Improvements in surgery and the application of combined approaches to fight rectal cancer have succeeded in reducing the local recurrence (LR) rate and when there is LR it tends to appear later and less often in isola...Improvements in surgery and the application of combined approaches to fight rectal cancer have succeeded in reducing the local recurrence (LR) rate and when there is LR it tends to appear later and less often in isolation. Moreover, a subtle change in the distribution of LRs with respect to the pelvis has been observed. In general terms, prior to total mesorectal excision the most common LRs were central types (perianastomotic and anterior) while lateral and posterior forms (presa-cral) have become more common since the growth in the use of combined treatments. No differences have been reported in the current pattern of LRs as a function of the type of approach used, that is, neo-adjuvant therapies (short-term or long-course radiotherapy, orchemoradiotherapy versus extended lymphadenectomy, though there is a trend towards posterior or presacral LR in patients in the Western world and lateral LR in Asia. Nevertheless, both may arise from the same mechanism. Moreover, as well as the mode of treatment, the type of LR is related to the height of the initial tumor. Nowadays most LRs are related to the advanced nature of the disease. Involvement of the circumferential radial margin and spillage of residual tumor cells from lymphatic leakage in the pelvic side wall are two plausible mechanisms for the genesis of LR. The patterns of pelvic recurrence itself (pelvic subsites) also have important implications for prognosis and are related to the potential success of salvage curative approach. The re-operability for cure and prognosis are generally better for anastomotic and anterior types than for presacral and lateral recurrences. Overall survival after LR diagnosis is lower with radio or chemoradiotherapy plus optimal surgery approaches, compared to optimal surgery alone.展开更多
Teaching English composition has long been recognized as one of the most daunting tasks of college education in China. So this thesis is intended to investigate the applicability of the audience-oriented rhetorical ap...Teaching English composition has long been recognized as one of the most daunting tasks of college education in China. So this thesis is intended to investigate the applicability of the audience-oriented rhetorical appeals to the teaching of English composition.展开更多
This paper argues for an overt innovational shift in praxis, as well as classroom configuration in the ESOL writing class by calling for a move away from the current foci on process-based pedagogies for newcomer popul...This paper argues for an overt innovational shift in praxis, as well as classroom configuration in the ESOL writing class by calling for a move away from the current foci on process-based pedagogies for newcomer populations, to an explicit teaching of modeling strategies with concomitant practice opportunities provided in the ESOL writing class. It is argued that explicit, sequenced instruction in the domains of rhetorical structure as well as grammatical accuracy provide ESOL （English for Speakers of Other Languages） learners in the emerging stages of language learning with a more concrete grasp of meaning, structure and grammar in rhetorical construction. The modeling strategies proposed in the paper focus on a simultaneous building of rhetorical fluency and grammatical accuracy via spotlighted and sequenced strategies which afford learners practice in smaller chunks of composition including but not limited to thesis statement writing, varied paragraph organization, multiple modes of exposition, and grammatical complexity all in a bid to generate rhetorical depth and grammatical detail in writing. In short, both form and function need to be explicitly taught in the ESOL writing class with adequate opportunities provided for rhetorical practice. Using a meticulous blend of meaningful, authentic and purposeful tasks combined with one-on-one instruction which incorporates a variety of visual and rhetorical modeling strategies, emerging writers, it is argued a move from controlled to automatic writing fluency within a short time span. The pedagogy proposed in the current paper spotlights the specific learner, rather than the writing process and entails a move away from traditional, teacher-fronted classrooms to targeted, workshop-centered configurations which permit for one-on-one conferencing in the ESOL writing class. The visually rendered modeling strategies proposed in this paper argue for writing instruction for ESOL students which is learner responsive, relevant and practical.展开更多
