Business English reading teaching under the mode of“literature circles”focuses on cultivating students’autonomy in reading,group cooperation,and the exchange of ideas among group members.In this teaching mode,teach...Business English reading teaching under the mode of“literature circles”focuses on cultivating students’autonomy in reading,group cooperation,and the exchange of ideas among group members.In this teaching mode,teachers are no longer the masters of the reading classroom,but the helpers,participants,and researchers in the process of students’reading.The reconstruction of teachers’role can promote the benign development of relationship not only between teachers and students,but also between students and students,inject new impetus and vitality into the classroom,and improve students’reading literacy.展开更多
During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, exc...During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.展开更多
Conductivities tomography with the interactions of magnetic field, electrical field, and ultrasound field is presented in this paper. We utilize a beam of ultrasound in scanning mode instead of the traditional ultraso...Conductivities tomography with the interactions of magnetic field, electrical field, and ultrasound field is presented in this paper. We utilize a beam of ultrasound in scanning mode instead of the traditional ultrasound field generated by point source. Many formulae for the reconstruction of conductivities are derived from the voltage signals detected by two electrodes arranged somewhere on tissue's surface. In a forward problem, the numerical solutions of ultrasound fields generated by the piston transducer are calculated using the angular spectrum method and its Green's function is designed approximately in far fields. In an inverse problems, the magneto-acousto-electrical voltage signals are proved to satisfy the wave equations if the voltage signals are extended to the whole region from the boundary locations of transducers. Thus the time-reversal method is applied to reconstructing the curl of the reciprocal current density. In addition, a least square iteration method of recovering conductivities from reciprocal current densities is discussed.展开更多
In Shamir’s(t,n) threshold of the secret sharing scheme, a secret is divided into n shares by a dealer and is shared among n shareholders in such a way that (a) the secret can be reconstructed when there are t or mor...In Shamir’s(t,n) threshold of the secret sharing scheme, a secret is divided into n shares by a dealer and is shared among n shareholders in such a way that (a) the secret can be reconstructed when there are t or more than t shares;and (b) the secret cannot be obtained when there are fewer than t shares. In the secret reconstruction, participating users can be either legitimate shareholders or attackers. Shamir’s scheme only considers the situation when all participating users are legitimate shareholders. In this paper, we show that when there are more than t users participating and shares are released asynchronously in the secret reconstruction, an attacker can always release his share last. In such a way, after knowing t valid shares of legitimate shareholders, the attacker can obtain the secret and therefore, can successfully impersonate to be a legitimate shareholder without being detected. We propose a simple modification of Shamir’s scheme to fix this security problem. Threshold cryptography is a research of group-oriented applications based on the secret sharing scheme. We show that a similar security problem also exists in threshold cryptographic applications. We propose a modified scheme to fix this security problem as well.展开更多
When the historic probabilistic S-N curves are given under special survival probability and confidence levels and there is no possible to re-test, fatigue reliability analysis at other levels can not be done except fo...When the historic probabilistic S-N curves are given under special survival probability and confidence levels and there is no possible to re-test, fatigue reliability analysis at other levels can not be done except for the special levels. Therefore, the wide applied curves are expected. Monte Carlo reconstruction methods of the test data and the curves are investigated under fatigue life following lognormal distribution. To overcome the non-conservative assessment of existent man-made enlarging the sample size up to thousands, a simulation policy is employed to address the true production where the sample size is controlled less than 20 for material specimens, 10 for structural component specimens and the errors matching the statistical parameters are less than 5 percent. Availability and feasibility of the present methods have been indicated by the reconstruction practice of the test data and curves for 60Si2Mn high strength spring steel of railway industry.展开更多
