Postoperative functional evaluation of gastrectomy for gastric cancer

To improve the quality of surgical procedures for gastric cancer,it is essential to consider many components comprehensively,including gastric motility,small intestinal absorption,hormones that affect gastric motility and appetite,presence or absence of vagus nerve preservation,esophageal regurgitation on endoscopic findings,in addition to whether or not there is a physiological route for food passage through the duodenum.Furthermore,proper functional evaluation cannot be performed without considering the form and amount of energy in the nutritional supplement to be loaded,and the posture at the time of investigation.The results of functional evaluation vary according to the method selected from many available options,but we believe that use of the most physiologically accurate,appropriate and selectable option will enable us to arrive at the best resection/reconstruction technique.We have reported that it is important to consider the preservation of three elements when performing gastrectomy:1)reduction of the extent of gastrectomy,2)preservation of the pylorus,and 3)preservation of the vagus nerve;among which preservation of the remnant stomach is the most important.Furthermore,the selection of a reconstruction method that maintains secretion of hormones beneficial to gastric motility preserves the energy balance inherent in the human body,and also provides better quality of life.

Functional evaluation using several evoked spinal cord potentials in elderly patients with cervical spondylotic myelopathy

BACKGROUND: The recordings of evoked spinal cord potentials following epidural spinal cord stimulation are thought to be generated by volleys traversing the dorsal column pathway, and it may not directly reflect conduction defects in corticospinal tracts of cervical spinal cord. To our knowledge there has been few report using several evoked spinal cord potentials in function evaluation of the cervical spinal cord in elderly patients with cervical spondylotic myelopathy (CSM). OBJECTIVE: To investigate the function states of the cervical spinal cord in elderly patients with CSM and explore its pathophysiologic mechanism. DESIGN: Case observation. SETTING: Department of Orthopedics for the aged, Shenzhen Pingle Hospital of Orthopedics. Department of Orthopedic Surgery, Yamaguchi University School of Medicine. PARTICIPANTS: A total of 23 elderly patients with CSM who received treatment in the Department of Orthopedic Surgery, Yamaguchi University School of Medicine of Japan from January 2003 to February 2004 were enrolled in this study. Inclusive criteria: ① Multiple intervertebral levels of cervical spinal cord compression confirmed by MRI, e.g. 3 or more than 3 levels of compressin. ② Age ≥70 years old. ③ Numbness and sensory disturbance in the upper limbs and showed hyperreflexia in the lower limbs. Exclusive criteria: Patients with abnormal motor and sensory nerve conduction velocities in both upper and lower limbs were excluded. METHODS: Evoked spinal cord potentials (ESCPs) following transcranial electric stimulation (TCE-ESCPs), epidural spinal cord stimulation (Spinal-ESCPs) and median nerve stimulation (MN-ESCPs) were recorded in 23 patients from posterior epidural space intraoperatively. The abnormalities of TCE-ESCPs were defined as attenuation of amplitude of the D wave. The most cranial intervertebral level showing abnormal TCE-ESCPs with a marked reduction in size of the negative peak (reduction of over 50%) was considered as the upper level of the spinal cord lesion with respect to the corticospinal tract in white matter. The abnormalities of Spinal-ESCPs were defined as marked reduction in the size of negative peak (reduction of over 50%). The most caudal intervertebral level showing abnormal Spinal-ESCPs was considered as the lower level of the spinal cord lesion with respect to the dorsal column pathway in white matter. The abnormalities of MN-ESCPs were defined as attenuation of the N13 amplitude,which was considered as the lesion level of the spinal cord with respect to the dorsal horn in gray matter. Radiological investigation: Lateral view of plain X-ray films was obtained in flexion and extension of the cervical spine. Instability of the cervical intervertebral level was determined as horizontal displacement of the vertebral body of over 3 mm. MAIN OUTCOME MEASURES: The results of examination of TCE-ESCPs, Spinal-ESCPs and MN-ESCPs in elderly patients with CSM. RESULTS: The 23 elderly patients with CSM were participated in the result analysis. ①TCE-ESCPs: The impairment of the corticospinal tract in white matter at single intervertebral level was revealed in 18 of 23 patients by recordings of TCE-ESCPs (sensitivity 78%). In the 18 patients, the lesion level was shown at the upper cervical segment in 14 patients (C3-4 n=10 and C4-5 n=4), and at the lower cervical segment in 4 patients (C5-6 n=4). ②Spinal-ESCPs: The impairment of the dorsal column pathway of white matter at single intervertebral level was revealed in 17 of 23 patients, by recordings of Spinal-ESCPs (sensitivity 74%). In the 17 patients, the lesion level was presented at the upper cervical segment in 14 patients (C3-4 n=10 and C4-5 n=4), and at the lower cervical segment in 3 patients (C5-6 n=3). ③MN-ESCPs: All patients revealed abnormal MN-ESCPs at one or more intervertebral levels (sensitivity 100%). The impairment at single intervertebral level was demonstrated in 17 patients, and the impairment at multiple intervertebral levels was shown in 4 patients (3 patients at the C3-4, C4-5, and C5-6, and one patient at the C4-5, C5-6, and C6-7). ④Radiological findings: The Instability of the intervertebral level at the C3-4 or C4-5 motion segment was seen in 15 patients, with a total of 20 levels, and where 10 were at the C3-4 intervertebral level and 5 were at the C3-4, C4-5 intervertebral level. CONCLUSION: The results suggest that in most elderly patients with CSM who have multiple intervertebral level compressions of the cervical spinal cord on MRI, white matter is impaired at the single cervical intervertebral level, and not only the dorsal column pathway, but also the corticospinal tract can be affected. Combined the findings of radiography, the excessive motion and instability of the C3-4 or C4-5 intervertebral level plays an important role in inducing the long tract lesion in elderly patients with CSM.

