和分析工作只有在整体数据质量符合基本要求的有效数据基础上进行,才能保障如模态参数识别、损伤识别和状态评估等后续工作的准确性。因此,基于量化改进的探索性分析方法(Exploratory Data Analysis,EDA)和相关...桥梁健康监测数据的挖掘和分析工作只有在整体数据质量符合基本要求的有效数据基础上进行,才能保障如模态参数识别、损伤识别和状态评估等后续工作的准确性。因此,基于量化改进的探索性分析方法(Exploratory Data Analysis,EDA)和相关性分析从数据完整性、准确性和一致性的角度建立了桥梁健康监测静、动态数据的质量评估方法。对某大跨度斜拉桥健康监测系统的静、动态数据进行质量评估,通过对比分析了不同评估质量的温度数据、静挠度数据和不同评估质量的主梁竖向加速度动力信号的模态参数识别的稳定图,验证了所提方法的正确性。结果表明,所提评估方法能够快速有效地判断数据质量的好坏,进而确保桥梁结构的服役性能评估和预测的准确性,有利于提高健康监测数据的可用性和效能。展开更多
文摘BACKGROUND Gastric cancer(GC)is a prevalent malignant tumor worldwide and ranks as the fourth leading cause of cancer-related mortality.Upper gastrointestinal bleeding(UGIB)is a frequent complication of GC.Radical gastrectomy and palliative therapy are widely used surgical procedures in the clinical management of GC.This study intends to probe the clinical efficacy and safety of radical gastrectomy and palliative therapy on the basis of exploratory laparotomy in patients with GC combined with UGIB,hoping to provide valuable information to aid patients in selecting the appropriate surgical intervention.AIM To investigate the clinical efficacy and safety of exploratory laparotomy^(+)radical gastrectomy and palliative therapy in patients with GC and UGIB combined.METHODS A total of 89 GC patients admitted to the First Affiliated Hospital of the University of South China between July 2018 and July 2020 were selected as participants for this study.The 89 patients were divided into two groups:radical resection group(n=46)treated with exploratory laparotomy^(+)radical gastrectomy and Palliative group(n=43)treated with palliative therapy.The study compared several variables between the two groups,including surgical duration,intraoperative blood transfusion volume,postoperative anal exhaust time,off-bed activity time,length of hospitalization,and incidence of complications such as duodenal stump rupture,anastomotic obstruction,and postoperative incision.Additionally,postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),and CD3^(+)/HLADR^(+)),immunoglobulin(IgG and IgM),tumor markers(CEA,CA199,and CA125),and inflammatory factors(IL-6,IL-17,and TNF-α)were assessed.The surgical efficacy and postoperative quality of life recovery were also evaluated.The patients were monitored for survival and tumor recurrence at 6 mo,1 year,and 2 years post-surgery.RESULTS The results indicated that the duration of operation time and postoperative hospitalization did not differ between the two surgical procedures.However,patients in the radical resection group exhibited shorter intraoperative blood loss,anus exhaust time,off-bed activity time,and inpatient activity time than those in the Palliative group.Although there was no substantial difference in the occurrence of postoperative complications,such as duodenal stump rupture and anastomotic obstruction,between the radical resection group and Palliative group(P>0.05),the radical resection group exhibited higher postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),etc.)and immunoglobulin levels(IgG,IgM)than the Palliative group,while tumor markers and inflammatory factors levels were lower than those in the radical resection group.Additionally,surgical efficacy,postoperative quality of life,and postoperative survival rates were higher in patients who underwent radical gastrectomy than in those who underwent palliative therapy.Moreover,the probability of postoperative tumor recurrence was lower in the radical gastrectomy group compared to the palliative therapy group,and these differences were all statistically significant(P<0.05).CONCLUSION Compared to palliative therapy,exploratory laparotomy^(+)radical gastrectomy can improve immune function,reduce the levels of tumor markers and inflammatory factors,improve surgical efficacy,promote postoperative quality of life recovery,enhance survival rates,and attenuate the probability of tumor recurrence.
基金the National Natural Science Foundation of China(61872378).
