1.Introduction With the implementation of modern production strategies,such as“Industry 4.0”and“Made in China 2025,”the development of high-end mechanical equipment is gradually reaching a high degree of parameter...1.Introduction With the implementation of modern production strategies,such as“Industry 4.0”and“Made in China 2025,”the development of high-end mechanical equipment is gradually reaching a high degree of parameterization,digitalization,networking,and intelligence[1].High-end mechanical equipment no longer consists of traditional single devices,but is closely linked to the overall production process;that is,a variety of devices interact with each other and collectively form a complex system.However,faults can lead to production delays throughout the system and even seriously threaten the safety of workers[2].In addition,equipment operating in unmanned air or space vehicles(including space robots)cannot be repaired by humans if they break down[3].Until recently,the typical method of addressing machine faults was primarily the“fault cure”method,which involves manually shutting down,inspecting,and repairing the equipment to restore normal operation.Accordingly,the maintenance cycle of the traditional“fault cure”method is time-consuming,and the quality of the maintenance depends on the skills of the technician[4].展开更多
Background:Emergency index-admission cholecystectomy(EIC)is recommended for acute cholecystitis in most cases.General surgeons have less exposure in managing“difficult”cholecystectomies.This study aimed to compare t...Background:Emergency index-admission cholecystectomy(EIC)is recommended for acute cholecystitis in most cases.General surgeons have less exposure in managing“difficult”cholecystectomies.This study aimed to compare the outcomes of EIC between hepatopancreatobiliary(HPB)versus non-HPB surgeons.Methods:This is a 10-year retrospective audit on patients who underwent EIC from December 2011 to March 2022.Patients who underwent open cholecystectomy,had previous cholecystitis,previous endoscopic retrograde cholangiopancreatography or cholecystostomy were excluded.A 1:1 propensity score matching(PSM)was performed to adjust for confounding variables(e.g.age≥75 years,history of abdominal surgery,presence of dense adhesions).Results:There were 1409 patients(684 HPB cases,725 non-HPB cases)in the unmatched cohort.Majority(52.3%)of them were males with a mean age of 59.2±14.9 years.Among 472(33.5%)patients with EIC performed≥72 hours after presentation,40.1%had dense adhesion.The incidence of any morbidity,open conversion,subtotal cholecystectomy and bile duct injury were 12.4%,5.0%,14.6%and 0.1%,respectively.There was one mortality within 30 days from EIC.PSM resulted in 1166 patients(583 per group).Operative time was shorter when EIC was performed by HPB surgeons(115.5 vs.133.4 min,P<0.001).The mean length of hospital stay was comparable.EIC performed by HPB surgeons was independently associated with lower open conversion[odds ratio(OR)=0.24,95%confidence interval(CI):0.12–0.49,P<0.001],lower fundus-first cholecystectomy(OR=0.58,95%CI:0.35–0.95,P=0.032),but higher subtotal cholecystectomy(OR=4.19,95%CI:2.24–7.84,P<0.001).Any morbidity,bile duct injury and mortality were comparable between the two groups.Conclusions:EIC performed by HPB surgeons were associated with shorter operative time and reduced risk of open conversion.However,the incidence of subtotal cholecystectomy was higher.展开更多
BACKGROUND The incidence of colorectal cancer(CRC)is increasing annually.Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.AIM To investigate the clinical effect of...BACKGROUND The incidence of colorectal cancer(CRC)is increasing annually.Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.AIM To investigate the clinical effect of laparoscopic radical resection of CRC on the basis of propensity score matching(PSM).METHODS The clinical data of 100 patients who received inpatient treatment for CRC at Changde Hospital,Xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City)were analyzed retrospectively.The control group included patients who underwent open surgery(n=43),and those who underwent laparoscopic surgery formed the observation group(n=57).The baseline information of both groups was equipoised using 1×1 PSM.Differences in the perioperative parameters,inflammatory response,immune function,degree of pain,and physical status between the groups were analyzed.RESULTS Thirty patients from both groups were successfully matched.After PSM,baseline data showed no statistically significant differences between the groups:(1)Periop-erative parameters:The observation group had a longer surgery time,less intra-operative blood loss,earlier first ambulation and first anal exhaust times,and shorter gastric tube indwelling time than the control group;(2)Inflammatory response:24 h after surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)between groups were higher than preoperatively.IL-6,CRP,and TNF-αlevels in the observation group were lower than in the control group;(3)Immune function:At 24 h after surgery,counts of CD4-positive T-lymphocytes(CD4+)and CD4+/CD8-positive T-lymphocytes(CD8+)in both groups were lower than those before surgery,whereas CD8+was higher than that before surgery.At 24 h after surgery,both CD4+counts and CD4+/CD8+in the observation group were higher than those in the control group,whereas CD8+counts were lower;(4)Degree of pain:The visual analog scale scores in the observation group were lower than those in the control group at 24 and 72 h after surgery;and(5)Physical status:One month after surgery,the Karnofsky performance score in the observation group was higher than that in the control group.CONCLUSION Laparoscopic radical resection of CRC has significant benefits,such as reducing postoperative pain and postoperative inflammatory response,avoiding excessive immune inhibition,and contributing to postoperative recovery.展开更多
On the ancient and mysterious land of Mexico,civilizations shine like stars,weaving together a long and unique history."The Pursuit of the Jaguar" allows visitors to witness the primal allure of the Olmec ci...On the ancient and mysterious land of Mexico,civilizations shine like stars,weaving together a long and unique history."The Pursuit of the Jaguar" allows visitors to witness the primal allure of the Olmec civilization,experience the enigmatic wonders of the Teotihuacan civilization,and marvel at the brilliance of the Maya civilization and the grandeur of the Aztec civilization.展开更多
When Malawian President Lazarus Chakwera delivered a State of the Nation Address at the 50th Parliamentary Session and Budget Meeting in February,tourism was top of mind.
在传统云平台网络带宽分配机制中,网络带宽仅在虚拟机创建时分配.虚拟机创建后已分配的带宽难以更改甚至无法更改,这在一定程度上造成了资源的浪费.因此,在不影响网络服务质量下,虚拟机需要一种有效的带宽分配机制来提高带宽的利用率....在传统云平台网络带宽分配机制中,网络带宽仅在虚拟机创建时分配.虚拟机创建后已分配的带宽难以更改甚至无法更改,这在一定程度上造成了资源的浪费.因此,在不影响网络服务质量下,虚拟机需要一种有效的带宽分配机制来提高带宽的利用率.本文以开源云平台Open Stack为实验环境,以虚拟交换软件Open v Switch和监控软件Ceilometer为工具,提出并实现了基于云平台的动态带宽分配策略.测试结果表明,本策略有效的提高了带宽的使用率.展开更多
基金supported by Natural Science Foundation of Beijing(3212010)National Natural Science Foundation of China(51875031 and 52242507).
文摘1.Introduction With the implementation of modern production strategies,such as“Industry 4.0”and“Made in China 2025,”the development of high-end mechanical equipment is gradually reaching a high degree of parameterization,digitalization,networking,and intelligence[1].High-end mechanical equipment no longer consists of traditional single devices,but is closely linked to the overall production process;that is,a variety of devices interact with each other and collectively form a complex system.However,faults can lead to production delays throughout the system and even seriously threaten the safety of workers[2].In addition,equipment operating in unmanned air or space vehicles(including space robots)cannot be repaired by humans if they break down[3].Until recently,the typical method of addressing machine faults was primarily the“fault cure”method,which involves manually shutting down,inspecting,and repairing the equipment to restore normal operation.Accordingly,the maintenance cycle of the traditional“fault cure”method is time-consuming,and the quality of the maintenance depends on the skills of the technician[4].