Evaluation of the Effects of Cypermethrin on Female Reproductive Function by Using Rabbit Model and of the Protective Role of Chinese Propolis

对 cypermethrin 毒性的中国 propolis 的预防效果被执行卵巢和子宫组织病理学说，以及由描绘卵巢的功能，胚胎，和崽评估。Cypermethrin 在卵巢和子宫导致了 atypia，并且减少排卵地点和胚胎的数字。导致 Cypermethrin 的氧化应力在怀孕期间，减少后代的生产率以及数字和重量并且在后代增加了词法畸形性的发生。到对待 cypermethrin 的动物的 propolis 的管理减轻了导致 cypermethrin 的繁殖毒性。

Evaluation and structural analysis of the functions of the Tibetan Plateau National Park Cluster

National parks are useful entities for looking at coordinated efforts to improve the Tibetan Plateau’s function as an ecological safety barrier and the region’s green development.Research on the characteristics of the function structures of the Tibetan Plateau’s national parks is vital to promoting their systematic and coordinated development.This paper combines the pressure-state-response model,the rank-size rule and a coupling and coordination model to identify and evaluate the functions of national parks on the Tibetan Plateau and to analyze the categories,hierarchy and structures behind those functions.The results indicate the following:(1)The Tibetan Plateau National Park Cluster needs to maintain internal and external relations.Internally it needs to rationally allocate resources between ecological protection,recreation and community development,and externally it needs to promote its role as an ecological security barrier and promote regional green development by rationally ranking and organizing the individual national parks,so as to handle their co-evolution of functions at multiple scales.(2)Ecological protection,recreation and community development are the most prominent functions of the Tibetan Plateau National Park Cluster,but there is scope to develop their scientific research and education functions.The Zipf index shows that their multi-functional level conforms with the rank-size rule,indicating balanced development.Individual national parks need to strengthen their optimal functions according to their characteristic localization.(3)The degree of coupling between the functions of the Tibetan Plateau National Park Cluster is 0.7809,and the degree of coordination is 0.6227,which indicates a very strong coupling and moderate coordination.The coupling strength and degree of coordination between the multiple functions vary greatly among the individual national parks,which reflects their different function structures.There are four function structure types:fully coordinated,optimally developed,moderately developed and moderately underdeveloped.This study contributes to research on evaluating the functions of national park clusters and analyzing their structures,and it serves as a reference on optimizing and sustainably developing the Tibetan Plateau National Park Cluster.

Indocyanine green plasma clearance rate and 99mTc-galactosyl human serum albumin single-photon emission computed tomography evaluated preoperative remnant liver

BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the primary method of preoperative evaluation,although functional examination may be more accurate.We have used the functional evaluation liver using the indocyanine green plasma clearance rate(KICG)and 99mTc-galactosyl human serum albumin single-photon emission computed tomography(99mTc-GSA SPECT)for safe hepatectomy.AIM To analyze the safety of our institution’s system for evaluating the remnant liver reserve.METHODS We retrospectively reviewed the records of 23 patients who underwent preoperative PVE.Two types of remnant liver KICG were defined as follows:Anatomical volume remnant KICG(a-rem-KICG),determined as the remnant liver anatomical volume rate×KICG;and functional volume remnant KICG(frem-KICG),determined as the remnant liver functional volume rate based on 99mTc-GSA SPECT×KICG.If either of the remnant liver KICGs were>0.05,a hepatectomy was performed.Perioperative factors were analyzed.We defined the marginal group as patients with a-rem-KICG of<0.05 and a f-rem-KICG of>0.05 and compared the postoperative outcomes between the marginal and not marginal(both a-rem-KICG and f-rem-KICG>0.05)groups.RESULTS All 23 patients underwent planned hepatectomies.Right hepatectomy,right trisectionectomy and left trisectionectomy were in 16,6 and 1 cases,respectively.The mean of blood loss and operative time were 576 mL and 474 min,respectively.The increased amount of frem-KICG was significantly larger than that of a-rem-KICG after PVE(0.034 vs 0.012,P=0.0273).The not marginal and marginal groups had 17(73.9%)and 6(26.1%)patients,respectively.The complications of Clavian-Dindo classification grade II or higher and post-hepatectomy liver failure were observed in six(26.1%)and one(grade A,4.3%)patient,respectively.The 90-d mortality was zero.The marginal group had no significant difference in postoperative outcomes(prothrombin time/international normalised ratio,total bilirubin,complication,post-hepatectomy liver failure,hospital stay,90-d,and mortality)compared with the not-marginal group.CONCLUSION Functional evaluation of the remnant liver enabled safe hepatectomy and may extend the indication for hepatectomy after PVE treatment.

Construction and Management of Public Welfare Forest in Hainan Province

Through investigating ecological service functions of public welfare forest in Hainan Province, this paper explored type constitution and problems of its ecological service functional value, optimization of its scale and layout, promoted effective protection and benign development, and proposed strategies for the construction and management of public welfare forest in Hainan Province.

A fast auto-focusing method of microscopic imaging based on an improved MCS algorithm

An improved"three steps"mountain-climb searching(MCS)algorithm is proposed which is applied to auto-focusing for microscopic imaging accurately and efficiently.By analyzing the performance of several evaluation functions,the variance function and the Brenner function are synthesized as a new evaluation function.In the first step,a self-adaptive step length which is much dependent on the reciprocal of the evaluation function value at the beginning position of climbing is used for approaching the halfway up the mountain roughly.Secondly,a fixed moderate step length is applied for approaching the mountaintop of the variance function as closer as possible.Finally,afine step is employed for reaching the exact mountaintop of the Brenner function.The microscope auto-focusing experiments based on the proposed algorithm for blood smear detection have been carried out comprehensively.The results show that the improved algorithm can not only guarantee the precision to get clear focal images,but also improve the auto-focusing e±ciency.

Electron densitymap evaluation functions for determining the quality of protein crystal structures

Background Finding methods to judge the quality of X-ray crystallographic information is an active research topic.The quality of electron density maps reconstructed by Fourier transform is always limited by the finite resolution,the amplitude/phase error and the completeness of diffraction data.At present,the R value and effective resolution are common ways of evaluating the quality of electron density maps.Unfortunately,the current evaluation methods are only dependent on diffraction amplitude,without any phase information.Methods Advanced evaluation functions in real space are designed to estimate the electron density map quality.The electron density map definition evaluation function relies on the atomicity of the electron density distribution.We use the power spectrum electron density entropy in protein crystallography for the first time.These two functions include both structure factor amplitudes and phases via the Fourier transform of electron density map.Results We carry out tests on synthetic data sets of known structures,varying the resolution and error,and draw the quality curves of electron density maps with theoretical,noisy and experimental diffraction data by two evaluation functions at different resolutions.The curves reveal the optimum structure and resolution of proteins clearly.Conclusions The work presented here offers new methods to evaluate the qualities of the electron density maps of proteins with slight differences,and brand new indicators to select the optimum diffraction resolution of protein structures.

Acoustic transfer function of cavity and its application to rapid evaluation of sound field at low frequency band

A new method to obtain numerical solution of Acoustic Transfer Function (ATF) by BEM is presented. For a simply supported panel backed by a rectangular cavity at low frequency band (0-200 Hz), the frequency property of ATF is analyzed. The relation between the accuracy of the rapid evaluation of sound field and the discretization schemes of the vibrational panel is discussed. The result shows that the method to obtain ATF and the rapid evaluation of sound field using the ATF is suitable to low frequency band. If an appropriate discretization scheme is choosed based on the frequency involved and the effort to obtain ATF, the accuracy of the rapid evaluation of sound field is acceptable.

