São Paulo State has witnessed CO_(2)storage-based investigations considering the availability of suitable geologic structures and proximity to primary CO_(2)source sinks related to bioenergy and carbon capture an...São Paulo State has witnessed CO_(2)storage-based investigations considering the availability of suitable geologic structures and proximity to primary CO_(2)source sinks related to bioenergy and carbon capture and storage(BECCS)activities.The current study presents the hydrocarbon viability evaluations and CO_(2)storage prospects,focusing on the sandstone units of the Rio Bonito Formation.The objective is to apply petrophysical evaluations with geochemical inputs in predicting future hydrocarbon(gas)production to boost CO_(2)storage within the study location.The study used data from eleven wells with associated wireline logs(gamma ray,resistivity,density,neutron,and sonic)to predict potential hydrocarbon accumulation and fluid mobility in the investigated area.Rock samples(shale and carbonate)obtained from depths>200 m within the study location have shown bitumen presence.Organic geochemistry data of the Rio Bonito Formation shale beds suggest they are potential hydrocarbon source rocks and could have contributed to the gas accumulations within the sandstone units.Some drilled well data,e.g.,CB-1-SP and TI-1-SP,show hydrocarbon(gas)presence based on the typical resistivity and the combined neutron-density responses at depths up to 3400 m,indicating the possibility of other hydrocarbon members apart from the heavy oil(bitumen)observed from the near-surface rocks samples.From the three-dimensional(3-D)model,the free fluid indicator(FFI)is more significant towards the southwest and southeast of the area with deeper depths of occurrence,indicating portions with reasonable hydrocarbon recovery rates and good prospects for CO_(2)injection,circulation and permanent storage.However,future studies based on contemporary datasets are required to establish the hydrocarbon viability further,foster gas production events,and enhance CO_(2)storage possibilities within the region.展开更多
It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follo...It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.展开更多
BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.MET...BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.METHODS A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018.Patients were classified into four groups based on the clinical grading system and treatment:(1)Observation group with score<4(Obs score<4);(2)Surgical group with score<4(Sur score<4);(3)Observation group with score≥4(Obs score≥4);and(4)Surgical group with score≥4(Sur score≥4).The clinico-pathological index and outcomes were evaluated.RESULTS There were significantly fewer symptomatic patients in surgical groups(Sur score≥4 vs Obs score≥4,P<0.001;Sur score<4 vs Obs score<4,χ^(2)=8.60,P=0.004;Sur score≥4 vs Obs score<4,P<0.001).The patients in Sur score≥4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score≥4(P<0.001;P<0.001).Nevertheless,there was no significant difference in need for intervention and total patients with adverse event between the Sur score<4 and Obs score<4(P>0.05;χ^(2)=1.68,P>0.05).CONCLUSION This clinical grading system appeared as a practical tool for hepatic hemangioma.Surgery can be suggested for patients with a score≥4.For those with<4,follow-up should be proposed.展开更多
Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital na...Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the Ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). Indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. Indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.展开更多
Taiyuan formation is the main exploration strata in Ordos Basin, and coals are widely developed. Due to the interference of strong reflection of coals, we cannot completely identify the effective reservoir information...Taiyuan formation is the main exploration strata in Ordos Basin, and coals are widely developed. Due to the interference of strong reflection of coals, we cannot completely identify the effective reservoir information of coal-bearing reservoir on seismic data. Previous researchers have studied the reservoir by stripping or weakening the strong reflection, but it is difficult to determine the effectiveness of the remaining reflection seismic data. In this paper, through the establishment of 2D forward model of coal-bearing strata, the corresponding geophysical characteristics of different reflection types of coal-bearing strata are analyzed, and then the favorable sedimentary facies zones for reservoir development are predicted. On this basis, combined with seismic properties, the coal-bearing reservoir is quantitatively characterized by seismic inversion. The above research shows that the Taiyuan formation in LS block of Ordos Basin is affected by coals and forms three or two peaks in different locations. The reservoir plane sedimentary facies zone is effectively characterized by seismic reflection structure. Based on the characteristics of sedimentary facies belt and petrophysical analysis, the reservoir is semi quantitatively characterized by attribute analysis and waveform indication, and quantitatively characterized by pre stack geostatistical inversion. Based on the forward analysis of coal measure strata, this technology characterizes the reservoir facies belt through seismic reflection characteristics, and describes coal measure reservoirs step by step. It effectively guides the exploration of LS block in Ordos Basin, and has achieved good practical application effect.展开更多
