Effect of an Airbag-selective Portal Vein Blood Arrester on the Liver after Hepatectomy:A New Technique for Selective Clamping of the Portal Vein

Objective:A novel technique was explored using an airbag-selective portal vein blood arrester that circumvents the need for an intraoperative assessment of anatomical variations in patients with complex intrahepatic space-occupying lesions.Methods:Rabbits undergoing hepatectomy were randomly assigned to 4 groups:intermittent portal triad clamping(PTC),intermittent portal vein clamping(PVC),intermittent portal vein blocker with an airbag-selective portal vein blood arrester(APC),and without portal blood occlusion(control).Hepatic ischemia and reperfusion injury were assessed by measuring the 7-day survival rate,blood loss,liver function,hepatic pathology,hepatic inflammatory cytokine infiltration,hepatic malondialdehyde levels,and proliferating cell nuclear antigen levels.Results:Liver damage was substantially reduced in the APC and PVC groups.The APC animals exhibited transaminase levels similar to or less oxidative stress damage and inflammatory hepatocellular injury compared to those exhibited by the PVC animals.Bleeding was significantly higher in the control group than in the other groups.The APC group had less bleeding than the PVC group because of the avoidance of portal vein skeletonization during hepatectomy.Thus,more operative time was saved in the APC group than in the PVC group.Moreover,the total 7-day survival rate in the APC group was higher than that in the PTC group.Conclusion:Airbag-selective portal vein blood arresters may help protect against hepatic ischemia and reperfusion injury in rabbits undergoing partial hepatectomy.This technique may also help prevent liver damage in patients requiring hepatectomy.

Maternal Effects of Immediate versus Delayed Umbilical Cord Clamping: A Randomized Clinical Trial

OBJECTIVE: To compare maternal preoperative and postoperative hemoglobin variation after cord clamping. METHODS: Randomized clinical trial performed in Porto Alegre, RS from January to December 2012. It was included 356 women with habitual risk gestations. In the immediate cord clamping group, the umbilical cord section was realized between 0 and 60 s (group 1) while in the delayed cord clamping group it was realized >60 s (group 2). RESULTS: The mean (±standard deviation [SD]) preoperative hemoglobin was 12.13 ± 1.06 in the group 1 and 12.13 ± 1.11 in the group 2. The mean (±SD) postoperative day 2 hemoglobin level was 10.19 ± 1.46 in the group 1 and 10.24 ± 1.42 in the group 2. CONCLUSIONS: Delayed umbilical cord clamping resulted in a similar maternal hemoglobin level reduction at postoperative day 2.

Plastic Mechanism of Multi-pass Double-roller Clamping Spinning for Arc-shaped Surface Flange

Compared with the conventional single-roller spinning process, the double-roller clamping spinning（DRCS） process can effectively prevent the sheet metal surface wrinkling and improve the the production efficiency and the shape precision of final spun part. Based on ABAQUS/Explicit nonlinear finite element software, the finite element model of the multi-pass DRCS for the sheet metal is established, and the material model, the contact definition, the mesh generation, the loading trajectory and other key technical problems are solved. The simulations on the multi-pass DRCS of the ordinary Q235A steel cylindrical part with the arc-shaped surface flange are carried out. The effects of number of spinning passes on the production efficiency, the spinning moment, the shape error of the workpiece, and the wall thickness distribution of the final part are obtained. It is indicated definitely that with the increase of the number of spinning passes the geometrical precision of the spun part increases while the production efficiency reduces. Moreover, the variations of the spinning forces and the distributions of the stresses, strains, wall thickness during the multi-pass DRCS process are revealed. It is indicated that during the DRCS process the radical force is the largest, and the whole deformation area shows the tangential tensile strain and the radial compressive strain, while the thickness strain changes along the generatrix directions from the compressive strain on the outer edge of the flange to the tensile strain on the inner edge of the flange. Based on the G-CNC6135 NC lathe, the three-axis linkage computer-controlled experimental device for DRCS which is driven by the AC servo motor is developed. And then using the experimental device, the Q235A cylindrical parts with the arc-shape surface flange are formed by the DRCS. The simulation results of spun parts have good consistency with the experimental results, which verifies the feasibility of DRCS process and the reliability of the finite element model for DRCS.