<strong>Introduction: </strong>Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of li...<strong>Introduction: </strong>Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. <strong>Objectives:</strong> To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years.<strong> Materials and Methods:</strong> Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. <strong>Results:</strong> 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. <strong>Conclusion:</strong> Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.展开更多
Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their pro...Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psychosocial well-being, sexual well-being, physical well-being regarding the chest area, with some degree of better perception of her breasts. Conclusion: This study suggests that the results in terms of satisfaction in BR after mastectomy for breast cancer are quite similar for patients who decide to take only the first reconstructive stage, compared with those that finished all the process along, this may be a valuable tool for decision making.展开更多
The novel Banengannen’s Soccer Team published in 1967has been classified as historical"meta narration"of Kenzaburo Oe.In the novel,there are two main characters—Mitsusaburo and Takashi,both of whom represe...The novel Banengannen’s Soccer Team published in 1967has been classified as historical"meta narration"of Kenzaburo Oe.In the novel,there are two main characters—Mitsusaburo and Takashi,both of whom represent two ways of exploring the historical truth.In the process of exploration of the two characters,Kenzaburo Oe symbolically analyzed the value presetting of the Japanese people—getting one’s own value through projecting the"Emperor",recreating a new chapter of history from personal experience.展开更多
An alternative concept or framework of reference is presented in this paper on the basis of Science of Human Settlements through the discussion of the relationship between the reconstruction and the development of the...An alternative concept or framework of reference is presented in this paper on the basis of Science of Human Settlements through the discussion of the relationship between the reconstruction and the development of the economy and society. Unprecedented conflicts and problems have emerged on an unprecedented scale in the urban and rural construction, which is moving forward at an unprecedented speed. In this context it appears significant to set up and develop a science which studies the "conservation and development" in the general terms of the human habitat.展开更多
Discussions about the U. S-Iraq war would last for years, but the war will surely produce long-term influences on international strategic structure and China’s security environment. The feature and influence of the w...Discussions about the U. S-Iraq war would last for years, but the war will surely produce long-term influences on international strategic structure and China’s security environment. The feature and influence of the war are determined by the America’ purposes in launching the war, which, in the common.展开更多
Contamination of water reserves by biological, chemical, and radiologic agents may affect the health of millions of residents in the Iraq as well as many others throughout the world. Fatal outbreaks of cholera struck ...Contamination of water reserves by biological, chemical, and radiologic agents may affect the health of millions of residents in the Iraq as well as many others throughout the world. Fatal outbreaks of cholera struck several provinces of the country, including Baghdad. The United Nations Environment Programme (UNEP) also says air pollution, resulting from burning oil and aggravated by war, is cause for concern. The study area Baghdad has been divided into two parts: Central Baghdad and Outskirts of Baghdad (included in Baghdad but near the boundaries of Baghdad). The outskirts of Baghdad comprises of 4 cities: Al-Hussaniya located in northern part of Baghdad, Abu-Gurabe located in the western side of Baghdad, Jissr