As China s largest oil crop,rape occupies a central position in ensuring the safety of China s cooking oil supply.This paper introduced China s rapeseed industry from the rape type,rapeseed production,planting area,na...As China s largest oil crop,rape occupies a central position in ensuring the safety of China s cooking oil supply.This paper introduced China s rapeseed industry from the rape type,rapeseed production,planting area,national rapeseed production protected area,rape national dominant characteristic industrial clusters,and rapeseed industry,etc.Besides,from the aspects of geographical indication products,geographical indication trademarks,and geographical indications of agricultural products,this paper discussed the intellectual property protection of geographical indications of rape,rapeseed,and rapeseed oil in China.It analyzed the main problems such as the lag in the formulation of relevant standards for geographical indications and the low use of special signs for geographical indications,and finally came up with recommendations including building a public brand of geographical indications and expanding foreign exchanges of geographical indications.展开更多
BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interv...BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interventions utilized among these patients is poorly studied.AIM To evaluate the surgical indications,timing,perioperative precautions and postoperative complications of PAs during pregnancy and to provide comprehensive guidance.METHODS Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 were recruited for this study.Another 35 pregnant patients who were profiled in the literature were included in our analysis.RESULTS The 41 enrolled patients had acute symptoms including visual field defects,severe headaches or vision loss that required emergency pituitary surgeries.PA apoplexies were found in 23 patients.The majority of patients(55.9%)underwent surgery in the second trimester of pregnancy.A multidisciplinary team was involved in patient care from the preoperative period through the postpartum period.With the exception of 1 patient who underwent an induced abortion and 1 fetus that died due to a nuchal cord,39 patients delivered successfully.Among them,37 fetuses were healthy until the most recent follow-up.CONCLUSION PA surgery during pregnancy is effective and safe during the second and third trimesters.Pregnant patients requiring emergency PA surgery require multidisciplinary evaluation and healthcare management.展开更多
Background: Trial of labor after cesarean delivery (TOLAC) has long been accepted as a safe option for women with previous cesarean delivery. Previous efforts have been exerted in trials to predict the success rates o...Background: Trial of labor after cesarean delivery (TOLAC) has long been accepted as a safe option for women with previous cesarean delivery. Previous efforts have been exerted in trials to predict the success rates of TOLAC according to specific parameters related to previous cesarean section and before TOLAC. We aimed to investigate the different indications of previous cesarean delivery as independent predictors for successful vaginal birth. Methods: A retrospective study was conducted in Armed Forces Hospitals of the Southern Region between December 15, 2019, and July 1, 2020. The included 566 patients with previous cesarean section who were willing to undergo a trial of labor were divided into two groups according to the success of vaginal birth (VBAC). Results: The nonrecurring indications for previous cesarean delivery were higher in the successful group (fetal distress 54.7% vs 41.1%, malpresentation 26% vs 21.4%, multifetal pregnancy 3.8% vs 2.7%). Additionally, the successful VBAC group had a significantly higher percentage of previous successful VBAC (47.7% vs 21.9%) and prior vaginal deliveries (58.5% vs 44.2%) and less coincidence of medical disorders and meconium-stained liquor (18.1% vs 26.3% and 3.2% vs 8.2%, respectively) than the unsuccessful group. Conclusion: During counseling regarding trial of labor after cesarean section, indications for previous cesarean section not related to arrest of labor can predict higher success of VBAC. Moreover, previous successful vaginal delivery or VBAC improves the success rates.展开更多
