Short-term efficacy of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy via Huang’s three-step maneuver for advanced upper gastric cancer: Results from a propensity scorematched study

BACKGROUND Robotic surgery has been considered to be significantly better than laparoscopic surgery for complicated procedures.AIM To explore the short-term effect of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy(SPSHL)for advanced gastric cancer(GC)by Huang’s three-step maneuver.METHODS A total of 643 patients who underwent SPSHL were recruited from April 2012 to July 2017,including 35 patients who underwent robotic SPSHL(RSPSHL)and 608 who underwent laparoscopic SPSHL(LSPSHL).One-to-four propensity score matching was used to analyze the differences in clinical data between patients who underwent robotic SPSHL and those who underwent laparoscopic SPSHL.RESULTS In all,175 patients were matched,including 35 patients who underwent RSPSHL and 140 who underwent LSPSHL.After matching,there were no significant differences detected in the baseline characteristics between the two groups.Significant differences in total operative time,estimated blood loss(EBL),splenic hilar blood loss(SHBL),splenic hilar dissection time(SHDT),and splenic trunk dissection time were evident between these groups(P<0.05).Furthermore,no significant differences were observed between the two groups in the overall noncompliance rate of lymph node(LN)dissection(62.9%vs 60%,P=0.757),number of retrieved No.10 LNs(3.1±1.4 vs 3.3±2.5,P=0.650),total number of examined LNs(37.8±13.1 vs 40.6±13.6,P=0.274),and postoperative complications(14.3%vs 17.9%,P=0.616).A stratified analysis that divided the patients receiving RSPSHL into an early group(EG)and a late group(LG)revealed that the LG experienced obvious improvements in SHDT and length of stay compared with the EG(P<0.05).Logistic regression showed that robotic surgery was a significantly protective factor against both SHBL and SHDT(P<0.05).CONCLUSION RSPSHL is safe and feasible,especially after overcoming the early learning curve,as this procedure results in a radical curative effect equivalent to that of LSPSHL.

Auxiliary principle and three-step iterative algorithms for generalized set-valued strongly nonlinear mixed variational-like inequalities

An auxiliary principle technique to study a class of generalized set-valued strongly nonlinear mixed variational-like inequalities is extended. The existence and uniqueness of the solution of the auxiliary problem for the generalized set-valued strongly nonlinear mixed variational-like inequalities are proved, a novel and innovative three-step iterative algorithm to compute approximate solution is constructed, and the existence of the solution of the generalized set-valued strongly nonlinear mixed variational-like inequality is shown using the auxiliary principle iterative sequences generated by the algorithm technique. The convergence of three-step is also proved.

ZnO micro-nano composite hydrophobic film prepared by the three-step method

The hydrophobicity of the lotus leaf is mainly due to its surface micro-nano composite structure. In order to mimic the lotus structure, ZnO micro-nano composite hydrophobic films were prepared via the three-step method. On thin buffer films of SiO2, which were first fabricated on glass substrates by the so,gel dip-coating method, a ZnO seed layer was deposited via RF magnetron sputtering. Then two different ZnO films, micro-nano and micro-only flowerlike structures, were grown by the hydrothermal method. The prepared films have different hydrophobic properties after surface modification. The structures of the obtained ZnO films were characterized using x-ray diffraction and field-emission scanning electron microscopy. A conclusion that a micro-nano composite structure is more beneficial to hydrophobicity than a micro-only structure was obtained through research into the effect of structure on hydrophobic properties.

Three-step acupuncture and cupping therapy:an effective approach to treat cervicogenic headache

As early as 1983,Sjaastad proposed the concept of cervicogenic headache(CH)in the World Headache Conference,that is,the pain from upper cervical joints and muscles can be referred to the head.CH is a group of syndromes mainly caused by dysfunction of the upper cervical spine and its component muscles,ligaments,bony,vertebral arteries and/or soft tissue elements,usually not accompanied by neck pain.Therefore,the treatment strategy of CH focuses on pain relief and repair cervical lesions.Patients with painful disorders of upper cervical zygapophysial joints showed significant headache relief after directly treated at disordered cervical joints[1].