Diyala located in the eastern side of Baghdad and finally Al-Mahmodiya located in the southern side of Baghdad. These cities are in very poor situation in terms of water supply. The quality of water supplied is bad as no attention is given to WTP's in these places, which is also because of the fact that given the insecure war conditions, these areas are inaccessible. The sewage is thrown directly into the river because these areas do not have sewage treatment plants. In case of central Baghdad the water supply and sewerage network are broken in some places. Due to this there is mixing of water between the two networks. For this study we taking water supply samples and collect all the samples from WTPs and water supply network (houses, shops and different places). We made the analysis to parts first bacteriologies, second chlorine and after analysis these samples in lab we will give in our study numbers of fail samples, type of diseases and how many case during year 2007 in Baghdad City. Also in this study we will give Estimated Deaths from Water-Related Diseases 2010 to 2035.展开更多
Surgical treatment of Peyronie's disease(PD) is still a challenge and a gold standard approach does not exist; however the main goal is to straight penile shaft, and to restore penetrative and coital capacity. The...Surgical treatment of Peyronie's disease(PD) is still a challenge and a gold standard approach does not exist; however the main goal is to straight penile shaft, and to restore penetrative and coital capacity. The less invasive approach aims to correct curvature without intervening directly on the fibrous plaque while the more complex "corporoplasty" applies specific geometric criteria and uses different autologous and heterologous grafts. Each approach has its pros and cons and decisionmaking should be tailored to the individual patient's expectations. Other surgical options include different use of patches to cover the tunica albuginea defect, with the choice depending on the surgeon's personal experience. Despite the wide range of autologous(buccal mucosa, vein, dermis, etc.) and heterologous grafts(bovine pericardium, swine intestinal submucosa, porcine dermis, etc.) none currently represents the real "gold standard" because the data are extremely variable and frequently not representative. Several factors seem to favor buccal mucosa grafts over inert biocompatible materials: as vital tissue, buccal mucosa tends to heal rapidly, immediately integrating with the surrounding albuginea tissue. This translates into a more rapid resumption of spontaneous erections(after 3/4 d) and sexual activity and into a reduced risk of curvature relapse and erectile dysfunction after surgery. Another advantage of the buccal mucosa graft is its low cost. In conclusion, despite the recent development of some exciting new surgical techniques we are still unable to deliver a definitive take-home message about reconstructive surgery in PD because the majority of the studies reported insufficient data. However, since it is clear that major outcomes, besides the cosmetic result, are the patient's and partner's satisfaction and the economic impact of each technique, we recommend they be included among the outcome assessment parameters in further展开更多
目的:利用计算机三维重建及模拟置钉技术评估S2髂骨螺钉在国人儿童应用可行性,且优化测量其钉道参数。方法:选取2018年12月至2020年12月行骨盆CT扫描且年龄5~16岁的儿童骨盆影像学资料83例,排除骨折、畸形、肿瘤等情况,其中男44例,女39...目的:利用计算机三维重建及模拟置钉技术评估S2髂骨螺钉在国人儿童应用可行性,且优化测量其钉道参数。方法:选取2018年12月至2020年12月行骨盆CT扫描且年龄5~16岁的儿童骨盆影像学资料83例,排除骨折、畸形、肿瘤等情况,其中男44例,女39例,年龄(10.66±3.52)岁,依据年龄分为4组(A组5~7岁;B组8~10岁;C组11~13岁;D组14~16岁)。将获得的原始CT数据导入Mimics软件中,三维重建骨盆骨性结构,并在三维视图模拟分别以螺钉最大头倾角、最小头倾角置入直径6.5 mm S2髂骨螺钉。随后在3-Matic软件中分别测量最大头倾角和最小头倾角下螺钉冠状位夹角、矢状位尾倾角、横断位外展角、置钉总长度、骶骨内螺钉长度、髂骨宽度、进钉点距皮肤距离。比较分析不同年龄段儿童S2髂骨螺钉置钉参数间的差异及性别与左右侧别间差异。结果:83例儿童均可置入直径6.5 mmS2髂骨螺钉。各置钉参数左右侧别间比较,差异无统计学意义(P>0.05)。5~7岁儿童螺钉冠状位角度小于其他年龄段(P<0.05);但在螺钉矢状位角度上,在螺钉最大头倾角下5~7岁儿童可获得较大角度,但在最小头倾角下较大角度获得年龄组为11~13岁。螺钉横断位角度各年龄组差异无统计学意义(P>0.05)。5~7岁男童在最大头角下的冠状位角度和最小头倾角下的矢状位角度均大于女童(P<0.05);8~10岁女童最小头倾角下的冠状位角度大于男童(P<0.05);其余置钉角度参数男女性别间差异均无统计学意义(P>0.05)。各年龄组间,髂骨最小宽度、最长钉道距离及骶骨内螺钉长度差异随年龄增长,均呈增长趋势(P<0.05)。5~7岁及8~10岁女童皮肤距离均大于男性(P<0.05)。男童在14~16岁髂骨最小宽度宽于同阶段女童(P<0.05)。而5~7岁及11~13岁女童,最长钉道距离长于同阶段男童(P<0.05)。结论:5~16岁儿童骨盆可安全容纳直径6.5 mmS2髂骨螺钉置入,但是由于儿童骨盆骨性结构处于发育生长时期,需精准评估,规划合理钉道、选择合适螺钉长度。展开更多
基金“Research on Reading Teaching Mode of Business English Majors From the Perspective of Literature Circles”(Project No.:2021SCG112)Laboratory Opening Project in Quzhou University(Project No.KFXM201808).