Introduction: Cesarean section is a surgical intervention which consists in the extraction of a fetus from the uterus after its incision. The rate of cesarean section varies depending on the country and the health fac...Introduction: Cesarean section is a surgical intervention which consists in the extraction of a fetus from the uterus after its incision. The rate of cesarean section varies depending on the country and the health facility. For this reason, in 2015, the World Health Organization (WHO) recommended the use of Robson’s classification to evaluate the practice of cesarean sections in order to identify the groups of women who had abnormally high rates. The objective of our study was to evaluate cesarean sections using the Robson’s classification in CHRACERH and in the Yaoundé Central Hospital (YCH). Methodology: We carried out a retrospective cross sectional and descriptive study in two (02) university hospitals in Yaoundé which took place from December 2017 to May 2018. We included in our study all women who gave birth over a period of two (02) years from January 2016 to December 2017 in these two health facilities. Our sampling was exhaustive over the study period. The parturients’ information was collected using an anonymous and pretested questionnaire. The Robson’s group of every parturient was determined. Descriptive parameters like mean and proportions were calculated. We compared the rates and indications of cesarean sections between the both hospitals using Chi<sup>2</sup> test. Results: Out of 330 deliveries realized in CHRACERH, we had 90 cesarean sections;hence, a rate of 27.2%. Out of 1863 deliveries carried out at the YCH, 462 were by cesarean section, hence a rate of 24.8%. The women who belonged to groups 1, 3 and 5 contributed to the highest rates of cesarean sections in both hospitals: in CHRACERH, group 5 (31.1%), group 3 (20%) and group 1 (15.6%), at YCH: group 3 (22.5%), group 1 (21.6%) and group 5 (17.3%). The indications of the cesarean sections varied depending on the Robson’s group and the hospital, the principal indication in group 1 was acute fetal distress (28.6%) in CHRACERH and cephalopelvic disproportion (36.7%) at YCH. Cephalopelvic disproportion was the predominant indication in groups 3 of CHRACERH (44.4%) and YCH (39.2%). In groups 5, CHRACERH and of YCH, a scarred uterus was the principal indication for the cesarean section at 82.4% and 78.4% respectively. At CHRACERH, the maternofetal complications were more frequent in groups 1 and 2 at the YCH, this was the case mostly in groups 1 and 3. Conclusion: The Robson’s classification is an adequate tool for the evaluation and comparison of the rates of cesarean sections. The rates of cesarean section in CHRACERH (27.2%) and at YCH (24.8%) were higher than the rates recommended by WHO. Robson’s groups 1, 3 and 5 were identified as the groups most at risk for cesarean sections in the both hospitals.展开更多
Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as wel...Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as well as the results by comparing them with the data in the literature. This was a retrospective study covering a sixteen-year period from January 2003 to December 2018. We collated 29 patient records from 3 to 15 years of age. The epidemiological aspect, the indication and the operative gesture, the anatomopathological result were studied. Data were processed using Epi Info version 3.5.4 and Microsoft Excel 2010. Our study shows that thyroid surgery in children accounted for 2% of all thyroidectomies performed (1350 cases). Females were most affected, with a sex ratio of 0.16. The mean age was 12 years, with extremes of 3 and 15 years. Three indication groups: Graves’ disease 62%, heteromulti nodular goiter (HMNG) 28%, thyroid nodule 10%. Thyroid surgery was total in 65.5% of cases;subtotal thyroidectomy in 20.7%. Partial thyroidectomy was performed in 13.7% of cases. We dissected 54 recurrent nerves, and the parathyroids were controlled. Drainage was systematic. We noted one complication (3.4%). It involved immediate postoperative dyspnea requiring a life-saving tracheotomy, and decanulation was performed 48 hours after surgery.展开更多
The pedestrian timing at signalized intersections is studied aiming at the problems of the inconsistency of the vehicular and pedestrian timing requirements and the insufficiency of pedestrian clearance. Based on the ...The pedestrian timing at signalized intersections is studied aiming at the problems of the inconsistency of the vehicular and pedestrian timing requirements and the insufficiency of pedestrian clearance. Based on the formulae of WALK and flashing DON'T WALK (FDW) in the highway capacity manual (HCM), the relationship between pedestrian signal indications and vehicular signal indications is discussed using the theory of traffic flow. Then, methods of pedestrian timing for different cases are established, particularly the methods of the pedestrian green adjustment. Ways of pedestrian crossing are analyzed for roadways with different forms and widths of the median island. The sampling values of calculation parameters are studied, and the recommended formulae of pedestrian timing for different conditions are presented.展开更多
In the study, analysis was made on present situation and development measures of geographical indications and cultural heritage protection of famous teas in Hubei Province. In addition, 8 related suggestions were prop...In the study, analysis was made on present situation and development measures of geographical indications and cultural heritage protection of famous teas in Hubei Province. In addition, 8 related suggestions were proposed as well.展开更多
