Double-tract reconstruction is superior to esophagogastrostomy in controlling reflux esophagitis and enhancing quality of life after proximal gastrectomy:Results from a prospective randomized controlled clinical trial in China

Objective:The aim of this study was to prospectively compare double-tract reconstruction(DTR)and esophagogastrostomy(EG)after proximal gastrectomy(PG)regarding the incidence of reflux esophagitis,quality of life(QOL),nutritional status and surgical safety.Methods:This study was a randomized controlled trial.Patients eligible for PG were enrolled and randomly assigned to the EG group and DTR group.The characteristics of patients,parameters for surgical safety,incidence of reflux esophagitis,nutrition status and QOL were collected and compared between the two groups.Univariate analysis and multivariate analysis were performed to determine the significant factors affecting the incidence of reflux esophagitis after PG.Results:Thirty-seven patients of the EG group and 36 patients of the DTR group were enrolled.The incidence of reflux esophagitis was significantly lower in the DTR group than in the EG group(8.3%vs.32.4%,P=0.019).The DTR group demonstrated a more favorable QOL than the EG group after PG.The nutritional status was balanced within the EG group and the DTR group.The operation time was longer in the DTR group than in the EG group(191 min vs.221 min,P=0.001),while surgical safety was similar in the two groups.Conclusions:Our research demonstrated that DTR is superior to EG after PG in terms of the incidence of reflux esophagitis and provides a more satisfactory QOL without increasing surgical complications or sacrificing nutritional status.

Reflection and reconstruction： The evaluation system of the construction of the national characteristic specialty in China

In this paper, the author reflects the evaluation and appraisal systems for the construction of the characteristic specialty. Guided by the selection of the contents and the path of the construction of the characteristic specialty, from the dimension of reviewing the problems existing in the construction, with the defects of the deliberative evaluation index as the power of the correction, on the foundation of distinguishing the necessity of the construction of the evaluation, the author treats the construction and the innovation as the connotation of the evaluating indexes, refers to the data for the professional evaluation as the reference model, and reconstructs the evaluation systems of the construction of the characteristic specialty.

Reflection and reconstruction： The evaluation system of the construction of the national characteristic specialty in China

In this paper, the author reflects the evaluation and appraisal systems for the construction of the characteristic specialty. Guided by the selection of the contents and the path of the construction of the characteristic specialty, from the dimension of reviewing the problems existing in the construction, with the defects of the deliberative evaluation index as the power of the correction, on the foundation of distinguishing the necessity of the construction of the evaluation, the author u＇eats the construction and the innovation as the connotation of the evaluating indexes, refers to the data for the professional evaluation as the reference model, and reconstructs the evaluation systems of the construction of the characteristic specialty.

Optimal choice of stapler and digestive tract reconstruction method after distal gastrectomy for gastric cancer:A prospective case–control study

BACKGROUND Gastric cancer is the most common cause of cancer-related deaths,and is classified according to its location in the proximal,middle,or distal stomach.Surgical resection is the primary approach for treating gastric cancer.This prospective study aimed to determine the best reconstruction method after distal gastrectomy for gastric cancer.AIM To explore the efficacy of different staplers and digestive tract reconstruction(DTR)methods after radical gastrectomy and their influence on prognosis.METHODS Eighty-seven patients who underwent radical gastrectomy for distal gastric cancer at our institution between April 2017 and April 2020 were included in this study,with a follow-up period of 12-26 mo.The patients were assigned to four groups based on the stapler and DTR plan as follows:BillrothⅠ(B-I)reconstruction+linear stapler group(group A,22 cases),B-I reconstruction+circular stapler group(group B,22 cases),Billroth II(B-II)reconstruction+linear stapler group(group C,22 cases),and B-II reconstruction+circular stapler group(group D,21 cases).The pathological parameters,postoperative gastrointestinal function recovery,postoperative complications,and quality of life(QOL)were compared among the four groups.RESULTS No significant differences in the maximum diameter of the gastric tumors,total number of lymph nodes dissected,drainage tube removal time,QLQ(QOL questionnaire)-C30 and QLQ-STO22 scores at 1 year postoperatively,and incidence of complications were observed among the four groups(P>0.05).However,groups A and C(linear stapler)had significantly lower intraoperative blood loss and significantly shorter anastomosis time,operation time,first fluid diet intake time,first exhaust time,and length of postoperative hospital stay(P<0.05)than groups B and D(circular stapler).CONCLUSION Linear staplers offer several advantages for postoperative recovery.B-I and B-II reconstruction methods had similar effects on QOL.The optimal solution can be selected according to individual conditions and postoperative convenience.