Plastic Deformation Mechanism in Double-Roller Clamping Spinning of Flanged Thin-Walled Cylinder

Double?roller clamping spinning(DRCS) is a new process for forming a thin?walled cylinder with a complex surface flange. The process requires a small spinning force,and can visibly improve forming quality and production e ciency. However,the deformation mechanism of the process has not been completely understood. Therefore,both a finite element numerical simulation and experimental research on the DRCS process are carried out. The results show that both radial force and axial force dominate the forming process of DRCS. The deformation area elongates along the radial direction and bends along the axial direction under the action of the two forces. Both the outer edge and round corner of the flange show the tangential tensile stress and radial compressive stress. The middle region shows tensile tangential stress and radial stress,while the inner edge shows compressive tangential stress and radial stress. Tan?gential tensile strain causes a wall thickness reduction in the outer edge and middle regions of the flange. The large compressive thickness strain causes material accumulation and thus,an increase in the wall thickness of the round corner. Because of bending deformation,the round corner shows a large radial tensile strain in addition. The inner edge of the flange shows small radial compressive strain and tensile strain in thickness. Thus,the wall thickness on the inner edge of the flange continues to increase,although the increment is small. Furthermore,microstructure analysis and tensile test results show that the flanged thin?walled cylinder formed by DRCS has good mechanical properties. The results provide instructions for the application of the DRCS process.

Minimum Normal Force Principle Based Quantitive Optimization of Clamping Forces for Thin Walled Part

Based on the stability criteria of workpiece-fixture system, quantitative optimization of clamping forces during precise machining process for thin walled part is studied considering the contact condition between wokpiece and locator, the contact mechanical model is achieved, which is further been used to calculate the entire passive forces acting on the statically undetermined workpiece by means of the force screw theory as well as minimum norm force principle. Furthermore, a new methodology to optimize clamping forces is put forward, on the criteria of keeping the stability of workpiece during cutting process. By this way, the intensity of clamping forces is decreased dramatically, which will be most beneficial for improving the machining quality of thin-walled parts. Finally, a case study is used to support and validate the proposed model.

STRENGTH ANALYSIS OF CLAMPING IN MICRO/NANO SCALE EXPERIMENTS

Two kinds of clamping in micro/nano scale experiments are investigated in this paper, one based on electron-beam-induced deposition, and the other on the van der Waals interaction. The clamping strength and mechanism are analyzed both theoretically and experimentally. The influence of relative humidity on the micro/nano clamping and the method of electrostatic clamping are discussed. The clamping strength and performance of different clamping methods are compared considering the size and material of the clamped objects, and the application environments.

Numerical simulation of horizontal transversal displacement under different fixed clamping force of welding fixture for superalloy during TIG welding

A numerical model is established by Abaqus software for superalloy during tungsten inert gas （TIG） welding with welding fixture to simulate the weld temperature filed, stress and strain field, and weld plate＇s horizontal trasnsveral shift. The clamp force perpendicular to the weld plate varying with welding time was analyzed. The maximum clamp force during welding process was calculated. Under the condition of insufficient of clamping force, a half or one third of the maximum clamp force for example, the weld plate＇s horizontal transversal displacement could happen and also be computed.

Tepid antegrade intermittent blood cardioplegia as an alternative for intermittent crossclamping with Lidoflazine

Background: Blood cardioplegia is a technique with many variations in its use. Intermittent cross clamping with Lidoflazine has proven to deliver good cardioprotection in our center. Question: Is tepid (32°C) antegrade intermittent blood cardioplegia an efficient, safe and easy-to-use alternative to intermittent cross-clamping with Lidoflazine in elective isolated CABG in low-risk patients? Primary outcomes are heart enzymes (cTnI, CK-MB). Secondary outcomes are operation times, length of hospital stay, major complications and in-hospital mortality. Methods: From January 2012 until November 2012, 40 patients with LVEF ≥50%, EuroSCORE

Design of a novel high holding voltage LVTSCR with embedded clamping diode

In order to reduce the latch-up risk of the traditional low-voltage-triggered silicon controlled rectifier(LVTSCR), a novel LVTSCR with embedded clamping diode(DC-LVTSCR) is proposed and verified in a 0.18-μm CMOS process. By embedding a p+implant region into the drain of NMOS in the traditional LVTSCR, a reversed Zener diode is formed by the p+implant region and the n+bridge, which helps to improve the holding voltage and decrease the snapback region.The physical mechanisms of the LVTSCR and DC-LVTSCR are investigated in detail by transmission line pulse(TLP)tests and TCAD simulations. The TLP test results show that, compared with the traditional LVTSCR, the DC-LVTSCR exhibits a higher holding voltage of 6.2 V due to the embedded clamping diode. By further optimizing a key parameter of the DC-LVTSCR, the holding voltage can be effectively increased to 8.7 V. Therefore, the DC-LVTSCR is a promising ESD protection device for circuits with the operation voltage of 5.5–7 V.