感知节点的定位是无线传感网应用的基础。现有的静态定位算法无法应用于动态传感网。针对一类目标节点移动而锚节点静止的传感网应用,提出了一种RRMCL(RSSI Rank Monte Carlo Localization)定位算法。该算法以蒙特卡罗算法为基础,利用RS...感知节点的定位是无线传感网应用的基础。现有的静态定位算法无法应用于动态传感网。针对一类目标节点移动而锚节点静止的传感网应用,提出了一种RRMCL(RSSI Rank Monte Carlo Localization)定位算法。该算法以蒙特卡罗算法为基础,利用RSSI(Received Signal Strength Indication)值与距离的单调递减关系划分通信域,减少采样区域大小。为了避免锚节点共线出现定位失效的情况,引入共线影响角度,提出了一种约束策略。仿真结果表明,提出的RRMCL与现有的MCL和MCB定位算法相比,能有效缩小采样区域,提高了定位精度和速度。展开更多
Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known...Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system.展开更多
Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiv...Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiveness in resecting lesions regardless of their size and severity of fibrosis.Based on excellent outcomes for esophageal neoplasms with a small likelihood of lymph node metastasis,the number of ESD candidates has increased.On the other hand,ESD still requires highly skilled endoscopists due to technical difficulties.To avoid unnecessary complications including perforation and postoperative stricture,the indications for ESD require careful consideration and a full understanding of this modality.This article,in the highlight topic series,provides detailed information on the indication,procedure,outcome,complications and their prevention in ESD of superficial esophageal neoplasms.展开更多
Endoscopic mucosal resection (EMR) has been established as one of the treatment options for early gastric cancer (EGC). However, there are many uncertain areas such as indications of EIR, best treatment methods, m...Endoscopic mucosal resection (EMR) has been established as one of the treatment options for early gastric cancer (EGC). However, there are many uncertain areas such as indications of EIR, best treatment methods, management of complications and follow-up methods after the procedure. Host studies on this topic have been carried out by researchers in Japan. In Korea, gastric cancer is the most common malignant disease, and the second leading cause of cancer death. In these days, EIR for EGC is widely performed in many centers in Korea. In this review, we will provide an overview of the bechniques and outcomes of EIR in Korea.展开更多
The technique of endoscopic submucosal dissection(ESD),which was developed for en bloc resection of large lesions in the stomach,has been widely accepted for the treatment of the entire gastrointestinal tract.Many min...The technique of endoscopic submucosal dissection(ESD),which was developed for en bloc resection of large lesions in the stomach,has been widely accepted for the treatment of the entire gastrointestinal tract.Many minimally invasive endoscopic therapies based on ESD have been developed recently.Endoscopic submucosal excavation,submucosal tunneling endoscopic resection and laparoscopic-endoscopic cooperative surgery have been used to remove submucosal tumors,especially tumors which originate from the muscularis propria of the digestive tract.Peroral endoscopic myotomy has recently been described as a scarless and less invasive surgical myotomy option for the treatment of achalasia.Patients benefit from minimally invasive endoscopic therapy.This article,in the highlight topic series,provides detailed information on the indications and treatments for esophageal diseases.展开更多
基金sponsored by Fundação de Amparoa Pesquisa do Estado de São Paulo(FAPESP)(2014/50279-4,2020/15230-5,2021/06158-1)Shell Brasil.
文摘São Paulo State has witnessed CO_(2)storage-based investigations considering the availability of suitable geologic structures and proximity to primary CO_(2)source sinks related to bioenergy and carbon capture and storage(BECCS)activities.The current study presents the hydrocarbon viability evaluations and CO_(2)storage prospects,focusing on the sandstone units of the Rio Bonito Formation.The objective is to apply petrophysical evaluations with geochemical inputs in predicting future hydrocarbon(gas)production to boost CO_(2)storage within the study location.The study used data from eleven wells with associated wireline logs(gamma ray,resistivity,density,neutron,and sonic)to predict potential hydrocarbon accumulation and fluid mobility in the investigated area.Rock samples(shale and carbonate)obtained from depths>200 m within the study location have shown bitumen presence.Organic geochemistry data of the Rio Bonito Formation shale beds suggest they are potential hydrocarbon source rocks and could have contributed to the gas accumulations within the sandstone units.Some drilled well data,e.g.,CB-1-SP and TI-1-SP,show hydrocarbon(gas)presence based on the typical resistivity and the combined neutron-density responses at depths up to 3400 m,indicating the possibility of other hydrocarbon members apart from the heavy oil(bitumen)observed from the near-surface rocks samples.From the three-dimensional(3-D)model,the free fluid indicator(FFI)is more significant towards the southwest and southeast of the area with deeper depths of occurrence,indicating portions with reasonable hydrocarbon recovery rates and good prospects for CO_(2)injection,circulation and permanent storage.However,future studies based on contemporary datasets are required to establish the hydrocarbon viability further,foster gas production events,and enhance CO_(2)storage possibilities within the region.
