This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and t...This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and the Muller maneuver（MM）. Seven patients with OSAS were involved to perform computed tomographic（CT） scanning during quiet respiration and the MM. CT data in DICOM format were transformed into an anatomically three-dimensional computational fluid dynamics（CFD） model of the upper airway. The velocity magnitude, relative pressure, and flow distribution were obtained. Numerical simulation of airflow was performed to discuss how the MM affected airflow in the upper airway. To measure the discrepancy, the SPSS19.0 software package was utilized for statistic analysis. The results showed that the shape of the upper airway became narrower, and the pressure decreased during the MM. The minimal cross-sectional area（MCSA） of velopharynx was significantly decreased（P〈0.05） and the airflow velocity in MCSAs of velopharynx and glossopharynx significantly accelerated（P〈0.05） during the MM. This study demonstrated the possibility of CFD model combined with the MM for understanding pharyngeal aerodynamics in the pathophysiology of OSAS.展开更多
BACKGROUND Robotic surgery has been considered to be significantly better than laparoscopic surgery for complicated procedures.AIM To explore the short-term effect of robotic and laparoscopic spleen-preserving splenic...BACKGROUND Robotic surgery has been considered to be significantly better than laparoscopic surgery for complicated procedures.AIM To explore the short-term effect of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy(SPSHL)for advanced gastric cancer(GC)by Huang’s three-step maneuver.METHODS A total of 643 patients who underwent SPSHL were recruited from April 2012 to July 2017,including 35 patients who underwent robotic SPSHL(RSPSHL)and 608 who underwent laparoscopic SPSHL(LSPSHL).One-to-four propensity score matching was used to analyze the differences in clinical data between patients who underwent robotic SPSHL and those who underwent laparoscopic SPSHL.RESULTS In all,175 patients were matched,including 35 patients who underwent RSPSHL and 140 who underwent LSPSHL.After matching,there were no significant differences detected in the baseline characteristics between the two groups.Significant differences in total operative time,estimated blood loss(EBL),splenic hilar blood loss(SHBL),splenic hilar dissection time(SHDT),and splenic trunk dissection time were evident between these groups(P<0.05).Furthermore,no significant differences were observed between the two groups in the overall noncompliance rate of lymph node(LN)dissection(62.9%vs 60%,P=0.757),number of retrieved No.10 LNs(3.1±1.4 vs 3.3±2.5,P=0.650),total number of examined LNs(37.8±13.1 vs 40.6±13.6,P=0.274),and postoperative complications(14.3%vs 17.9%,P=0.616).A stratified analysis that divided the patients receiving RSPSHL into an early group(EG)and a late group(LG)revealed that the LG experienced obvious improvements in SHDT and length of stay compared with the EG(P<0.05).Logistic regression showed that robotic surgery was a significantly protective factor against both SHBL and SHDT(P<0.05).CONCLUSION RSPSHL is safe and feasible,especially after overcoming the early learning curve,as this procedure results in a radical curative effect equivalent to that of LSPSHL.展开更多
This paper is mainly concerned with the coupling dynamic analysis of a complex spacecraft consisting of one main rigid platform, multiple liquid-filled cylindrical tanks, and a number of flexible appendages. Firstly, ...This paper is mainly concerned with the coupling dynamic analysis of a complex spacecraft consisting of one main rigid platform, multiple liquid-filled cylindrical tanks, and a number of flexible appendages. Firstly, the carrier potential function equations of liquid in the tanks are deduced according to the wall boundary conditions. Through employ- ing the Fourier-Bessel series expansion method, the dynamic boundaries conditions on a curved free-surface under a low-gravity environment are transformed to general simple differential equations and the rigid-liquid coupled sloshing dynamic state equations of liquid in tanks are obtained. The state vectors of rigid-liquid coupled equations are composed with the modal coordinates of the relative potential func- tion and the modal coordinates of wave height. Based on the B ernoulli-Euler beam theory and the D＇Alembert＇s prin- ciple, the rigid-flexible coupled dynamic state equations of flexible appendages are directly derived, and the coordi- nate transform matrixes of maneuvering flexible appendages are precisely computed as time-varying. Then, the cou- pling dynamics state equations of the overall system of the spacecraft are modularly built by means of the Lagrange＇s equations in terms of quasi-coordinates. Lastly, the cou-piing dynamic performances of a typical complex spacecraft are studied. The availability and reliability of the presented method are also confirmed.展开更多
基金supported by grants from Shanghai College Young Teacher Training Program(No.shjdy029)Youth Projects of Shanghai Municipality Health and Family Planning Commission(No.20144Y0124)
文摘This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and the Muller maneuver（MM）. Seven patients with OSAS were involved to perform computed tomographic（CT） scanning during quiet respiration and the MM. CT data in DICOM format were transformed into an anatomically three-dimensional computational fluid dynamics（CFD） model of the upper airway. The velocity magnitude, relative pressure, and flow distribution were obtained. Numerical simulation of airflow was performed to discuss how the MM affected airflow in the upper airway. To measure the discrepancy, the SPSS19.0 software package was utilized for statistic analysis. The results showed that the shape of the upper airway became narrower, and the pressure decreased during the MM. The minimal cross-sectional area（MCSA） of velopharynx was significantly decreased（P〈0.05） and the airflow velocity in MCSAs of velopharynx and glossopharynx significantly accelerated（P〈0.05） during the MM. This study demonstrated the possibility of CFD model combined with the MM for understanding pharyngeal aerodynamics in the pathophysiology of OSAS.
