目的 分析老年胆总管结石患者应用经腹腔镜胆总管切开探查并取石术(Laparoscopic Common Bile Duct Ex-ploration,LCBDE)并一期缝合与并T形管引流治疗取得的疗效。方法 采用目的抽样法选取2020年2月—2023年12月安徽省池州市人民医院78...目的 分析老年胆总管结石患者应用经腹腔镜胆总管切开探查并取石术(Laparoscopic Common Bile Duct Ex-ploration,LCBDE)并一期缝合与并T形管引流治疗取得的疗效。方法 采用目的抽样法选取2020年2月—2023年12月安徽省池州市人民医院78例老年胆总管结石患者为研究对象(均行LCBDE术治疗),按照治疗方法不同分为两组,每组39例,分别提供一期缝合治疗(观察组)和T形管引流治疗(对照组),比较两组手术时间、引流时间、住院时间、出血量、并发症发生率。结果 两组引流时间比较,差异无统计学意义(P>0.05)。观察组手术时间、住院时间短于对照组,出血量少于对照组,差异有统计学意义(P均<0.05)。观察组水电解质紊乱率(2.56%)、胆道出血率为(0)、残余结石率(2.56%)、胆道感染率为(0)低于对照组,差异有统计学意义(χ^(2)=3.924、5.343、3.924、5.343,P均<0.05)。结论 老年胆总管结石应用LCBDE术并一期缝合的效果更佳,相比于T形管引流治疗,可以更好地改善患者预后,应用价值高。展开更多
To study a more micro-invasive procedure for patients having pancreatic duct stones(PDS).Till now,there has been no report of laparoscopic pancreatic duct incision and stone removal and T-type tube drainage for PDS in...To study a more micro-invasive procedure for patients having pancreatic duct stones(PDS).Till now,there has been no report of laparoscopic pancreatic duct incision and stone removal and T-type tube drainage for PDS in the English literature.An 82-year-old man suffered from subxiphoid pain associated with a dilated pancreatic duct(7 mm)containing one stone,but without a mass in the head of the pancreas.Laparoscopic pancreatic duct incision,stone removal,and T-type tube drainage were successfully performed without intraoperative or postoperative complications.An uneventful operation was performed with laparoscopically completed procedures in 160 min.The intraoperative loss of blood was around 50 mL.After patient a discharge on day 11,complete relief from the subxiphoid pain was reported at a follow-up visit 15 mo later.Laparoscopic pancreatic duct incision with stone removal and T-type tube drainage is applicable in carefully selected patients and can be effectively and safely used for the treatment of the abdominal pain of chronic pancreatitis.展开更多
Simulations were performed to examine the effects of a coiled tube after a T-junction on the mixing and flow characteristics. A coiled tube was found to have two effects: inducing a radial flow and flattening the axia...Simulations were performed to examine the effects of a coiled tube after a T-junction on the mixing and flow characteristics. A coiled tube was found to have two effects: inducing a radial flow and flattening the axial velocity distribution, which enhances and weakens the mixing, respectively. In the straight tube section connecting the Tjunction and coiled tube, the latter may dominate and cause the mixing to deteriorate. An experiment was performed with the Villermaux/Dushman method to verify the simulation results. Based on a mixing performance simulation with various fluid and geometric structure parameters, a dimensionless correlation was obtained that can be used to determine the mixing intensity along the coiled tube with a deviation of less than 1.5%.These results provide guidance for designing a coiled tube or optimizing the operating conditions to meet the mixing requirements of specific chemical processes.展开更多
Treatment of nucleos(t)ide antiviral drugs for decompensated HBV-related cirrhosis can significantly improve the prognosis. But those patients with refractory ascites possibly deteriorate due to the complications of a...Treatment of nucleos(t)ide antiviral drugs for decompensated HBV-related cirrhosis can significantly improve the prognosis. But those patients with refractory ascites possibly deteriorate due to the complications of ascites before any benefit from anti-viral drugs could be observed. Therefore, it is important to find a way to help the patients with HBV-related cirrhosis and refractory ascites to receive the full benefits from antiviral therapy. Peritoneovenous shunt(PVS) using Denver tube enables ascites to continuously bypass into systemic circulation, thereby reducing ascites and albumin input and improving quality of life. We report herein 3 cases of decompensated HBV-related cirrhosis with refractory ascites, PVS using Denver tube was combined with lamivudine for antiviral treatment before and after. Then, ascites was alleviated significantly or disapeared and viral responsed well. All patients achieved a satisfactory long-term survival from 6.7 to 14.7 years. It was suggested that the Denver shunt could be used as an adjuvant method to antiviral drugs for decompensated HBV-related cirrhosis with refractory ascites to help the patients reap the full benefits and maximize efficacy of antiviral treatment.展开更多
