Field observations illustrated that, right-turn vehicles stopped at various positions when proceeding within the right-turn lanes, while some of them trespassed on the crosswalks with multiple stops. In this case, ped...Field observations illustrated that, right-turn vehicles stopped at various positions when proceeding within the right-turn lanes, while some of them trespassed on the crosswalks with multiple stops. In this case, pedestrians and bikes (ped/bike) are encountered unsmooth and hazardous crossings when right-turn vehicles encroaching their lanes. Meanwhile, this also causes conflicts between right-turn and through vehicles at the crossing street. To better protect ped/bike at crossings with right-turn vehicles, this paper proposes a concept of “right-turn vehicle box” (RTVB) as a supplemental treatment within right-turn lanes. Sight distance, geometric conditions, and behaviors of vehicles and ped/bike are key factors to consider so as to set up the criteria and to design the suitable treatment. A case study was conducted at an intersection pair in Houston, USA to shape the idea of RTVB, together with driving simulator tests under relevant scenarios. The preliminary crosscheck examination shows that the right-turn vehicle box could possibly provide ped/ bike with smoother and safer crossings. In the interim, the safety and efficiency of right-turn operations were also improved. To further validate the effects, implementation studies should be conducted before the RTVB can make its debut in practice. Future works will focus on the complete warrants and design details of this treatment. Moreover, the concept of “vehicle box” could also be transplanted to other places where turning movement(s) needs assistance or improvements.展开更多
Axons in the peripheral nervous system(PNS)can regenerate after injury.However,the adult mammalian central nervous system(CNS)loses the intrinsic regrowth ability.No robust axon regeneration occurs spontaneously after...Axons in the peripheral nervous system(PNS)can regenerate after injury.However,the adult mammalian central nervous system(CNS)loses the intrinsic regrowth ability.No robust axon regeneration occurs spontaneously after nerve injury,which was clearly observed by Ramon y Cajal in the early 20^(th) century(1,2).Due to lack展开更多
<strong>Objective:</strong> To investigate the rescue and nursing process of a trauma patient with multiple injuries and rupture of the right main bronchus.<strong> Methods:</strong> A patient ...<strong>Objective:</strong> To investigate the rescue and nursing process of a trauma patient with multiple injuries and rupture of the right main bronchus.<strong> Methods:</strong> A patient with multiple injuries and rupture of the right main bronchus admitted to the emergency department of the Shenzhen Hospital of the University of Hong Kong was selected as the research object on December 11, 2019. <strong>Results:</strong> In this case, the medical team treated the patient under the guidance of ATLS (Advanced Traumatic Life Support), and for the first time in our department, we used bronchoscopy to replace the double-lumen endotracheal tube for left lung single-lung ventilation, finally the patient was successfully treated. <strong>Conclusion:</strong> Through a literature search, it is found that the main bronchus rupture is less common in clinical practice. In the trauma group, the use of fiberoptic bronchoscopy and the replacement of a double-lumen tracheal tube for left lung single-lung ventilation can improve the treatment rate of such patients and is worthy of clinical application.展开更多
Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, reveal...Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple;the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.展开更多
BACKGROUND:Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture,a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis,...BACKGROUND:Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture,a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis,after failed endoscopic treatment.The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of endto-side hepaticojejunostomy.METHODS:Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed.Diagnosis of biliary anastomotic stricture was made based on clinical,biochemical,histological and radiological results.Endoscopic treatment was the first-line treatment of biliary anastomotic stricture.RESULTS:Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients,so they underwent conversion hepaticojejunostomy.Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy.In the end-to-side group,two patients sustained hepatic artery injury requiring repeated microvascular anastomosis,two developed restenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation,and two required revision hepaticojejunostomy.In the side-to-side group,one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation.No re-operation was needed in this group.Otherwise,outcomes in the two groups were similar in terms of liver function and graft survival.CONCLUSIONS:Despite the similar outcomes,side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops.However,more large-scale studies are warranted to validate the results.展开更多
文摘Field observations illustrated that, right-turn vehicles stopped at various positions when proceeding within the right-turn lanes, while some of them trespassed on the crosswalks with multiple stops. In this case, pedestrians and bikes (ped/bike) are encountered unsmooth and hazardous crossings when right-turn vehicles encroaching their lanes. Meanwhile, this also causes conflicts between right-turn and through vehicles at the crossing street. To better protect ped/bike at crossings with right-turn vehicles, this paper proposes a concept of “right-turn vehicle box” (RTVB) as a supplemental treatment within right-turn lanes. Sight distance, geometric conditions, and behaviors of vehicles and ped/bike are key factors to consider so as to set up the criteria and to design the suitable treatment. A case study was conducted at an intersection pair in Houston, USA to shape the idea of RTVB, together with driving simulator tests under relevant scenarios. The preliminary crosscheck examination shows that the right-turn vehicle box could possibly provide ped/ bike with smoother and safer crossings. In the interim, the safety and efficiency of right-turn operations were also improved. To further validate the effects, implementation studies should be conducted before the RTVB can make its debut in practice. Future works will focus on the complete warrants and design details of this treatment. Moreover, the concept of “vehicle box” could also be transplanted to other places where turning movement(s) needs assistance or improvements.
基金supported by National Natural Science Foundation of China [31600839]Guangdong Innovative and Entrepreneurial Research Team Program [2013S046]+1 种基金Shenzhen Peacock Plansupported by Funds of Leading Talents of Guangdong [2013] and Program of Introducing Talents of Discipline to Universities (B14036)
文摘Axons in the peripheral nervous system(PNS)can regenerate after injury.However,the adult mammalian central nervous system(CNS)loses the intrinsic regrowth ability.No robust axon regeneration occurs spontaneously after nerve injury,which was clearly observed by Ramon y Cajal in the early 20^(th) century(1,2).Due to lack
文摘<strong>Objective:</strong> To investigate the rescue and nursing process of a trauma patient with multiple injuries and rupture of the right main bronchus.<strong> Methods:</strong> A patient with multiple injuries and rupture of the right main bronchus admitted to the emergency department of the Shenzhen Hospital of the University of Hong Kong was selected as the research object on December 11, 2019. <strong>Results:</strong> In this case, the medical team treated the patient under the guidance of ATLS (Advanced Traumatic Life Support), and for the first time in our department, we used bronchoscopy to replace the double-lumen endotracheal tube for left lung single-lung ventilation, finally the patient was successfully treated. <strong>Conclusion:</strong> Through a literature search, it is found that the main bronchus rupture is less common in clinical practice. In the trauma group, the use of fiberoptic bronchoscopy and the replacement of a double-lumen tracheal tube for left lung single-lung ventilation can improve the treatment rate of such patients and is worthy of clinical application.
文摘Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple;the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.
文摘BACKGROUND:Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture,a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis,after failed endoscopic treatment.The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of endto-side hepaticojejunostomy.METHODS:Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed.Diagnosis of biliary anastomotic stricture was made based on clinical,biochemical,histological and radiological results.Endoscopic treatment was the first-line treatment of biliary anastomotic stricture.RESULTS:Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients,so they underwent conversion hepaticojejunostomy.Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy.In the end-to-side group,two patients sustained hepatic artery injury requiring repeated microvascular anastomosis,two developed restenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation,and two required revision hepaticojejunostomy.In the side-to-side group,one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation.No re-operation was needed in this group.Otherwise,outcomes in the two groups were similar in terms of liver function and graft survival.CONCLUSIONS:Despite the similar outcomes,side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops.However,more large-scale studies are warranted to validate the results.