MODELING, VALIDATION AND OPTIMAL DESIGN OF THE CLAMPING FORCE CONTROL VALVE USED IN CONTINUOUSLY VARIABLE TRANSMISSION

Associated dynamic performance of the clamping force control valve used in continuously variable transmission （CVT） is optimized. Firstly, the structure and working principle of the valve are analyzed, and then a dynamic model is set up by means of mechanism analysis. For the purpose of checking the validity of the modeling method, a prototype workpiece of the valve is manufactured for comparison test, and its simulation result follows the experimental result quite well. An associated performance index is founded considering the response time, overshoot and saving energy, and five structural parameters are selected to adjust for deriving the optimal associated performance index. The optimization problem is solved by the genetic algorithm （GA） with necessary constraints. Finally, the properties of the optimized valve are compared with those of the prototype workpiece, and the results prove that the dynamic performance indexes of the optimized valve are much better than those of the prototype workpiece.

IMPROVE THE KINETIC PERFORMANCE OF THE PUMP CONTROLLED CLAMPING UNIT IN PLASTIC INJECTION MOLDING MACHINE WITH ADAPTIVE CONTROL STRATEGY

The kinetic characteristics of the clamping unit of plastic injection molding machine that is controlled by close loop with newly developed double speed variable pump unit are investigated. Considering the wide variation of the cylinder equivalent mass caused by the transmission ratio of clamping unit and the severe instantaneous impact force acted on the cylinder during the mold closing and opening process, an adaptive control principle of parameter and structure is proposed to improve its kinetic performance. The adaptive correlation between the acceleration feedback gain and the variable mass is derived. The pressure differential feedback is introduced to improve the dynamic performance in the case of small inertia and heavy impact load. The adaptation of sum pressure to load is used to reduce the energy loss of the system. The research results are verified by the simulation and experiment, The investigation method and the conclusions are also suitable for the differential cylinder system controlled by the traditional servo pump unit.

Gradual Clamping Reduced Ischemia-Reperfusion Injury in an Isolated Rat Heart Model

Objectives: We hypothesized that the organisms and their organs or tissues could adapt themselves to the gradual changes of environment for surviving or reducing damage. This study explored whether gradual clamping (GC) could reduce myocardial ischemia-reperfusion (IR) injury in rat heart. Methods: Twelve rats were randomized to IR group and GC group, then the hearts were isolated and perfused with Langendorff apparatus. Before cardioplegia, the perfusion was stopped abruptly in IR group while slowly with 5-minute in GC group. The hearts were subjected to 30-minute ischemia and 60-minute reperfusion. The left ventricular develop pressure (LVDP) and systolic pressure (LVSP), the maximal rate of the increase and decrease of left ventricular pressure (+dp/dtmax, ﹣dp/dtmax) were measured by polygraph system at different time points. The recovery of the variables was expressed as the ratio of these values at individual time point after reperfusion to the baseline respectively. Results: The recovery of LVDP after reperfusion was better than that in IR group (P = 0.034). No significant difference in the recovery of LVSP, +dp/dtmax and ﹣dp/dtmax between groups was observed. Conclusions: Gradual clamping could improve the recovery of LVDP after IR, suggesting that gradual clamping could reduce myocardial IR injury.

Floating Clamping Mechanism of PT Fuel Injector and Its Dynamic Characteristics Analysis