Digestive tract reconstruction pattern as a determining factor in postgastrectomy quality of life

Postgastrectomy quality of life (QoL) is affected by various symptoms, and compared with the preoperative baseline QoL, is typically impaired for the first 6 mo after surgery. Thereafter, improvement to a stable QoL is observed at approximately 12 mo postoperatively. We consider the digestive tract reconstruction pattern to be a determining factor in postgastrectomy QoL among gastric cancer patients, and believe it requires further discussion. Proximal gastrectomy is associated with the worst postoperative QoL among gastrectomy procedures and should be performed cautiously. The trend of better QoL provided by the pouch procedure of total gastrectomy requires further robust support. Whether the use of Billroth-I gastroduodenostomy or Roux-en-Y gastrojejunostomy for distal gastrectomy is optimal remains controversial, but Roux-en-Y gastrojejunostomy is likely to be preferable. (c) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

Fatigue life prediction of workpiece with 3D rough surface topography based on surface reconstruction technology

The fatigue performance of a workpiece depends on its surface quality.In traditional fatigue life prediction,the effect of surface quality is commonly accounted for by using empirical correction factors,which is imprecise when safety is of great concern.For surface quality,the surface topography is an important parameter,which introduces stress concentration that reduces the fatigue life.It is not feasible to test the stress concentration of different surface topographies.On the one hand,it is time-consuming and high-cost,and on the other hand,it cannot reflect the general statistical characteristics.With the help of surface reconstruction technology and interpolation method,a more efficient and economic approach is proposed,where FE simulation of workpiece with the reconstructed surface topography is used as a foundation for fatigue life prediction.The relationship between surface roughness(Sa)and fatigue life of the workpiece is studied with the proposed approach.

The Quality of Life of Gastric Cancer Patients with and without Duodenal Passage Reconstructions after Total Gastrectomy

OBJECTIVE To evaluate the Quality of Life of the patients who received a total gastrectomy with different kinds of reconstruction methods. METHODS Patients who received a total gastrectomy between May 1999 to May 2003 were followed-up via questionnaires. Fifty-nine who were alive more than 2 years with no sigh of recurrence were enrolled in this study. The patients were divided into 2 groups as follows： a group treated with reconstruction with a duodenal passage after total gastrectomy （gastric substitute, GS）; and a group receiving reconstruction without duodenal passage after total gastrectomy （Jejenal pouch, JP）. Follow-up feedback data of 14 items from the patients were analyzed, comparing the Quality of Life （QOL） between the 2 groups. RESULTS Six months after operation, the most common symptoms of all patients were reflux and loss of body weight, but there was no statistically significant differences in the 14 items related to the special post-operation symptoms between the 2 groups. At 12 months after the operations, there were significant differences between the 2 groups in body weight （P=0.01）, eating time （P=0.034〈0.05）, and frequency of food intake （P= 0.040〈0.05）; At 24 months after the operations, the only difference between the 2 groups was body weight gain （P=0.025〈0.05）. The JP group was better than the GS group. CONCLUSION The JP reconstruction pattern is superior to a simple GS in gain of body weight, volume of food intake and frequency of food intake, soon after the operation.

Patient Satisfaction Index and Quality of Life Measurement with Breast-Q after Breast Reconstruction in a Plastic Surgery Center in Mexico

Introduction: 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. Objectives: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.

Long-Term Follow-Up of Microsurgical Reconstruction for Pelvic Tumor Focusing on Spinal Deformity and Quality of Life

Background: To provide patients with a superior quality of life (QOL) after their pelvic tumor resection, ensuring the stability of the trunk as well as satisfactory lower extremity function is important. Although microsurgical reconstructions for the pelvic ring and hip are used clinically, the details of postoperative long-term spinal deformity and QOL remain unclear. Methods: The patients were 66- and 43-year-old men and a 43-year-old woman. The mean postoperative follow-up period was 134 months. The surgical procedures performed on these patients were: pelvic ring reconstruction using a double-barreled free vascularized fibular graft (FVFG) in Patient 1;simultaneous pelvic ring reconstruction using FVFG and hip arthrodesis in Patient 2;and latissimus dorsi free flap without pelvic ring reconstruction in Patient 3. As indicators of spinal deformity, we measured the Cobb angle, thoracic kyphosis angle, lumbar lordosis angle, pelvic angle on the sagittal plane, and sagittal plane balance using whole spine radiography. To assess the patients’ QOL, we examined the International Society of Limb Salvage (ISOLS) score, the Roland-Morris Disability Questionnaire (RDQ), activities of daily living (ADL) satisfaction using a visual analogue scale (VAS), and the SF-36. Results: Spinal alignment in the frontal plane worsened in order from Patient 1 to 3. Spinal alignment and pelvic tilt in the sagittal plane were at appropriate levels in Patients 1 and 2. The trunk tilt in the sagittal plane was at an appropriate level only in Patient 1. In the QOL assessment, the function of the affected limb worsened in order from Patient 1 to 3. RDQ scores were lower than the national norm in Patients 2 and 3. With respect to ADL satisfaction and the SF-36, Patient 3 had a markedly low VAS, physical functioning, role-physical, and role-emotional scores. Conclusion: In the long-term clinical course after pelvic tumor resection, in order to obtain satisfactory spinal alignment and QOL, pelvic ring reconstruction and hip arthrodesis are important.