文摘It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.
文摘BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.METHODS A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018.Patients were classified into four groups based on the clinical grading system and treatment:(1)Observation group with score<4(Obs score<4);(2)Surgical group with score<4(Sur score<4);(3)Observation group with score≥4(Obs score≥4);and(4)Surgical group with score≥4(Sur score≥4).The clinico-pathological index and outcomes were evaluated.RESULTS There were significantly fewer symptomatic patients in surgical groups(Sur score≥4 vs Obs score≥4,P<0.001;Sur score<4 vs Obs score<4,χ^(2)=8.60,P=0.004;Sur score≥4 vs Obs score<4,P<0.001).The patients in Sur score≥4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score≥4(P<0.001;P<0.001).Nevertheless,there was no significant difference in need for intervention and total patients with adverse event between the Sur score<4 and Obs score<4(P>0.05;χ^(2)=1.68,P>0.05).CONCLUSION This clinical grading system appeared as a practical tool for hepatic hemangioma.Surgery can be suggested for patients with a score≥4.For those with<4,follow-up should be proposed.
文摘Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the Ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). Indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. Indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.
文摘Taiyuan formation is the main exploration strata in Ordos Basin, and coals are widely developed. Due to the interference of strong reflection of coals, we cannot completely identify the effective reservoir information of coal-bearing reservoir on seismic data. Previous researchers have studied the reservoir by stripping or weakening the strong reflection, but it is difficult to determine the effectiveness of the remaining reflection seismic data. In this paper, through the establishment of 2D forward model of coal-bearing strata, the corresponding geophysical characteristics of different reflection types of coal-bearing strata are analyzed, and then the favorable sedimentary facies zones for reservoir development are predicted. On this basis, combined with seismic properties, the coal-bearing reservoir is quantitatively characterized by seismic inversion. The above research shows that the Taiyuan formation in LS block of Ordos Basin is affected by coals and forms three or two peaks in different locations. The reservoir plane sedimentary facies zone is effectively characterized by seismic reflection structure. Based on the characteristics of sedimentary facies belt and petrophysical analysis, the reservoir is semi quantitatively characterized by attribute analysis and waveform indication, and quantitatively characterized by pre stack geostatistical inversion. Based on the forward analysis of coal measure strata, this technology characterizes the reservoir facies belt through seismic reflection characteristics, and describes coal measure reservoirs step by step. It effectively guides the exploration of LS block in Ordos Basin, and has achieved good practical application effect.
基金Youth Project of the National Social Science Fund of China(22CMZ015).
文摘As China s largest oil crop,rape occupies a central position in ensuring the safety of China s cooking oil supply.This paper introduced China s rapeseed industry from the rape type,rapeseed production,planting area,national rapeseed production protected area,rape national dominant characteristic industrial clusters,and rapeseed industry,etc.Besides,from the aspects of geographical indication products,geographical indication trademarks,and geographical indications of agricultural products,this paper discussed the intellectual property protection of geographical indications of rape,rapeseed,and rapeseed oil in China.It analyzed the main problems such as the lag in the formulation of relevant standards for geographical indications and the low use of special signs for geographical indications,and finally came up with recommendations including building a public brand of geographical indications and expanding foreign exchanges of geographical indications.
文摘BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interventions utilized among these patients is poorly studied.AIM To evaluate the surgical indications,timing,perioperative precautions and postoperative complications of PAs during pregnancy and to provide comprehensive guidance.METHODS Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 were recruited for this study.Another 35 pregnant patients who were profiled in the literature were included in our analysis.RESULTS The 41 enrolled patients had acute symptoms including visual field defects,severe headaches or vision loss that required emergency pituitary surgeries.PA apoplexies were found in 23 patients.The majority of patients(55.9%)underwent surgery in the second trimester of pregnancy.A multidisciplinary team was involved in patient care from the preoperative period through the postpartum period.With the exception of 1 patient who underwent an induced abortion and 1 fetus that died due to a nuchal cord,39 patients delivered successfully.Among them,37 fetuses were healthy until the most recent follow-up.CONCLUSION PA surgery during pregnancy is effective and safe during the second and third trimesters.Pregnant patients requiring emergency PA surgery require multidisciplinary evaluation and healthcare management.