文摘Business English reading teaching under the mode of“literature circles”focuses on cultivating students’autonomy in reading,group cooperation,and the exchange of ideas among group members.In this teaching mode,teachers are no longer the masters of the reading classroom,but the helpers,participants,and researchers in the process of students’reading.The reconstruction of teachers’role can promote the benign development of relationship not only between teachers and students,but also between students and students,inject new impetus and vitality into the classroom,and improve students’reading literacy.
文摘During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.51137004,51277169,and 61271424)
文摘Conductivities tomography with the interactions of magnetic field, electrical field, and ultrasound field is presented in this paper. We utilize a beam of ultrasound in scanning mode instead of the traditional ultrasound field generated by point source. Many formulae for the reconstruction of conductivities are derived from the voltage signals detected by two electrodes arranged somewhere on tissue's surface. In a forward problem, the numerical solutions of ultrasound fields generated by the piston transducer are calculated using the angular spectrum method and its Green's function is designed approximately in far fields. In an inverse problems, the magneto-acousto-electrical voltage signals are proved to satisfy the wave equations if the voltage signals are extended to the whole region from the boundary locations of transducers. Thus the time-reversal method is applied to reconstructing the curl of the reciprocal current density. In addition, a least square iteration method of recovering conductivities from reciprocal current densities is discussed.
文摘In Shamir’s(t,n) threshold of the secret sharing scheme, a secret is divided into n shares by a dealer and is shared among n shareholders in such a way that (a) the secret can be reconstructed when there are t or more than t shares;and (b) the secret cannot be obtained when there are fewer than t shares. In the secret reconstruction, participating users can be either legitimate shareholders or attackers. Shamir’s scheme only considers the situation when all participating users are legitimate shareholders. In this paper, we show that when there are more than t users participating and shares are released asynchronously in the secret reconstruction, an attacker can always release his share last. In such a way, after knowing t valid shares of legitimate shareholders, the attacker can obtain the secret and therefore, can successfully impersonate to be a legitimate shareholder without being detected. We propose a simple modification of Shamir’s scheme to fix this security problem. Threshold cryptography is a research of group-oriented applications based on the secret sharing scheme. We show that a similar security problem also exists in threshold cryptographic applications. We propose a modified scheme to fix this security problem as well.
基金Project supported by the National High Technology Research and Development Program of China(863 Program) (No.2006AA04Z406)the National Natural Science Foundation of China (Nos.50375130, 50323003 and 50575189)+1 种基金the Special Foundation for the Authors of National Excellent Doctoral Dissertations (No.200234)the Program for New Century Excellent Talents in University(No.NCET040890)
文摘When the historic probabilistic S-N curves are given under special survival probability and confidence levels and there is no possible to re-test, fatigue reliability analysis at other levels can not be done except for the special levels. Therefore, the wide applied curves are expected. Monte Carlo reconstruction methods of the test data and the curves are investigated under fatigue life following lognormal distribution. To overcome the non-conservative assessment of existent man-made enlarging the sample size up to thousands, a simulation policy is employed to address the true production where the sample size is controlled less than 20 for material specimens, 10 for structural component specimens and the errors matching the statistical parameters are less than 5 percent. Availability and feasibility of the present methods have been indicated by the reconstruction practice of the test data and curves for 60Si2Mn high strength spring steel of railway industry.
文摘<strong>Introduction: </strong>Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. <strong>Objectives:</strong> To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years.<strong> Materials and Methods:</strong> Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. <strong>Results:</strong> 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. <strong>Conclusion:</strong> Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.