文摘Background:Emergency index-admission cholecystectomy(EIC)is recommended for acute cholecystitis in most cases.General surgeons have less exposure in managing“difficult”cholecystectomies.This study aimed to compare the outcomes of EIC between hepatopancreatobiliary(HPB)versus non-HPB surgeons.Methods:This is a 10-year retrospective audit on patients who underwent EIC from December 2011 to March 2022.Patients who underwent open cholecystectomy,had previous cholecystitis,previous endoscopic retrograde cholangiopancreatography or cholecystostomy were excluded.A 1:1 propensity score matching(PSM)was performed to adjust for confounding variables(e.g.age≥75 years,history of abdominal surgery,presence of dense adhesions).Results:There were 1409 patients(684 HPB cases,725 non-HPB cases)in the unmatched cohort.Majority(52.3%)of them were males with a mean age of 59.2±14.9 years.Among 472(33.5%)patients with EIC performed≥72 hours after presentation,40.1%had dense adhesion.The incidence of any morbidity,open conversion,subtotal cholecystectomy and bile duct injury were 12.4%,5.0%,14.6%and 0.1%,respectively.There was one mortality within 30 days from EIC.PSM resulted in 1166 patients(583 per group).Operative time was shorter when EIC was performed by HPB surgeons(115.5 vs.133.4 min,P<0.001).The mean length of hospital stay was comparable.EIC performed by HPB surgeons was independently associated with lower open conversion[odds ratio(OR)=0.24,95%confidence interval(CI):0.12–0.49,P<0.001],lower fundus-first cholecystectomy(OR=0.58,95%CI:0.35–0.95,P=0.032),but higher subtotal cholecystectomy(OR=4.19,95%CI:2.24–7.84,P<0.001).Any morbidity,bile duct injury and mortality were comparable between the two groups.Conclusions:EIC performed by HPB surgeons were associated with shorter operative time and reduced risk of open conversion.However,the incidence of subtotal cholecystectomy was higher.
基金Supported by Scientific Research Project of Hunan Provincial Health Commission,No.202204114103.
文摘BACKGROUND The incidence of colorectal cancer(CRC)is increasing annually.Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.AIM To investigate the clinical effect of laparoscopic radical resection of CRC on the basis of propensity score matching(PSM).METHODS The clinical data of 100 patients who received inpatient treatment for CRC at Changde Hospital,Xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City)were analyzed retrospectively.The control group included patients who underwent open surgery(n=43),and those who underwent laparoscopic surgery formed the observation group(n=57).The baseline information of both groups was equipoised using 1×1 PSM.Differences in the perioperative parameters,inflammatory response,immune function,degree of pain,and physical status between the groups were analyzed.RESULTS Thirty patients from both groups were successfully matched.After PSM,baseline data showed no statistically significant differences between the groups:(1)Periop-erative parameters:The observation group had a longer surgery time,less intra-operative blood loss,earlier first ambulation and first anal exhaust times,and shorter gastric tube indwelling time than the control group;(2)Inflammatory response:24 h after surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)between groups were higher than preoperatively.IL-6,CRP,and TNF-αlevels in the observation group were lower than in the control group;(3)Immune function:At 24 h after surgery,counts of CD4-positive T-lymphocytes(CD4+)and CD4+/CD8-positive T-lymphocytes(CD8+)in both groups were lower than those before surgery,whereas CD8+was higher than that before surgery.At 24 h after surgery,both CD4+counts and CD4+/CD8+in the observation group were higher than those in the control group,whereas CD8+counts were lower;(4)Degree of pain:The visual analog scale scores in the observation group were lower than those in the control group at 24 and 72 h after surgery;and(5)Physical status:One month after surgery,the Karnofsky performance score in the observation group was higher than that in the control group.CONCLUSION Laparoscopic radical resection of CRC has significant benefits,such as reducing postoperative pain and postoperative inflammatory response,avoiding excessive immune inhibition,and contributing to postoperative recovery.
文摘On the ancient and mysterious land of Mexico,civilizations shine like stars,weaving together a long and unique history."The Pursuit of the Jaguar" allows visitors to witness the primal allure of the Olmec civilization,experience the enigmatic wonders of the Teotihuacan civilization,and marvel at the brilliance of the Maya civilization and the grandeur of the Aztec civilization.
文摘When Malawian President Lazarus Chakwera delivered a State of the Nation Address at the 50th Parliamentary Session and Budget Meeting in February,tourism was top of mind.
文摘在传统云平台网络带宽分配机制中,网络带宽仅在虚拟机创建时分配.虚拟机创建后已分配的带宽难以更改甚至无法更改,这在一定程度上造成了资源的浪费.因此,在不影响网络服务质量下,虚拟机需要一种有效的带宽分配机制来提高带宽的利用率.本文以开源云平台Open Stack为实验环境,以虚拟交换软件Open v Switch和监控软件Ceilometer为工具,提出并实现了基于云平台的动态带宽分配策略.测试结果表明,本策略有效的提高了带宽的使用率.