Reflection on the Human-Nature Relationship: Reinterpretation of Emily Dickinson’s “My Life had stood——a Loaded Gun”

Emily Dickenson’s poems have long enjoyed considerable acclaims from critics and common readers for her delicate and profound writing of life and death,love,nature,etc.Her short poem“My Life had stood—a Loaded Gun”is one receiving relatively few academic discussion.Among the rather few existent studies,many discuss Dickenson’s feminist ideas,religious bewilderment,literary creation views or even personal feeling in this poem.This article,instead,gives an interpretation of this poem from an ecocritical perspective.It points out that Emily Dickenson in this poem expresses her condemnation on human’s cruelty and indiffer?ence to nature.After a thorough interpretation of Dickenson’s reflection on human-nature relationship in this poem,the article fur?ther explores Dickenson’s attitudes toward nature through her personal writing background and clues in her other works to support this interpretation.

Transmission cable fault detector based on waveform reconstruction

In order to improve the accuracy of cable fault position location at a low cost and make the testing results intuitive, a cable fault detector based on wave form reconstruction is designed. In this detector, the cable fault position is located based on the time-domain pulse reflection （TDR） principle. A pulse waveform is injected in the tested cable, and a high-speed comparator with changeable reference voltages is used to binarize the test pulse waveform to a binary sequence on a certain voltage. Through scanning the reference voltage in a full voltage range, multi-sequences are acquired to reconstruct the pulse waveform transmission in the cable, and then the pulse attenuation feature, electrical open circuit fault, electrical short circuit fault, and the fault position of the cable are diagnosed. Experimental results show that the designed cable fault detector can determine the fault type and its position of the cable being tested, and the testing results are intuitive.

Digestive tract reconstruction options after laparoscopic gastrectomy for gastric cancer

In addition to the popularity of laparoscopic gastrectomy(LG),many reconstructive procedures after LG have been reported.Surgical resection and lymphatic dissection determine long-term survival;however,the election of a reconstruction procedure determines the postoperative quality of life for patients with gastric cancer(GC).Presently,no consensus exists regarding the optimal reconstructive procedure.In this review,the current state of digestive tract reconstruction after LG is reviewed.According to the determining influence of the tumor site on the procedures of surgical resection and reconstruction,we divide these reconstruction procedures into three categories consistent with the resection procedures.We focus on the technical tips of every reconstruction procedure and examine the surgical outcomes(length of surgery and blood loss)and postoperative complications(anastomotic leakage and stricture)to facilitate gastrointestinal surgeons to understand the merits and demerits of every reconstruction procedure.

RECONSTRUCTION OF WELD POOL SURFACE BASED ON SHAPE FROM SHADING

A valid image-processing algorithm of weld pool surface reconstruction according to an input image of weld pool based on shape from shading （SFS） in computer vision is presented. The weld pool surface information is related to the backside weld width, which is crucial to the quality of weld joint. The image of weld pool is recorded with an optical sensing method. Firstly, the reflectance map model, which specifies the imaging process, is estimated. Then, the algorithm of weld pool surface reconstruction based on SFS is implemented by iteration scheme and speeded by hierarchical structure. The results indicate the accuracy and effectiveness of the approach.

Breast Reconstruction: Does It Worth to Start If the Patient Is Not Sure to Take All the Process Along?

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.

Cognition Embodied in Buddhist Philosophy A Comparative Reflection of D6gen and Heidegger

Contrary to occidental philosophy, oriented to grasping and solidifying the principles of essential being （ontos on）, Buddhism seeks to understand the aspect of our existence that experiences suffering in life. In the East Asian languages Human beings are described as Inter-Beings in that they are enveloped by the topos of life and death. From breath to breath, our life is bound to the moments of emerging and vanishing, being and non-being in an essential unity. D6gen＇s philosophical thinking integrated this conception with the embodied cognition of both thinking and acting self. In the phenomenological point of view, Heidegger （1927; 1993） emphasizes Being as bound to fundamental substantiality, which borders at the Ab-grund, falling into nothingness. With D^gen, the unity-within-contrast of life and death is exemplified in our breathing, because it achieves the unity of body and cognition which can be called ＂corpus.＂ In perfect contrast, the essential reflection for Heidegger is that of grasping the fundament of Being in the world, which represents the actualization of a Thinking-Being-Unity. The goal of this comparison is to fundamentally grasp what is the essentiality of being, life, and recognition （in Japanesejikaku f~ ~） bound to embodied cognition in our globalized world.