基金Supported by the Scientific and Technological Innovation Joint Capital Projects of Fujian Province,China,No.2016Y9031the Construction Project of Fujian Province Minimally Invasive Medical Center,No.[2017]171+2 种基金the Second-batch Special Support Funds for Fujian Province Innovation and Entrepreneurship Talents,No.2016B013Science and Technology Innovation Joint Fund Project of Fujian Province,No.2017Y9004the Special Fund for Clinical Research of the Wu Jieping Medical Foundation,No.320.6750.17511
文摘BACKGROUND Robotic surgery has been considered to be significantly better than laparoscopic surgery for complicated procedures.AIM To explore the short-term effect of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy(SPSHL)for advanced gastric cancer(GC)by Huang’s three-step maneuver.METHODS A total of 643 patients who underwent SPSHL were recruited from April 2012 to July 2017,including 35 patients who underwent robotic SPSHL(RSPSHL)and 608 who underwent laparoscopic SPSHL(LSPSHL).One-to-four propensity score matching was used to analyze the differences in clinical data between patients who underwent robotic SPSHL and those who underwent laparoscopic SPSHL.RESULTS In all,175 patients were matched,including 35 patients who underwent RSPSHL and 140 who underwent LSPSHL.After matching,there were no significant differences detected in the baseline characteristics between the two groups.Significant differences in total operative time,estimated blood loss(EBL),splenic hilar blood loss(SHBL),splenic hilar dissection time(SHDT),and splenic trunk dissection time were evident between these groups(P<0.05).Furthermore,no significant differences were observed between the two groups in the overall noncompliance rate of lymph node(LN)dissection(62.9%vs 60%,P=0.757),number of retrieved No.10 LNs(3.1±1.4 vs 3.3±2.5,P=0.650),total number of examined LNs(37.8±13.1 vs 40.6±13.6,P=0.274),and postoperative complications(14.3%vs 17.9%,P=0.616).A stratified analysis that divided the patients receiving RSPSHL into an early group(EG)and a late group(LG)revealed that the LG experienced obvious improvements in SHDT and length of stay compared with the EG(P<0.05).Logistic regression showed that robotic surgery was a significantly protective factor against both SHBL and SHDT(P<0.05).CONCLUSION RSPSHL is safe and feasible,especially after overcoming the early learning curve,as this procedure results in a radical curative effect equivalent to that of LSPSHL.
基金project was supported by the National Natural Science Foundation of China (Grants 11472041, 11302244, 11532002)Guangxi Natural Science Foundation (2015GXNSFBA 139013)
文摘This paper is mainly concerned with the coupling dynamic analysis of a complex spacecraft consisting of one main rigid platform, multiple liquid-filled cylindrical tanks, and a number of flexible appendages. Firstly, the carrier potential function equations of liquid in the tanks are deduced according to the wall boundary conditions. Through employ- ing the Fourier-Bessel series expansion method, the dynamic boundaries conditions on a curved free-surface under a low-gravity environment are transformed to general simple differential equations and the rigid-liquid coupled sloshing dynamic state equations of liquid in tanks are obtained. The state vectors of rigid-liquid coupled equations are composed with the modal coordinates of the relative potential func- tion and the modal coordinates of wave height. Based on the B ernoulli-Euler beam theory and the D＇Alembert＇s prin- ciple, the rigid-flexible coupled dynamic state equations of flexible appendages are directly derived, and the coordi- nate transform matrixes of maneuvering flexible appendages are precisely computed as time-varying. Then, the cou- pling dynamics state equations of the overall system of the spacecraft are modularly built by means of the Lagrange＇s equations in terms of quasi-coordinates. Lastly, the cou-piing dynamic performances of a typical complex spacecraft are studied. The availability and reliability of the presented method are also confirmed.