Objective： To evaluate the treatment effects of total gastrectomy （TG） and proximal gastrectomy （PG） for cancer of the cardia and esophagogastric junction. Methods： forty-five patients with cancer of the cardia ...Objective： To evaluate the treatment effects of total gastrectomy （TG） and proximal gastrectomy （PG） for cancer of the cardia and esophagogastric junction. Methods： forty-five patients with cancer of the cardia and esophagogastric junction underwent surgical resection. Of them, 29 were treated using proximal gastrectomy and 16 total gastrectomy. The 3-year and 5-year survival rate and the postoperative complication rate and mortality rate were followed up and compared between the two groups. Results： The 3-year and 5-year survival rates of group PG were 44.8% and 20.7%, of group TG were 37.5% and 18.8%, respectively, and the differences were not statistically significant （X^2= 3.84, P 〉 0.05; X^2= 3.89, P 〉 0.05）. The postoperative complication and mortality rate of group PG were 13.7% and 6.8%, of group TG was all 6%, respectively. Conclusion： Proximal and total gastrectomy treatment effects can not significantly influence the prognosis of patients in progressive stage of cancer of cardia and esophagogastric junction.展开更多
By analyzing several effective finger practices, it is possible to consolidate the basic skills to help students adjust and establish a good touch mode. This is an important pre-requisite for pursuing strength and spe...By analyzing several effective finger practices, it is possible to consolidate the basic skills to help students adjust and establish a good touch mode. This is an important pre-requisite for pursuing strength and speed during playing. The training method can be targeted to solve some common problems, and guide students to consciously feel the touch and the change of tone, listening with ears, controlling with fingers to achieve solid and soft balanced unity.展开更多
To improve the efficiency of operating rooms, reduce the hospital＇ s costs and improve the level of service qualities, a scheduling method is presented based on a filtered-beam-search-based algo- rithm. Firstly, a sc...To improve the efficiency of operating rooms, reduce the hospital＇ s costs and improve the level of service qualities, a scheduling method is presented based on a filtered-beam-search-based algo- rithm. Firstly, a scheduling problem domain is described. Mathematical programming models are al- so set up with an objective function of minimizing related costs of the system. On the basis of the de= scriptions mentioned above, a solving policy of generating feasible scheduling solutions is estab- lished. Combining with the speeific constraints of operation theatres, a filtered-beam-search-based algorithm is put forward to solve scheduling problems. Finally, simulation experiments are designed. The performance of the proposed algorithm is evaluated and compared with that of other approaches through simulations. Results indicate that the proposed algorithm can reduce costs, and are of prac- ticality and effectiveness.展开更多
objective： to study the problem oriented （PBL） teaching method application in surgery theory teaching effect. Methods： according to the student id number of single and double the surgical theory study stage of the...objective： to study the problem oriented （PBL） teaching method application in surgery theory teaching effect. Methods： according to the student id number of single and double the surgical theory study stage of the 160 cases of medical students divided into two groups, the number into the control group （80 cases）, double number into the experimental group （80 cases）, traditional teaching method and PBL teaching method, respectively with the method of questionnaire survey to evaluate the two teaching methods. Results： after the introduction of PBL method in the experimental teaching, the students＇ classroom situation, knowledge situation, learning efficiency index score significantly higher than the control group, and the ability training all indicators were significantly higher than that of control group （P 〈 0.05）. Conclusion： the introduction of PBL in surgery theory teaching method, the feasibility of high, can provide a good decision for surgical theory teaching.展开更多
The kinematic accuracy of space manipulator determines whether the spacecraft performs normally or not. Problems pertaining to structural deformation have received increased attention in recent times. In the space man...The kinematic accuracy of space manipulator determines whether the spacecraft performs normally or not. Problems pertaining to structural deformation have received increased attention in recent times. In the space manipulator systems, flexible arms and joints can induce drastic dynamic instabilities. In applications such as the space station, kinematic error due to structural deformation can jointly affect the performance characteristics. And it is crucial for accuracy control of space manipulator to establish a precision index. Here we analyze the dynamics characteristic of flexible space manipulator considering the hysteresis of harmonic reducer based on method of nonconstraint boundary modal. For the sake of describing the output accuracy, we integrate the method of analytic hierarchy process(AHP) to establish a comprehensive evaluation index. A numerical simulation