文摘Background: Trial of labor after cesarean delivery (TOLAC) has long been accepted as a safe option for women with previous cesarean delivery. Previous efforts have been exerted in trials to predict the success rates of TOLAC according to specific parameters related to previous cesarean section and before TOLAC. We aimed to investigate the different indications of previous cesarean delivery as independent predictors for successful vaginal birth. Methods: A retrospective study was conducted in Armed Forces Hospitals of the Southern Region between December 15, 2019, and July 1, 2020. The included 566 patients with previous cesarean section who were willing to undergo a trial of labor were divided into two groups according to the success of vaginal birth (VBAC). Results: The nonrecurring indications for previous cesarean delivery were higher in the successful group (fetal distress 54.7% vs 41.1%, malpresentation 26% vs 21.4%, multifetal pregnancy 3.8% vs 2.7%). Additionally, the successful VBAC group had a significantly higher percentage of previous successful VBAC (47.7% vs 21.9%) and prior vaginal deliveries (58.5% vs 44.2%) and less coincidence of medical disorders and meconium-stained liquor (18.1% vs 26.3% and 3.2% vs 8.2%, respectively) than the unsuccessful group. Conclusion: During counseling regarding trial of labor after cesarean section, indications for previous cesarean section not related to arrest of labor can predict higher success of VBAC. Moreover, previous successful vaginal delivery or VBAC improves the success rates.
文摘Introduction: Cesarean section is a surgical intervention which consists in the extraction of a fetus from the uterus after its incision. The rate of cesarean section varies depending on the country and the health facility. For this reason, in 2015, the World Health Organization (WHO) recommended the use of Robson’s classification to evaluate the practice of cesarean sections in order to identify the groups of women who had abnormally high rates. The objective of our study was to evaluate cesarean sections using the Robson’s classification in CHRACERH and in the Yaoundé Central Hospital (YCH). Methodology: We carried out a retrospective cross sectional and descriptive study in two (02) university hospitals in Yaoundé which took place from December 2017 to May 2018. We included in our study all women who gave birth over a period of two (02) years from January 2016 to December 2017 in these two health facilities. Our sampling was exhaustive over the study period. The parturients’ information was collected using an anonymous and pretested questionnaire. The Robson’s group of every parturient was determined. Descriptive parameters like mean and proportions were calculated. We compared the rates and indications of cesarean sections between the both hospitals using Chi<sup>2</sup> test. Results: Out of 330 deliveries realized in CHRACERH, we had 90 cesarean sections;hence, a rate of 27.2%. Out of 1863 deliveries carried out at the YCH, 462 were by cesarean section, hence a rate of 24.8%. The women who belonged to groups 1, 3 and 5 contributed to the highest rates of cesarean sections in both hospitals: in CHRACERH, group 5 (31.1%), group 3 (20%) and group 1 (15.6%), at YCH: group 3 (22.5%), group 1 (21.6%) and group 5 (17.3%). The indications of the cesarean sections varied depending on the Robson’s group and the hospital, the principal indication in group 1 was acute fetal distress (28.6%) in CHRACERH and cephalopelvic disproportion (36.7%) at YCH. Cephalopelvic disproportion was the predominant indication in groups 3 of CHRACERH (44.4%) and YCH (39.2%). In groups 5, CHRACERH and of YCH, a scarred uterus was the principal indication for the cesarean section at 82.4% and 78.4% respectively. At CHRACERH, the maternofetal complications were more frequent in groups 1 and 2 at the YCH, this was the case mostly in groups 1 and 3. Conclusion: The Robson’s classification is an adequate tool for the evaluation and comparison of the rates of cesarean sections. The rates of cesarean section in CHRACERH (27.2%) and at YCH (24.8%) were higher than the rates recommended by WHO. Robson’s groups 1, 3 and 5 were identified as the groups most at risk for cesarean sections in the both hospitals.