PT fuel injector is one of the most important parts of modern diesel engine.To satisfy the requirements of the rapid and accurate test of PT fuel injector,the self-adaptive floating clamping mechanism was developed and used in the relevant bench.Its dynamic characteristics directly influence the test efficiency and accuracy.However,due to its special structure and complex oil pressure signal,related documents for evaluating dynamic characteristics of this mechanism are lack and some dynamic characteristics of this mechanism can＇t be extracted and recognized effectively by traditional methods.Aiming at the problem above-mentioned,a new method based on Hilbert-Huang transform（HHT） is presented.Firstly,combining with the actual working process,the dynamic liquid pressure signal of the mechanism is acquired.By analyzing the pressure fluctuation during the whole working process in time domain,oil leakage and hydraulic shock in the clamping chamber are discovered.Secondly,owing to the nonlinearity and nonstationarity of pressure signal,empirical mode decomposition is used,and the signal is decomposed and reconstructed into forced vibration,free vibration and noise.By analyzing forced vibration in the time domain,machining error and installation error of cam are revealed.Finally,free vibration component is analyzed in time-frequency domain with HHT,the traits of free vibration in the time-frequency domain are revealed.Compared with traditional methods,Hilbert spectrum has higher time-frequency resolutions and higher credibility.The improved mechanism based on the above analyses can guarantee the test accuracy of injector injection.This new method based on the analyses of the pressure signal and combined with HHT can provide scientific basis for evaluation,design improvement of the mechanism,and give references for dynamic characteristics analysis of the hydraulic system in the interrelated fields.

Supraceliac Aortic Clamping for Repair of Ruptured Abdominal Aortic Aneurysm in Patients with Short Aortic Neck Length

Objective: Prompt bleeding control with proximal aortic clamping and subsequent aortic repair are very important for ruptured abdominal aortic aneurysm. However, unsuitable anatomy, such as short aortic neck length, not only disturbs the means to an expeditious repair, but may also increase morbidity and mortality. In the present study, we aimed to evaluate the efficacy of supraceliac aortic clamping for improving surgical outcomes for patients with ruptured abdominal aortic aneurysm, who have a short aortic neck length. Method: Between April 2010 and September 2015, eighteen patients underwent emergent open surgical repair of ruptured abdominal aortic aneurysm. Eight patients with a short aortic neck length underwent supraceliac aortic clamping, and 10 underwent infrarenal aortic clamping. Results: The mean supraceliac aortic clamping time was 30 ± 7 minutes. There was 1 operative death in the infrarenal aortic clamping group due to respiratory failure, and the overall operative mortality was 6%. There were no significant differences between the 2 groups with respect to postoperative complication rates or mortality. Furthermore, there were no significant differences in variables of renal function between the 2 groups, through-out the study period. Conclusion: Supraceliac aortic clamping was associated with minimal mortality and morbidity, but not with harmful effects on postoperative renal function. Thus, supraceliac aortic clamping can be safely applied for ruptured abdominal aortic aneurysm with short aortic neck length.

Dimensional Variation Modeling of Aircraft Compliant Part Assembly Considering Clamping Force Change

Compliant parts are widely applied to aircraft structures.Due to the ease of deformation of compliant parts in assembly,the prediction of assembly variation is especially important for assembly quality control.A dimensional variation model considering the clamping force change in assembly is proposed based on the method of influence coefficient(MIC).First,the assembly process is decomposed into several steps including positioning,clamping,joining,and spring-back.Then,the force-displacement relationship is formulated according to the varied force conditions on the parts in each assembly step.Finally,two examples are illustrated to validate the proposed assembly variation model.The results show the impact of clamping force change is significant on the assembly variation,and the proposed model can predict the assembly variation more accurately than the referred method without clamping force correction at the over-constrained locating points of fixture.

Intermittent portal triad clamping in resection of liver tumors involving the hepatocaval confluence

Objective: To review our experience in and the re-sults of resecting liver tumors involving the hepatoca-val confluence under intermittent portal triad clam-ping (PTC).Methods: Sixty-eight consecutive patients with livertumors involving the hepatocaval confluence under-went hepatectomies with liver parenchymal transec-tions under intermittent PTC.Results: All the tumors were successfully resected un-der PTC, except for one in which the infrahepatic in-ferior vena cava was concomitantly occluded in addi-tion to PTC. There was neither operative death noruncontrollable massive bleeding or air embolism oc-curred in our patients. The bleedings from the mainand short hepatic veins and right adrenal veins wereproperly managed during the operation, with a meanintraoperative blood loss of 1400 ml. Of the 68tumors resected, 65 were hepatocellular carcinomas(HCC). Their 1-, 2-, 3- and 4-year suvival rateswere 64.11%, 52. 82%, 44.90% and 36.98%, re-spectively, and the patients with HCC with capsulessurvived significantly longer than those with HCCwithout capsules.Conclusions: The liver tumors involving the hepato-caval confluence could be safely resected simply un-der PTC, without routine use of total hepatic vascu-lar exclusion. As for HCCs in this area, the tumorwith capsule is a better indicator for surgical resec-tion than that without capsule.