文摘Some attributes are uncertain for evaluation work because of incomplete or limited information and knowledge.It leads to uncertainty in evaluation results.To that end,an evaluation method,uncertainty entropy-based exploratory evaluation(UEEE),is proposed to guide the evaluation activities,which can iteratively and gradually reduce uncertainty in evaluation results.Uncertainty entropy(UE)is proposed to measure the extent of uncertainty.First,the belief degree distributions are assumed to characterize the uncertainty in attributes.Then the belief degree distribution of the evaluation result can be calculated by using uncertainty theory.The obtained result is then checked based on UE to see if it could meet the requirements of decision-making.If its uncertainty level is high,more information needs to be introduced to reduce uncertainty.An algorithm based on the UE is proposed to find which attribute can mostly affect the uncertainty in results.Thus,efforts can be invested in key attribute(s),and the evaluation results can be updated accordingly.This update should be repeated until the evaluation result meets the requirements.Finally,as a case study,the effectiveness of ballistic missiles with uncertain attributes is evaluated by UEEE.The evaluation results show that the target is believed to be destroyed.
文摘Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection(SSI).Although several effor ts are being under taken to determine the proper means to reduce such complications,there is still a high incidence of SSI worldwide.Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site.This study tested the effectiveness of an operating room(OR)bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.Methods:A quasi-experimental pretest and posttest design was utilized to determine its effectiveness.The study was composed of 60 par ticipants divided into two groups:30 subjects were selected to receive the OR bundle of care,while the other 30 subjects received the usual care.The groupings were determined through a systematic random sampling technique.The OR bundle of care had three interventions,namely:(1)maintaining perioperative normothermia,(2)no pre-operative surgical site hair removal,and(3)changing gloves before abdominal wall closure.These patients were evaluated using the standard instrument,Bates–Jensen Wound Assessment Tool(BWAT)in the post-intervention phases of the wound healing process,which are as follows:hemostasis,inflammatory,and proliferative phases.To describe the difference in the patients’wound status after implementation of the OR bundle of care in each post-intervention phase,Friedman’s test was used.To describe the difference in the patients’wound status in both groups after implementation of the OR bundle of care,the Mann–Whitney U test was used.Results:The patient’s wound status was lower,indicating a more healing process.Differences between the wound status of the control and the experimental group were observed on the third postoperative day.This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring.A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.Conclusions:The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital,if there is uniform and consistent implementation of the said intervention.
基金supported by Department of Science and Technology of Liaoning Province(2019-ZD-0196)Department of Education of Liaoning Province(LJC202009)。
文摘Personality widely exists in diverse animal taxa.Such inter-individual variance in behaviour is supposed to be influenced by social context.However,it remains unknown whether the experience of social life has any carryover effects on the subsequent expression of personality.Here,we examined exploratory behaviour in caged Java Sparrows(Lonchura oryzivora)using exploration assays.Birds were assigned to live in either a solitary or a social context for four weeks.We compared the expressions of exploration before and after the treatments,and found that birds showed higher exploration tendencies after than before social life,while the isolated birds were consistent in their exploratory behaviours.Different living experience led to differences in the exploration activities for birds without significant differences in exploration before.Our results indicate that social experience can make birds more proactive.
基金Supported by Education and Teaching Reform Research Project of Hainan University(HDJY2251)New Agricultural Science Research and Reform Practice Project of the Ministry of Education of China(Exploration and Practice of the Collaborative Cultivation Model of Science and Education Integration for High Quality Talents in Tropical Horticulture).
文摘The cooperative education mode of academy system and undergraduate tutorial system is an important reform mode for cultivating top-notch innovative talents in colleges and universities.However,there is still room for improvement in the operation of tutorial system.For example,the lack of synergy in the academy system leads to problems such as insufficient understanding between teachers and students and limited guidance effect.Therefore,this study analyzes the implementation status of tutorial system,and puts forward the corresponding strategies for the existing problems.
文摘桥梁健康监测数据的挖掘和分析工作只有在整体数据质量符合基本要求的有效数据基础上进行,才能保障如模态参数识别、损伤识别和状态评估等后续工作的准确性。因此,基于量化改进的探索性分析方法(Exploratory Data Analysis,EDA)和相关性分析从数据完整性、准确性和一致性的角度建立了桥梁健康监测静、动态数据的质量评估方法。对某大跨度斜拉桥健康监测系统的静、动态数据进行质量评估,通过对比分析了不同评估质量的温度数据、静挠度数据和不同评估质量的主梁竖向加速度动力信号的模态参数识别的稳定图,验证了所提方法的正确性。结果表明,所提评估方法能够快速有效地判断数据质量的好坏,进而确保桥梁结构的服役性能评估和预测的准确性,有利于提高健康监测数据的可用性和效能。
