The shortage and inefficiency of public cultural services are common problems in China, especially in the western regions. Baiyun District has made use- ful exploration to the construction of rural public cultural ser...The shortage and inefficiency of public cultural services are common problems in China, especially in the western regions. Baiyun District has made use- ful exploration to the construction of rural public cultural service system, network system, resource system, management system and service system.展开更多
Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph no...Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph node metastasis.Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology,though there are clinically suitable expanded criteria.As ESD requires specific skill and expertise,endoscopists need to be familiarized with basic methods and the use of special devices.The essence of the technique is to dissect the submucosal layer with direct vision and maintain thecutting plane above the underlying proper muscle layer.Although there are some differences in the detailed technical aspect,the cardinal method of ESD is now well established and standardized.Furthermore,research and development of new ESD devices that render more efficient,safe ESD are still in progress to improve the overall result of ESD on early gastric cancer.展开更多
Endoscopic submucosal dissection(ESD) is a widely accepted treatment for early gastric cancer(EGC),especially in Korea and Japan.The criteria for the therapeutic use of ESD for EGC have been expanded recently.However,...Endoscopic submucosal dissection(ESD) is a widely accepted treatment for early gastric cancer(EGC),especially in Korea and Japan.The criteria for the therapeutic use of ESD for EGC have been expanded recently.However,attention should be drawn to the technical feasibility of the ESD treatment which depends on a lesion's location,size or fibrosis level,or operator's experience.In the case of a lesion with a high level of difficulty,a more experienced operator is required.Thus,the treatment for a lesion with a high level of difficulty should be performed according to the degree of the operator's experience.In this paper,the authors describe the ESD procedure for lesions with a high level of difficulty.展开更多
Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric c...Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric cancer.The major difference and advantage of ESD compared to existing endoscopic resection techniques,such as endoscopic mucosal resection(EMR) and polypectomy,are the width and depth of the resection.Newly developed cutting devices,distal attachable endoscopic accessories,and an advanced electrosurgical unit have helped to overcome the limitations of therapeutic endoscopy in terms of lesion size,location,presence of fibrotic scarring,and accompanying ulcers.As a result,the indications for ESD have been expanded from the classical indication for EMR and polypectomy,and there is now support for a further expansion of ESD indications.At present,the most critical factor to consider in the decision of whether to perform ESD is the probability of unexpected lymph node metastasis.The guidelines for ESD are continually being updated and debated.In this review,we discuss the strengths and weaknesses of the expanded guidelines,based on evidence found in the literature.展开更多
As a major mode choice of commuters for daily travel, bus transit plays an important role in many urban and metropolitan areas. This work proposes a mathematical model to optimize bus service by minimizing total cost ...As a major mode choice of commuters for daily travel, bus transit plays an important role in many urban and metropolitan areas. This work proposes a mathematical model to optimize bus service by minimizing total cost and considering a temporally and directionally variable demand. An integrated bus service, consisting of all-stop and stop-skipping services is proposed and optimized subject to directional frequency conservation, capacity and operable fleet size constraints. Since the research problem is a combinatorial optimization problem, a genetic algorithm is developed to search for the optimal result in a large solution space. The model was successfully implemented on a bus transit route in the City of Chengdu, China, and the optimal solution was proved to be better than the original operation in terms of total cost. The sensitivity of model parameters to some key attributes/variables is analyzed and discussed to explore further the potential of accruing additional benefits or avoiding some of the drawbacks of stop-skipping services.展开更多
Endoscopic submucosal dissection(ESD) is becoming a popular procedure for the diagnosis and treatment of superficial mucosal lesions,and has the advantage of en bloc resection which yields a higher complete resection ...Endoscopic submucosal dissection(ESD) is becoming a popular procedure for the diagnosis and treatment of superficial mucosal lesions,and has the advantage of en bloc resection which yields a higher complete resection and remission rate compared to endoscopic mucosal resection(EMR).However,the learning process of this advanced endoscopic procedure requires a lengthy training period and considerable experience to be proficient.A well framed training protocol which is safe,effective,easily reproducible and cost-effective is desirable to teach ESD.In addition,the training course may need to be tailored around settings such as ethnicity,culture,workload,and disease incidence.In Asian countries with a large volume of early gastric lesions which need endoscopic treatment,endoscopists would be able to learn ESD expanding their skills from EMR to ESD under the supervision of experts.Whereas,in Western countries due to the low incidence of superficial gastric tumors,trials have utilized simulator models to improve learning.In Korea,the Korean Society of Gastrointestinal Endoscopy(KSGE) is playing an important role in training many gastroenterologists who have shown an interest in performing ESD by providing an annual live demonstration and a nationwide tutoring program.The purpose of this article is to introduce our ESD tutoring experience,review the published papers related to this topic,and propose several suggestions for future directions in teaching and learning ESD.展开更多
文摘The shortage and inefficiency of public cultural services are common problems in China, especially in the western regions. Baiyun District has made use- ful exploration to the construction of rural public cultural service system, network system, resource system, management system and service system.