文摘Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psychosocial well-being, sexual well-being, physical well-being regarding the chest area, with some degree of better perception of her breasts. Conclusion: This study suggests that the results in terms of satisfaction in BR after mastectomy for breast cancer are quite similar for patients who decide to take only the first reconstructive stage, compared with those that finished all the process along, this may be a valuable tool for decision making.
文摘The novel Banengannen’s Soccer Team published in 1967has been classified as historical"meta narration"of Kenzaburo Oe.In the novel,there are two main characters—Mitsusaburo and Takashi,both of whom represent two ways of exploring the historical truth.In the process of exploration of the two characters,Kenzaburo Oe symbolically analyzed the value presetting of the Japanese people—getting one’s own value through projecting the"Emperor",recreating a new chapter of history from personal experience.
文摘An alternative concept or framework of reference is presented in this paper on the basis of Science of Human Settlements through the discussion of the relationship between the reconstruction and the development of the economy and society. Unprecedented conflicts and problems have emerged on an unprecedented scale in the urban and rural construction, which is moving forward at an unprecedented speed. In this context it appears significant to set up and develop a science which studies the "conservation and development" in the general terms of the human habitat.
文摘Discussions about the U. S-Iraq war would last for years, but the war will surely produce long-term influences on international strategic structure and China’s security environment. The feature and influence of the war are determined by the America’ purposes in launching the war, which, in the common.
文摘Contamination of water reserves by biological, chemical, and radiologic agents may affect the health of millions of residents in the Iraq as well as many others throughout the world. Fatal outbreaks of cholera struck several provinces of the country, including Baghdad. The United Nations Environment Programme (UNEP) also says air pollution, resulting from burning oil and aggravated by war, is cause for concern. The study area Baghdad has been divided into two parts: Central Baghdad and Outskirts of Baghdad (included in Baghdad but near the boundaries of Baghdad). The outskirts of Baghdad comprises of 4 cities: Al-Hussaniya located in northern part of Baghdad, Abu-Gurabe located in the western side of Baghdad, Jissr Diyala located in the eastern side of Baghdad and finally Al-Mahmodiya located in the southern side of Baghdad. These cities are in very poor situation in terms of water supply. The quality of water supplied is bad as no attention is given to WTP's in these places, which is also because of the fact that given the insecure war conditions, these areas are inaccessible. The sewage is thrown directly into the river because these areas do not have sewage treatment plants. In case of central Baghdad the water supply and sewerage network are broken in some places. Due to this there is mixing of water between the two networks. For this study we taking water supply samples and collect all the samples from WTPs and water supply network (houses, shops and different places). We made the analysis to parts first bacteriologies, second chlorine and after analysis these samples in lab we will give in our study numbers of fail samples, type of diseases and how many case during year 2007 in Baghdad City. Also in this study we will give Estimated Deaths from Water-Related Diseases 2010 to 2035.