A new three-step procedure for pancreatic head carcinoma with invasion of superior mesenteric artery

Pancreatic head carcinoma is characterized by high malignancy and a low survival rate and its mortality ranks fourth for malignant tumors with a 5-year survival rate of only 5%[1].Treatment of this cancer relies on surgical resection.However,the resection rate is only about 20%,because majority of the patients are classified as unresectable when diagnosed due to distant metastasis or

Effect of a novel three-step aging on strength, stress corrosion cracking and microstructure of AA7085

The influence of a novel three-step aging on strength, stress corrosion cracking(SCC) and microstructure of AA7085 was investigated by tensile testing and slow strain rate testing combined with transmission electron microscopy(TEM). The results indicate that with the increase of second-step aging time of two-step aging, the mechanical properties increase first and then decrease, while the SCC resistance increases. Compared with two-step aging, three-step aging treatment improves SCC resistance and the strength increases by about 5%. The effects of novel three-step aging on strength and SCC resistance are explained by the role of matrix precipitates and grain boundary precipitates, respectively.

Three-Steps-Meshing Based Multiple Crack Identification for Structures and Its Experimental Studies

Multiple crack identification plays an important role in vibration-based crack identification of structures. Traditional crack detection method of single crack is difficult to be used in multiple crack diagnosis. A three-step-meshing method for the multiple cracks identification in structures is presented. Firstly, the changes in natural frequency of a structure with various crack locations and depth are accurately obtained by means of wavelet finite element method, and then the damage coefficient method is used to determine the number and the region of cracks. Secondly, different regions in the cracked structure are divided into meshes with different scales, and then the small unit containing cracks in the damaged area is gradually located by iterative computation. Lastly, by finding the points of intersection of three frequency contour lines in the small unit, the crack location and depth are identified. In order to verify the effectiveness of the presented method, a multiple cracks identification experiment is carried out. The diagnostic tests on a cantilever beam under two working conditions show the accuracy of the proposed method： with a maximum error of crack location identification 2.7% and of depth identification 5.2%. The method is able to detect multiple crack of beam with less subdivision and higher precision, and can be developed as a multiple crack detection approach for complicated structures.

Three-Step Difference Scheme for Solving Nonlinear Time-Evolution Partial Differential Equations

In this paper, a special three-step difference scheme is applied to the solution of nonlinear time-evolution equations, whose coefficients are determined according to accuracy constraints, necessary conditions of square conservation, and historical observation information under the linear supposition. As in the linear case, the schemes also have obvious superiority in overall performance in the nonlinear case compared with traditional finite difference schemes, e.g., the leapfrog(LF) scheme and the complete square conservation difference(CSCD) scheme that do not use historical observations in determining their coefficients, and the retrospective time integration(RTI) scheme that does not consider compatibility and square conservation. Ideal numerical experiments using the one-dimensional nonlinear advection equation with an exact solution show that this three-step scheme minimizes its root mean square error(RMSE) during the first 2500 integration steps when no shock waves occur in the exact solution, while the RTI scheme outperforms the LF scheme and CSCD scheme only in the first 1000 steps and then becomes the worst in terms of RMSE up to the 2500th step. It is concluded that reasonable consideration of accuracy, square conservation, and historical observations is also critical for good performance of a finite difference scheme for solving nonlinear equations.

JOINT RANDOM OPTIMIZED THREE-STEP SEARCH ALGORITHM BASED-ON GRAY AND CHROMATIC INFORMATION

In this letter, an improved three-step search algorithm is presented, which uses both gray and chromatic information to boost the performance with random optimization and converge the motion vectors to global optima. Experimental results show that this algorithm can efficiently improve the PSNR after motion compensation.

Three-Step Iterative Sequences with Errors for Uniformly Quasi-Lipschitzian Mappings

The purpose of this paper is to investigate some sufficient and necessary conditions for three-step Ishikawa iterative sequences with error terms for uniformly quasi-Lipschitzian mappings to converge to fixed points. Our results extend and improve the recent ones announced by Liu [3,4], Xu and Noor [5], and many others.

General Convergence Analysis for Three-step Projection Methods and Applications to Variational Problems

为一个三步的设计方法的第一个一一般模型被介绍，并且第二，它在 Hilbert 空格设置被用于非线性的变化不平等问题的一个系统的近似解决之可能性。让 H 是一个真实 Hilbert 空格和 K nonempty 被关上 H 的凸的子集。为任意地选择的起始的点 x0 ， y0 ， z0 K ，计算序列 xn ， yxn ， zxn 以便{xn+1=( 1-n-rn ) xn+xPk [ yn-Tyn ] +rnun ，yn=( 1--n ) xn+nPk [ zn-Txn ] +nun ，zn=( 1-an-n ) xn+akPk [ xn-Txn ] +nwn .For ，，> 0 是常数，{ n }，{ n }，{一}，{ rn }，{ n }，{ n } C [ 0,1 ]，{ un }，{ vn }，{ wn }是在 K 的序列，并且 0n + rn 1,0 n + n 1,0 一+ n 1 ，(A) n 0 ，在此 T ：K H 是到 K 上的非线性的印射。最后三步的模型被用于一些变化不平等问题。