文摘Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph node metastasis.Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology,though there are clinically suitable expanded criteria.As ESD requires specific skill and expertise,endoscopists need to be familiarized with basic methods and the use of special devices.The essence of the technique is to dissect the submucosal layer with direct vision and maintain thecutting plane above the underlying proper muscle layer.Although there are some differences in the detailed technical aspect,the cardinal method of ESD is now well established and standardized.Furthermore,research and development of new ESD devices that render more efficient,safe ESD are still in progress to improve the overall result of ESD on early gastric cancer.
文摘Endoscopic submucosal dissection(ESD) is a widely accepted treatment for early gastric cancer(EGC),especially in Korea and Japan.The criteria for the therapeutic use of ESD for EGC have been expanded recently.However,attention should be drawn to the technical feasibility of the ESD treatment which depends on a lesion's location,size or fibrosis level,or operator's experience.In the case of a lesion with a high level of difficulty,a more experienced operator is required.Thus,the treatment for a lesion with a high level of difficulty should be performed according to the degree of the operator's experience.In this paper,the authors describe the ESD procedure for lesions with a high level of difficulty.
文摘Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric cancer.The major difference and advantage of ESD compared to existing endoscopic resection techniques,such as endoscopic mucosal resection(EMR) and polypectomy,are the width and depth of the resection.Newly developed cutting devices,distal attachable endoscopic accessories,and an advanced electrosurgical unit have helped to overcome the limitations of therapeutic endoscopy in terms of lesion size,location,presence of fibrotic scarring,and accompanying ulcers.As a result,the indications for ESD have been expanded from the classical indication for EMR and polypectomy,and there is now support for a further expansion of ESD indications.At present,the most critical factor to consider in the decision of whether to perform ESD is the probability of unexpected lymph node metastasis.The guidelines for ESD are continually being updated and debated.In this review,we discuss the strengths and weaknesses of the expanded guidelines,based on evidence found in the literature.
基金Project(B01B1203)supported by Sichuan Province Key Laboratory of Comprehensive Transportation,ChinaProject(SWJTU09BR141)supported by the Southwest Jiaotong University,China
文摘As a major mode choice of commuters for daily travel, bus transit plays an important role in many urban and metropolitan areas. This work proposes a mathematical model to optimize bus service by minimizing total cost and considering a temporally and directionally variable demand. An integrated bus service, consisting of all-stop and stop-skipping services is proposed and optimized subject to directional frequency conservation, capacity and operable fleet size constraints. Since the research problem is a combinatorial optimization problem, a genetic algorithm is developed to search for the optimal result in a large solution space. The model was successfully implemented on a bus transit route in the City of Chengdu, China, and the optimal solution was proved to be better than the original operation in terms of total cost. The sensitivity of model parameters to some key attributes/variables is analyzed and discussed to explore further the potential of accruing additional benefits or avoiding some of the drawbacks of stop-skipping services.
文摘Endoscopic submucosal dissection(ESD) is becoming a popular procedure for the diagnosis and treatment of superficial mucosal lesions,and has the advantage of en bloc resection which yields a higher complete resection and remission rate compared to endoscopic mucosal resection(EMR).However,the learning process of this advanced endoscopic procedure requires a lengthy training period and considerable experience to be proficient.A well framed training protocol which is safe,effective,easily reproducible and cost-effective is desirable to teach ESD.In addition,the training course may need to be tailored around settings such as ethnicity,culture,workload,and disease incidence.In Asian countries with a large volume of early gastric lesions which need endoscopic treatment,endoscopists would be able to learn ESD expanding their skills from EMR to ESD under the supervision of experts.Whereas,in Western countries due to the low incidence of superficial gastric tumors,trials have utilized simulator models to improve learning.In Korea,the Korean Society of Gastrointestinal Endoscopy(KSGE) is playing an important role in training many gastroenterologists who have shown an interest in performing ESD by providing an annual live demonstration and a nationwide tutoring program.The purpose of this article is to introduce our ESD tutoring experience,review the published papers related to this topic,and propose several suggestions for future directions in teaching and learning ESD.