文摘Surgical treatment of Peyronie's disease(PD) is still a challenge and a gold standard approach does not exist; however the main goal is to straight penile shaft, and to restore penetrative and coital capacity. The less invasive approach aims to correct curvature without intervening directly on the fibrous plaque while the more complex "corporoplasty" applies specific geometric criteria and uses different autologous and heterologous grafts. Each approach has its pros and cons and decisionmaking should be tailored to the individual patient's expectations. Other surgical options include different use of patches to cover the tunica albuginea defect, with the choice depending on the surgeon's personal experience. Despite the wide range of autologous(buccal mucosa, vein, dermis, etc.) and heterologous grafts(bovine pericardium, swine intestinal submucosa, porcine dermis, etc.) none currently represents the real "gold standard" because the data are extremely variable and frequently not representative. Several factors seem to favor buccal mucosa grafts over inert biocompatible materials: as vital tissue, buccal mucosa tends to heal rapidly, immediately integrating with the surrounding albuginea tissue. This translates into a more rapid resumption of spontaneous erections(after 3/4 d) and sexual activity and into a reduced risk of curvature relapse and erectile dysfunction after surgery. Another advantage of the buccal mucosa graft is its low cost. In conclusion, despite the recent development of some exciting new surgical techniques we are still unable to deliver a definitive take-home message about reconstructive surgery in PD because the majority of the studies reported insufficient data. However, since it is clear that major outcomes, besides the cosmetic result, are the patient's and partner's satisfaction and the economic impact of each technique, we recommend they be included among the outcome assessment parameters in further
文摘为提高高速公路改扩建工程交通安全风险评估结果的确定性和准确性,建立了基于改进D-S证据理论的相关风险评估模型。首先建立包含24个影响因素的三层级评估指标体系;然后利用云模型(Cloud Model,CM)求出定性指标的基本信度赋值(Basic Probability Assignment,BPA),利用高斯隶属度函数求出定量指标BPA;接着,通过层次分析法确定各评估指标的权重,进而对各指标BPA进行加权;利用D-S证据理论融合加权后的BPA,归一化处理后得到改扩建工程交通安全风险状态评估结果。最后,为验证模型的准确性,选取沪陕高速公路平潮至广陵段高速公路改扩建工程作为实例进行交通安全风险评估。评估结果显示,实例工程的低风险水平隶属度最大,为0.6615,表明该实例总体处于低风险水平,与现有资料和现实情况吻合。同时发现,基于CM、AHP及D-S证据理论的评估模型对各评估指标进行量化、加权、融合后所得到的风险等级隶属度和不确定性有所区别,能更均衡地表示风险的隶属度,量化后的安全风险状态评估结果具有更好的准确性,解决了指标体系中模糊定性指标难以量化表征及指标差异化权重赋值的难题。
文摘目的:利用计算机三维重建及模拟置钉技术评估S2髂骨螺钉在国人儿童应用可行性,且优化测量其钉道参数。方法:选取2018年12月至2020年12月行骨盆CT扫描且年龄5~16岁的儿童骨盆影像学资料83例,排除骨折、畸形、肿瘤等情况,其中男44例,女39例,年龄(10.66±3.52)岁,依据年龄分为4组(A组5~7岁;B组8~10岁;C组11~13岁;D组14~16岁)。将获得的原始CT数据导入Mimics软件中,三维重建骨盆骨性结构,并在三维视图模拟分别以螺钉最大头倾角、最小头倾角置入直径6.5 mm S2髂骨螺钉。随后在3-Matic软件中分别测量最大头倾角和最小头倾角下螺钉冠状位夹角、矢状位尾倾角、横断位外展角、置钉总长度、骶骨内螺钉长度、髂骨宽度、进钉点距皮肤距离。比较分析不同年龄段儿童S2髂骨螺钉置钉参数间的差异及性别与左右侧别间差异。结果:83例儿童均可置入直径6.5 mmS2髂骨螺钉。各置钉参数左右侧别间比较,差异无统计学意义(P>0.05)。5~7岁儿童螺钉冠状位角度小于其他年龄段(P<0.05);但在螺钉矢状位角度上,在螺钉最大头倾角下5~7岁儿童可获得较大角度,但在最小头倾角下较大角度获得年龄组为11~13岁。螺钉横断位角度各年龄组差异无统计学意义(P>0.05)。5~7岁男童在最大头角下的冠状位角度和最小头倾角下的矢状位角度均大于女童(P<0.05);8~10岁女童最小头倾角下的冠状位角度大于男童(P<0.05);其余置钉角度参数男女性别间差异均无统计学意义(P>0.05)。各年龄组间,髂骨最小宽度、最长钉道距离及骶骨内螺钉长度差异随年龄增长,均呈增长趋势(P<0.05)。5~7岁及8~10岁女童皮肤距离均大于男性(P<0.05)。男童在14~16岁髂骨最小宽度宽于同阶段女童(P<0.05)。而5~7岁及11~13岁女童,最长钉道距离长于同阶段男童(P<0.05)。结论:5~16岁儿童骨盆可安全容纳直径6.5 mmS2髂骨螺钉置入,但是由于儿童骨盆骨性结构处于发育生长时期,需精准评估,规划合理钉道、选择合适螺钉长度。