Design and Evaluation of an Exergame System of Knee with the Azure Kinect

Timely and effective knee function evaluation and knee exercises promote the prevention and self-management of knee diseases.In this paper,aKinectbased exergame system is proposed to assess and train the knee function.Azure Kinect was used to capture and generate 3D models of the user and immerse them in an interactive virtual environment.The software included three functional modules:knee function evaluation,Knee exercises game,and Comprehensive evaluation.The stand,step,leg lift,and squat were selected for knee function evaluation and exercises.Twenty volunteers participated in the experiment.Intraclass correlation coefficients(ICCs)were calculated to assess the reliability of kinematic measurements of knee angles during the movements.The ICC of these movements were stand(ICC=0.987),step(ICC=0.997),left leg lift(ICC=0.981),right leg lift(ICC=0.990),stand(ICC=0.998).The results show that the test-retest reliability is high.It means that the motion capture data is effective and the data obtained by Kinect is stable.

On Evaluating the Rate Function of Large Deviations for Jump Processes

This is a sequel to our joint paper in which upper bound estimates for large deviationsfor Markov chains are studied.The purpose of this paper is to characterize the rate function of large devia-tions for jump processes.In particular,an explicit expression of the rate function is given in the case of theprocess being symmetrizable.

“颈五针”穴位埋线治疗椎动脉型颈椎病疗效及对血流动力学的影响:随机临床试验

Objective:To observe the effect of catgut-embedding therapy at five neck points in the treatment of cervical spondylotic arteriopathy(CSA)and analyze its effects on the hemodynamics of patients with CSA.Methods:Using the computer randomization method,72 patients with CSA were divided into a catgutembedding therapy group(n=36,none dropped out)and a western medication group(n=36,none dropped out).In the catgut-embedding therapy group,the therapy was applied to five neck points,i.e.bilateral Jǐngjiājǐ(颈夹脊)at C5,bilateral Jǐngjiājǐ(颈夹脊)at C6,and Dàzhuī(大椎GV14)once a week.One3-week treatment session was required.In the western medication group,flunarizine hydrochloride 5 mg capsules were administered orally once daily for 3 weeks.Efficacy was assessed before and after 3 weeks treatment using a functional evaluation scale for cervical spondylotic arteriopathy(FS-CSA).Changes in vertebral-basilar arterial hemodynamics,serum nitric oxide(NO)level,and plasma endothelin(ET)level were detected.Results:Efficacy was assessed when the treatment session was completed.The total efficacy rate was significantly higher in the catgut-embedding therapy group(86.1%)than in the western medication group(61.1%;P<0.01).The after treatment FS-CSA score was reduced compared with baseline score in both groups(P<0.05),and the reduction in the catgut-embedding therapy group was superior to that in the Western medication group(P<0.05).Compared with baseline,the flow velocity and pulsatility index of the bilateral vertebral and basilar arteries increased at each period in both groups(P<0.05)except for the left systolic velocity of the vertebral artery after treatment.The increase in the catgut-embedding therapy group was greater than that in the western medication group(P<0.05).After treatment,the serum NO concentration was increased and the plasma ET concentration was reduced compared to baseline in both groups(P<0.05),while the improvements in the catgut-embedding therapy group were superior to those in the western medication group(P<0.05).Conclusion:The clinical efficacy in the catgut-embedding therapy group was superior to that in the western medication group.Catgut-embedding therapy at five neck points may effectively improve psychological and functional conditions,promote vertebral basilar arterial supply,and relieve clinical symptoms in patients with CSA.

Detecting P2P bots by mining the regional periodicity

Peer-to-peer (P2P) botnets outperform the traditional Internet relay chat (IRC) botnets in evading detection and they have become a prevailing type of threat to the Internet nowadays.Current methods for detecting P2P botnets,such as similarity analysis of network behavior and machine-learning based classification,cannot handle the challenges brought about by different network scenarios and botnet variants.We noticed that one important but neglected characteristic of P2P bots is that they periodically send requests to update their peer lists or receive commands from botmasters in the command-and-control (C&C) phase.In this paper,we propose a novel detection model named detection by mining regional periodicity (DMRP),including capturing the event time series,mining the hidden periodicity of host behaviors,and evaluating the mined periodic patterns to identify P2P bot traffic.As our detection model is built based on the basic properties of P2P protocols,it is difficult for P2P bots to avoid being detected as long as P2P protocols are employed in their C&C.For hidden periodicity mining,we introduce the so-called regional periodic pattern mining in a time series and present our algorithms to solve the mining problem.The experimental evaluation on public datasets demonstrates that the algorithms are promising for efficient P2P bot detection in the C&C phase.