is performed to analyze the nonlinear dynamic characteristics of space manipulator with harmonic reducer. With the analysis of accuracy assessment, the relation among the hysteresis angle, rigidity and output accuracy is revealed. Considering the elastic modulus of flexible space manipulator and the hysteresis angle of harmonic reducer, we conduct an evaluation of output characteristics of flexible space manipulator with the proposed comprehensive evaluation index. The accuracy evaluation of output characteristics based on the proposed comprehensive evaluation index is implemented in the initial stage of space manipulator's design, which can not only solve the problems existing in the design but also save cost savings for ground tests. The results can be used in designing and optimizing future space manipulators, which may provide valuable references for design and thermal control of the space manipulator.展开更多
基金Supported by CIBERehd, funded by the Carlos Ⅲ Health Institute
文摘Improvements in surgery and the application of combined approaches to fight rectal cancer have succeeded in reducing the local recurrence (LR) rate and when there is LR it tends to appear later and less often in isolation. Moreover, a subtle change in the distribution of LRs with respect to the pelvis has been observed. In general terms, prior to total mesorectal excision the most common LRs were central types (perianastomotic and anterior) while lateral and posterior forms (presa-cral) have become more common since the growth in the use of combined treatments. No differences have been reported in the current pattern of LRs as a function of the type of approach used, that is, neo-adjuvant therapies (short-term or long-course radiotherapy, orchemoradiotherapy versus extended lymphadenectomy, though there is a trend towards posterior or presacral LR in patients in the Western world and lateral LR in Asia. Nevertheless, both may arise from the same mechanism. Moreover, as well as the mode of treatment, the type of LR is related to the height of the initial tumor. Nowadays most LRs are related to the advanced nature of the disease. Involvement of the circumferential radial margin and spillage of residual tumor cells from lymphatic leakage in the pelvic side wall are two plausible mechanisms for the genesis of LR. The patterns of pelvic recurrence itself (pelvic subsites) also have important implications for prognosis and are related to the potential success of salvage curative approach. The re-operability for cure and prognosis are generally better for anastomotic and anterior types than for presacral and lateral recurrences. Overall survival after LR diagnosis is lower with radio or chemoradiotherapy plus optimal surgery approaches, compared to optimal surgery alone.
文摘Teaching English composition has long been recognized as one of the most daunting tasks of college education in China. So this thesis is intended to investigate the applicability of the audience-oriented rhetorical appeals to the teaching of English composition.
文摘This paper argues for an overt innovational shift in praxis, as well as classroom configuration in the ESOL writing class by calling for a move away from the current foci on process-based pedagogies for newcomer populations, to an explicit teaching of modeling strategies with concomitant practice opportunities provided in the ESOL writing class. It is argued that explicit, sequenced instruction in the domains of rhetorical structure as well as grammatical accuracy provide ESOL （English for Speakers of Other Languages） learners in the emerging stages of language learning with a more concrete grasp of meaning, structure and grammar in rhetorical construction. The modeling strategies proposed in the paper focus on a simultaneous building of rhetorical fluency and grammatical accuracy via spotlighted and sequenced strategies which afford learners practice in smaller chunks of composition including but not limited to thesis statement writing, varied paragraph organization, multiple modes of exposition, and grammatical complexity all in a bid to generate rhetorical depth and grammatical detail in writing. In short, both form and function need to be explicitly taught in the ESOL writing class with adequate opportunities provided for rhetorical practice. Using a meticulous blend of meaningful, authentic and purposeful tasks combined with one-on-one instruction which incorporates a variety of visual and rhetorical modeling strategies, emerging writers, it is argued a move from controlled to automatic writing fluency within a short time span. The pedagogy proposed in the current paper spotlights the specific learner, rather than the writing process and entails a move away from traditional, teacher-fronted classrooms to targeted, workshop-centered configurations which permit for one-on-one conferencing in the ESOL writing class. The visually rendered modeling strategies proposed in this paper argue for writing instruction for ESOL students which is learner responsive, relevant and practical.