煤矸石精确产酸潜力评价方法对比研究

为有效避免重大酸性水污染事故,需提高矿山岩石产酸潜力评价的精度。通过全面阐述矸石中常见含硫矿物的产酸潜力计算方法,采用三步连续提取法测定了多个矿石和煤矸石中产酸矿物的硫含量,对比分析了精确产酸潜力和最大产酸潜力。结果表明:煤矸石的产酸潜力值取决于各产酸硫的质量分数和单位硫产酸值;对大部分样品,用产酸硫含量计算的产酸潜力值不同程度地低于用全硫预测的产酸潜力值;样品SC中的硫成分主要为砷黄铁矿硫,相比黄铁矿的单位硫产酸值更高,导致SC样品计算的精确产酸潜力相比全硫预测的产酸潜力更高;三步连续提取法适用于以铁和铜的硫化物为主要含硫矿物的煤矸石;当矿石中其他硫化物成分增多和空白样品混合不均匀都会对结果产生一定干扰。研究结果为准确评价矿区煤矸石精确产酸潜力提供了依据。

构建要素、逻辑序位与路径依赖:农村集体经济从“锁定”到“进阶”实证

农村集体经济是农村集体成员利用集体所有的资源要素开展经济活动的一种经济形态,这意味着最大化资源要素效用是农村集体经济发展的应有之义,是农村与城市一道实现共同富裕的重要途径。文章从经济组织资源要素配置研究文献切题,缕析了农村集体经济发展必备资源要素,并基于案例分析提出打开“黑箱”的逻辑线索,即“开眼”识资源、“格物”纠序位、“优术”明道路“三步进阶”理论假说。同时利用收集的案例数据,依次分析地理区位、制度(政策)、带头人(企业家精神)对农村集体经济发展的作用。结果表明,农村集体经济高质量发展的要素构成中,存在普适性的“地理区位→制度(政策)→带头人(企业家精神)→资本→技术→劳动力→土地”排列逻辑序位,不同序位的资源要素内生经济发展路径依赖。认为坚持最优序位要素本位、依赖精英农民、要素序位纠偏、精准立地最优序位要素引入外部要素是集体经济高质量发展良性路径依赖的四种表现,强化带头人能力提升、建立发展资源县域基础数据库、建立资源要素对接响应及纠偏机制等措施有助于推动农村集体经济高质量发展。

核心素养培养在“三步九核”教学法的探索与实践——以“洗涤剂和化妆品生产实训”课程为例

为落实教育部关于全面深化课程改革、落实立德树人根本任务的要求,以“洗涤剂和化妆品生产实训”课程教学为依托,以核心素养培养为主,任务驱动的项目教学为辅,结合高职院校的课程特点和学生的职业需求与岗位实际,对教学内容进行模块化整合,提出了“三步九核”项目任务驱动教学法。探索与实践证明,“三步九核”项目任务驱动教学法将核心素养融入课堂,推动课堂转型,贴近岗位实际,较好地培养和发展学生的核心素养,实施效果显著,有助于培养学生的核心素养和科研实践创新能力。

TPC三能力提高进阶混合式智慧教学模式构建与应用——以“数字信号处理”课程为例

数字信号处理课程以工程教育专业认证为抓手,以新工科建设和双一流建设为背景,坚持以学生为中心,成果为导向,实现“理论Theory+实践Practice+协作Cooperation”TPC三能力提高.即依据建构主义学习理论,课前三阶导学智慧预习,学生线上自主学习,教师采用PBL教学模式在线发布项目任务书和导学攻略完成课前测;课中五步教学智慧课堂,线下以项目为驱动采用TBL教学模式,以小组为单位项目实践、展示和评价;课后三省思学智慧提升,学生知识拓展、思维导图总结,教师教学反思用于持续改进.最后采用知识、能力、行为多维度智慧评价实现学生TPC三维目标进阶提升.