Clamping force of a multilayered cylindrical clamper with internalfriction

Holding an object by clamping force is a fundamental phenomena.Layered or laminated architectures with internal sliding features are essential mechanism in natural and man-made structural system.In this paper,we combine the layered architecture and clamping mechanism to form a multilayered clamper and study the clamping force with internal friction.Our investigations show that the clamping force and energy dissipation are very much depend on the number of layers,its geometry and elasticity,as well as internal friction.The central goal of studying the multilayered clamp is not only to predict the clamping force,but also as a representative case to help finding some clue on the universal behaviours of multilayered architectures with internal friction.

Study on a clamping device of leveling equipment mounted on jacket

This paper proposes a novel clamping device for leveling equipment mounted on offshore oil platform jacket,which solves the problem of leveling equipment clamping lifting force of more than 2000 tons.The main features are that lifting force transmits to clamp claw through wedge force amplifier,embed the teeth of claw into the pile,and the embedded depth increases with the lifting force,resulting in a gravitational self-locking function.This theoretical model of clamping device was established,and the force and material characteristic were analyzed,and the feasibility of the theoretical model was verified by thin shell elastic-plastic stability theory and thin-walled structures theory.An experimental prototype of clamping device was produced to test gravity self-locking function and bearable leveling force.Compared with the theoretical model and the experimental results,it proved that the embedded clamping devices have gravitational self-locking function and can meet the need of actual leveling equipment.

Effect of Delayed versus Early Cord Clamping on Neonatal Outcomes and Iron Status at 4 Months

Background: The optimal timing of umbilical cord clamping has been debated in the scientific literature for over a century. Early clamping of the umbilical cord is widely practised as part of the management of labour. Early clamping of the cord was one of the first routine medical interventions in labour. Its place in modern births was guaranteed by its incorporation into the triad of interventions that make up the active management of the third stage of labour. Babies who have immediate cord clamping have also been shown to be more likely to be anaemic, have decreased fine motor skills, and have decreased social skills during their first few years of age. Delayed umbilical cord clamping appears to have clear benefit for term infants. Delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first few months of life, which improve the developmental outcomes. There is growing evidence that delayed cord clamping is beneficial and can improve the infant’s iron status for up to 6 months after birth. For the first few minutes after birth, there is still circulation from the placenta to the infant. Waiting to clamp the umbilical cord for 2 - 3 min, or until cord pulsations cease, allows a physiological transfer of placental blood to the infant (placental transfusion), the majority of which occurs within 3 min. This placental transfusion provides sufficient iron reserves for the first 6 - 8 months of life, preventing or delaying the development of iron deficiency until other interventions. WHO’s findings suggest that late cord clamping (one to three minutes after delivery or longer) is recommended for all births. Aim of the study: 1) To evaluate the benefit of delayed cord clamping on the infant’s health status. 2) To assess hemoglobin, iron and ferritin at birth and at 4 months of age in infants who underwent early cord clamping (at 30 seconds) as compared with infants who underwent delayed cord clamping (at 60 seconds). Methods: A randomized controlled trial was conducted in Benghazi Medical Center and Elmgharif Hospital at Ejdabia. Study population was 256 women. The participants were randomized to delayed cord clamping or early cord clamping study groups. The data were checked manually for completeness, coded and analyzed by using Statistical Package for Social Sciences (SPSS). The incidence, relative risk, risk reduction, frequency percentage, mean, and standard deviation were used. Also t-test and chi sequare test (to test difference between means and proportions respectively) were used to compare between early and late cord clamping groups. Results: Two hundred forty seven participants completed the study (the attrition rate was 3.5%);121 (49%) were control group (early cord clamping) and 126 (51%) were study group (delayed cord clamping) group. At birth no significant difference between two groups regarding the level of hemoglobin, iron and ferritin. At 4th month of age delayed cord clamping was associated with improved hemoglobin, iron and ferritin and that the incidence of anemia among infants who exposed to delayed cord clamping was 0.07, while the incidence of anemia among the infants who exposed to early cord clamping was 0.5. Conclusion: There was strong association between delayed umbilical cord clamping and improvement of iron indices and developmental mile stones in infants at 4th month of age.