基金Shanghai Baoshan Science and Technology developing funds (No: 03-A-34)
文摘Objective： To evaluate the treatment effects of total gastrectomy （TG） and proximal gastrectomy （PG） for cancer of the cardia and esophagogastric junction. Methods： forty-five patients with cancer of the cardia and esophagogastric junction underwent surgical resection. Of them, 29 were treated using proximal gastrectomy and 16 total gastrectomy. The 3-year and 5-year survival rate and the postoperative complication rate and mortality rate were followed up and compared between the two groups. Results： The 3-year and 5-year survival rates of group PG were 44.8% and 20.7%, of group TG were 37.5% and 18.8%, respectively, and the differences were not statistically significant （X^2= 3.84, P 〉 0.05; X^2= 3.89, P 〉 0.05）. The postoperative complication and mortality rate of group PG were 13.7% and 6.8%, of group TG was all 6%, respectively. Conclusion： Proximal and total gastrectomy treatment effects can not significantly influence the prognosis of patients in progressive stage of cancer of cardia and esophagogastric junction.
文摘By analyzing several effective finger practices, it is possible to consolidate the basic skills to help students adjust and establish a good touch mode. This is an important pre-requisite for pursuing strength and speed during playing. The training method can be targeted to solve some common problems, and guide students to consciously feel the touch and the change of tone, listening with ears, controlling with fingers to achieve solid and soft balanced unity.
基金Supported by the National Natural Science Foundation of China(No.61273035,71471135)
文摘To improve the efficiency of operating rooms, reduce the hospital＇ s costs and improve the level of service qualities, a scheduling method is presented based on a filtered-beam-search-based algo- rithm. Firstly, a scheduling problem domain is described. Mathematical programming models are al- so set up with an objective function of minimizing related costs of the system. On the basis of the de= scriptions mentioned above, a solving policy of generating feasible scheduling solutions is estab- lished. Combining with the speeific constraints of operation theatres, a filtered-beam-search-based algorithm is put forward to solve scheduling problems. Finally, simulation experiments are designed. The performance of the proposed algorithm is evaluated and compared with that of other approaches through simulations. Results indicate that the proposed algorithm can reduce costs, and are of prac- ticality and effectiveness.
文摘objective： to study the problem oriented （PBL） teaching method application in surgery theory teaching effect. Methods： according to the student id number of single and double the surgical theory study stage of the 160 cases of medical students divided into two groups, the number into the control group （80 cases）, double number into the experimental group （80 cases）, traditional teaching method and PBL teaching method, respectively with the method of questionnaire survey to evaluate the two teaching methods. Results： after the introduction of PBL method in the experimental teaching, the students＇ classroom situation, knowledge situation, learning efficiency index score significantly higher than the control group, and the ability training all indicators were significantly higher than that of control group （P 〈 0.05）. Conclusion： the introduction of PBL in surgery theory teaching method, the feasibility of high, can provide a good decision for surgical theory teaching.
文摘The kinematic accuracy of space manipulator determines whether the spacecraft performs normally or not. Problems pertaining to structural deformation have received increased attention in recent times. In the space manipulator systems, flexible arms and joints can induce drastic dynamic instabilities. In applications such as the space station, kinematic error due to structural deformation can jointly affect the performance characteristics. And it is crucial for accuracy control of space manipulator to establish a precision index. Here we analyze the dynamics characteristic of flexible space manipulator considering the hysteresis of harmonic reducer based on method of nonconstraint boundary modal. For the sake of describing the output accuracy, we integrate the method of analytic hierarchy process(AHP) to establish a comprehensive evaluation index. A numerical simulation is performed to analyze the nonlinear dynamic characteristics of space manipulator with harmonic reducer. With the analysis of accuracy assessment, the relation among the hysteresis angle, rigidity and output accuracy is revealed. Considering the elastic modulus of flexible space manipulator and the hysteresis angle of harmonic reducer, we conduct an evaluation of output characteristics of flexible space manipulator with the proposed comprehensive evaluation index. The accuracy evaluation of output characteristics based on the proposed comprehensive evaluation index is implemented in the initial stage of space manipulator's design, which can not only solve the problems existing in the design but also save cost savings for ground tests. The results can be used in designing and optimizing future space manipulators, which may provide valuable references for design and thermal control of the space manipulator.