多元家庭参与计划在乳腺癌乳房重建术患者院外延续性护理中的应用

目的:观察多元家庭参与计划在乳房重建术患者院外延续性护理中的应用效果。方法:以2020年9月笔者医院实施基于多元家庭参与计划的院外延续性护理干预模式为分界线,将2019年2月-2020年8月实施常规院外延续性护理的40例乳房重建术患者纳入对照组,将2020年9月-2022年3月实施基于多元家庭参与计划院外延续性护理的40例乳房重建术患者纳入观察组,比较两组患者干预前后认知偏差、体象、希望水平、生活质量及美学效果满意度。结果:干预后,两组认知偏差评分(对生命质量的影响、对他人评价、感知到的认知障碍及认知能力)均较干预前降低(P<0.05),且观察组各维度评分均低于对照组(P<0.05);干预后,两组体象评分(身体羞耻、疾病易感、身体关注、功能受限、患臂关注及透视)均较干预前降低(P<0.05),且观察组各维度评分均低于对照组(P<0.05);干预后,两组希望水平评分(未来和现实的积极态度、与他人保持亲密关系、采取积极行动)均较干预前升高(P<0.05),且观察组各维度评分均高于对照组(P<0.05);干预后,两组生活质量评分(心理状态、身体状态、性健康、假体满意度、乳房满意度、手术及信息满意度、医疗团队满意度)均较干预前升高(P<0.05),且观察组各维度评分均高于对照组(P<0.05);两组美学效果总满意率比较差异无统计学意义(P>0.05),但观察组满意率高于对照组(P<0.05)。结论:在乳房重建术患者院外延续性护理中应用多元家庭参与计划,能够有效改善患者心理状态,提高患者生活质量,值得临床推广。

旅游能带给人们生命意义感吗?——旅游情境下的生命意义感生成机制研究

生命意义感是人类活动的关键引擎,有意义的生活是幸福的最深层次含义。文章以人们踏上旅途寻求生活的意义这一现实现象为切入点,将积极心理学中的生命意义感范畴引入旅游研究视野,以相关网络游记与社区问答文本为材料,运用扎根理论进行编码分析,最终提炼出“旅游世界中的顿悟时刻”这一核心范畴,对旅游者获取生命意义感的具体过程与一般路径作出理论解释。研究发现:1)旅游者以具身实践的方式主动地构建生命意义,具身实践是旅游者生命意义感的来源;2)旅游者由审美体验中的自我超越激发生命活力,自发地觉察生命意义;3)旅游者通过自我反思这一内省过程形成对世界与真实自我的深刻理解,不断地追寻生命意义;4)旅游者通过自我认同的强化实现自我价值的确认,进而真正地肯定生命价值;5)回归日常生活世界时,人们通过回忆与回味重新赋予旅游体验以新的意义,个体生命状态的转变是旅游积极人生意义的一种体现。文章创新地构建出旅游世界中的生命意义感生成模型,对人们在旅游世界中获取生命意义感的顿悟时刻进行了深入解读,丰富了旅游体验的研究内容,深化了现有研究对旅游积极效应的认识,为深入理解旅游的意义提供了新思考。

透明物体非侵入式三维重建方法综述(特邀)

玻璃、透镜以及显示屏等透明物体在各个领域有着大量需求和应用,需要快速、精确和完整地对它们进行三维重建,从而客观描述物体形态、检测表面质量和保障元器件功能。但由于透明物体表面的镜面反射和折射特性,传统的三维重建方法并不适合直接应用于其三维形貌测量。为此,概述了透明物体的非侵入式三维重建方法,从基于反射光重建和基于透射光重建两个方面展开,回顾了近年来的主要研究工作。然后,详细比较了各种技术的优缺点及其适用情况,使用者们可以根据不同应用需求和测量条件选择合适的透明物体重建方案。最后,展望了该领域未来的研究方向,希望能为研究人员在完善现有方法或探索新方法时提供参考和思路。

“三生”视角下非物质文化遗产的保护困境与关系重构

非物质文化遗产是中华民族传统文化的精华,凝聚了中华民族千百年的精神创造。为保护文化的多样性,促进非遗保护传承的可持续发展,重构人与非遗在创造、传承、创新及精神价值层面的关系,本文突破了创作视角的传统非遗定义,构筑了一个凸显人在非遗传承中主体地位的“三生”理论分析框架,以映射当下人们对精神生活、技艺水平和身体健康的追求,凸显非遗与当代人的生产、生活与生命的紧密联系。从文化新质生产力视角,高质量推动非遗保护传承,应发掘非遗承载的价值追求,以更好地满足人民日益增长的精神文化需求。