文摘Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as well as the results by comparing them with the data in the literature. This was a retrospective study covering a sixteen-year period from January 2003 to December 2018. We collated 29 patient records from 3 to 15 years of age. The epidemiological aspect, the indication and the operative gesture, the anatomopathological result were studied. Data were processed using Epi Info version 3.5.4 and Microsoft Excel 2010. Our study shows that thyroid surgery in children accounted for 2% of all thyroidectomies performed (1350 cases). Females were most affected, with a sex ratio of 0.16. The mean age was 12 years, with extremes of 3 and 15 years. Three indication groups: Graves’ disease 62%, heteromulti nodular goiter (HMNG) 28%, thyroid nodule 10%. Thyroid surgery was total in 65.5% of cases;subtotal thyroidectomy in 20.7%. Partial thyroidectomy was performed in 13.7% of cases. We dissected 54 recurrent nerves, and the parathyroids were controlled. Drainage was systematic. We noted one complication (3.4%). It involved immediate postoperative dyspnea requiring a life-saving tracheotomy, and decanulation was performed 48 hours after surgery.
基金The National Natural Science Foundation of China(No50378016)
文摘The pedestrian timing at signalized intersections is studied aiming at the problems of the inconsistency of the vehicular and pedestrian timing requirements and the insufficiency of pedestrian clearance. Based on the formulae of WALK and flashing DON'T WALK (FDW) in the highway capacity manual (HCM), the relationship between pedestrian signal indications and vehicular signal indications is discussed using the theory of traffic flow. Then, methods of pedestrian timing for different cases are established, particularly the methods of the pedestrian green adjustment. Ways of pedestrian crossing are analyzed for roadways with different forms and widths of the median island. The sampling values of calculation parameters are studied, and the recommended formulae of pedestrian timing for different conditions are presented.
基金Supported by Project of Scientific and Technological Innovations by Ministry of Culture(2011021)Foundation Project of Humanities and Social Sciences of Education Department (11YJA850019)Project supported by "11th Five-Year Plan" of Hubei Socia Sciences Foundation ([2010]274)~~
文摘In the study, analysis was made on present situation and development measures of geographical indications and cultural heritage protection of famous teas in Hubei Province. In addition, 8 related suggestions were proposed as well.
文摘感知节点的定位是无线传感网应用的基础。现有的静态定位算法无法应用于动态传感网。针对一类目标节点移动而锚节点静止的传感网应用,提出了一种RRMCL(RSSI Rank Monte Carlo Localization)定位算法。该算法以蒙特卡罗算法为基础,利用RSSI(Received Signal Strength Indication)值与距离的单调递减关系划分通信域,减少采样区域大小。为了避免锚节点共线出现定位失效的情况,引入共线影响角度,提出了一种约束策略。仿真结果表明,提出的RRMCL与现有的MCL和MCB定位算法相比,能有效缩小采样区域,提高了定位精度和速度。
文摘Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system.
文摘Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiveness in resecting lesions regardless of their size and severity of fibrosis.Based on excellent outcomes for esophageal neoplasms with a small likelihood of lymph node metastasis,the number of ESD candidates has increased.On the other hand,ESD still requires highly skilled endoscopists due to technical difficulties.To avoid unnecessary complications including perforation and postoperative stricture,the indications for ESD require careful consideration and a full understanding of this modality.This article,in the highlight topic series,provides detailed information on the indication,procedure,outcome,complications and their prevention in ESD of superficial esophageal neoplasms.
文摘Endoscopic mucosal resection (EMR) has been established as one of the treatment options for early gastric cancer (EGC). However, there are many uncertain areas such as indications of EIR, best treatment methods, management of complications and follow-up methods after the procedure. Host studies on this topic have been carried out by researchers in Japan. In Korea, gastric cancer is the most common malignant disease, and the second leading cause of cancer death. In these days, EIR for EGC is widely performed in many centers in Korea. In this review, we will provide an overview of the bechniques and outcomes of EIR in Korea.
基金Supported by National Natural Science Funds of China,No.81101566Scientific Funds of Shanghai Government,11DZ2280400,12QA1400600,XYQ2011017,11411950500
文摘The technique of endoscopic submucosal dissection(ESD),which was developed for en bloc resection of large lesions in the stomach,has been widely accepted for the treatment of the entire gastrointestinal tract.Many minimally invasive endoscopic therapies based on ESD have been developed recently.Endoscopic submucosal excavation,submucosal tunneling endoscopic resection and laparoscopic-endoscopic cooperative surgery have been used to remove submucosal tumors,especially tumors which originate from the muscularis propria of the digestive tract.Peroral endoscopic myotomy has recently been described as a scarless and less invasive surgical myotomy option for the treatment of achalasia.Patients benefit from minimally invasive endoscopic therapy.This article,in the highlight topic series,provides detailed information on the indications and treatments for esophageal diseases.