证人出庭“三要件”的法教义学解读

通说认为,证人出庭“三要件”中“法院认为有必要出庭作证”为决定性要件。该观点符合当前绝大多数案件法院均以“无必要”为由限制证人出庭的司法现状。然而根据立法原意,证人出庭“三要件”处于平行、独立地位,不得以“有必要”为决定要件而忽略了对前两个要件的判断。在坚守“证人出庭为原则”基本立场基础上,以“三步检验法”重新构建证人出庭审查内容:第一,“控辩双方有异议”注意提出异议时间、异议方式以及异议主体;第二,“证人证言对定罪量刑有重大影响”应当从证人证言所蕴含的“待证事实”内容出发,由申请方承担初步证明,法院履行“无重大影响”说理义务;第三,法院认为“无必要”出庭仅限于明显重复、合理预断以及证人基于特殊原因无法出庭三种情形。

揿针联合西黄丸治疗实证肝癌化疗栓塞术后临床观察

目的:对揿针联合西黄丸治疗实证肝癌化疗栓塞术后的临床疗效进行观察研究。方法:将某院就诊的原发性肝癌患者随机分为对照组和观察组,各48例。对照组采用三阶梯药物止痛法治疗,观察组在对照组治疗的基础上给予揿针联合西黄丸治疗,比较两组患者治疗前后的腹痛(VAS)评分、中医证候积分、生活质量(KPS)评分以及血清AFP和GAS水平。结果:观察组总有效率为95.83%,显著高于对照组的89.58%(P<0.05);治疗后观察组中医证候积分、腹痛评分以及AFP水平均显著低于对照组和治疗前(P<0.05),生活质量KPS评分以及血清GAS水平显著高于对照组和治疗前(P<0.05)。结论:揿针联合西黄丸治疗实证肝癌腹痛患者疗效显著,可显著降低患者的疼痛评分,提高患者生活质量,值得临床推广应用。

一体两步三引导应用于针灸临床在线课程教学改革研究

中医针灸临床课程是针灸推拿专业必修的主干课程,其教学效果影响学生实习甚至是毕业后的临床工作。在近几年新型冠状病毒肺炎疫情防控的大背景下,各高校均无法正常开展线下教学,线上教学已成为必然趋势。如何提高中医临床课程学生的临床能力,已经成为全国高校线上教育教学综合改革的重要内容之一。文章针对传统线上教学存在的问题进行分析,根据针灸推拿学专业特点、针灸临床能力培养的重要性,探讨“一体两步三引导”在针灸临床在线教学改革中的应用,制定相应的改革方案,旨在为相关人员提供参考和借鉴。

中外合作办学人才培养新模式研究——以“混凝土结构”课程为例

随着国家对中外合作办学的支持,越来越多的高校致力于对中外合作办学模式的探讨。青岛理工大学土木工程学院以“混凝土结构”课程为例,针对中美合作办学培养新模式构建了经济全球化背景下源源不断培养国际人才的教学体系:中外教师先后对同一门课程进行线下课堂与远程授课紧密结合的“三位一体”教学,实行“分步走一体化”的流程,保证学生能够立足于国内外的混凝土建筑案例,夯实专业基础,充分拓宽国际视野。与传统中外合作办学模式相比,新型模式避免了赴外求学可能面临的种种风险,提高了学生对外文专业知识的了解程度。最终达到培养着眼于国际视野的高素质技术人才的目标,保证各种突发情况下国际化人才教育培养不停摆。

航天器表面材料紫外光电子发射产额理论模型发展及实验测试应用

空间环境会对航天器在轨效能发挥产生强烈影响,紫外(ultraviolet,UV)辐射是其中的一个重要因素,它可以导致航天器表面材料的电荷积累和电荷放电。通过测量航天器表面材料的紫外光电子发射产额(photoelectron emission yield,PEEY),获得光电发射基本数据,进行表面带电仿真分析,是研究航天器表面材料带电问题的一个重要方法。本文首先介绍PEEY理论模型的发展,包括福勒-杜布里奇(Fowler-Dubridge,FD)模型、一步模型、基于三步光电发射理论的三步模型(three-step model,TSM)/蒙特卡罗(Monte Carlo,MC)模型以及基于矩的(momentsbased,MB)发射模型和量子模型(quantum model,QM),对各个模型的研究方法和适用条件进行分析对比,梳理PEEY模型的发展脉络。然后介绍PEEY的实验测试应用,包括国内外紫外光电子产额谱(UV-PEEY)仪器的发展和典型空间材料的PEEY实验研究,并着重讨论外界条件和表面条件对PEEY的影响,最后对空间表面材料PEEY的深入研究提出建议。