This paper proposed a T- Y tube model to simulate foe input impedance of arterial system. It improves and extends the asymmetric T-tube model which was firstproposed by O' Rourke[1] and developed laier by Liu et a...This paper proposed a T- Y tube model to simulate foe input impedance of arterial system. It improves and extends the asymmetric T-tube model which was firstproposed by O' Rourke[1] and developed laier by Liu et al.[2]. Based on foe asymmetricT-tube model. a T-Y tube model was proposed by adding branching tubes whichrepresem the iliac arteries.All the tubes are considered to be uniform,viscoelasticlongitudinally tethered cylindrical tubes.The upper tube terminates with a windkesselmodel, while the terminal arterioles of the lowr tube are expressed as a resistance.After proper eraluation of the parameters.the impedance of the arterial system iscalculated under normal physiological and hypertensive condition.The model canpredict impedance in good agreement with the experimentally obtained data no matterin normal physiological condition or in pathological condition In comparison with theasymmeric T-tube model,T- Y tube model is closer to anatomy structure of the human arlerial system and at the sametime much simpler than the extremely complex multiplebranching tube model Therefore it will be a valuable model in studying the influencesof various parameters on aorta impedance and ventricular-vascular coupling.展开更多
The out-of-plane distortion induced in a multi-pass circumferential fillet welding of tube to pipe under different weld sequences and directions was studied using Finite Element Method(FEM) based Sysweld software and ...The out-of-plane distortion induced in a multi-pass circumferential fillet welding of tube to pipe under different weld sequences and directions was studied using Finite Element Method(FEM) based Sysweld software and verified experimentally. The FEM analyses consisted of thermal and mechanical analyses.Thermal analysis was validated with experimental transient temperature measurements. In the mechanical analysis, three different weld sequences and directions were considered to understand the mechanism of out-of-plane distortion in the tube to pipe T-joints. It was learnt that the welding direction plays a major role in minimizing the out-of-plane distortion. Further, during circumferential fillet welding of the tube to pipe component, the out-of-plane distortion generated in the x direction was primarily influenced by heat input due to the start and stop points, whereas the distortion in the z direction was influenced by time lag and welding direction. The FEM predicted distortion was compared with experimental measurements and the mechanism of out-of-plane distortion was confirmed.展开更多
文摘目的 分析老年胆总管结石患者应用经腹腔镜胆总管切开探查并取石术(Laparoscopic Common Bile Duct Ex-ploration,LCBDE)并一期缝合与并T形管引流治疗取得的疗效。方法 采用目的抽样法选取2020年2月—2023年12月安徽省池州市人民医院78例老年胆总管结石患者为研究对象(均行LCBDE术治疗),按照治疗方法不同分为两组,每组39例,分别提供一期缝合治疗(观察组)和T形管引流治疗(对照组),比较两组手术时间、引流时间、住院时间、出血量、并发症发生率。结果 两组引流时间比较,差异无统计学意义(P>0.05)。观察组手术时间、住院时间短于对照组,出血量少于对照组,差异有统计学意义(P均<0.05)。观察组水电解质紊乱率(2.56%)、胆道出血率为(0)、残余结石率(2.56%)、胆道感染率为(0)低于对照组,差异有统计学意义(χ^(2)=3.924、5.343、3.924、5.343,P均<0.05)。结论 老年胆总管结石应用LCBDE术并一期缝合的效果更佳,相比于T形管引流治疗,可以更好地改善患者预后,应用价值高。
基金Supported by Foundation of Department of Science and Technology of Jinhua,No.2015-3-0012015-3-012
文摘To study a more micro-invasive procedure for patients having pancreatic duct stones(PDS).Till now,there has been no report of laparoscopic pancreatic duct incision and stone removal and T-type tube drainage for PDS in the English literature.An 82-year-old man suffered from subxiphoid pain associated with a dilated pancreatic duct(7 mm)containing one stone,but without a mass in the head of the pancreas.Laparoscopic pancreatic duct incision,stone removal,and T-type tube drainage were successfully performed without intraoperative or postoperative complications.An uneventful operation was performed with laparoscopically completed procedures in 160 min.The intraoperative loss of blood was around 50 mL.After patient a discharge on day 11,complete relief from the subxiphoid pain was reported at a follow-up visit 15 mo later.Laparoscopic pancreatic duct incision with stone removal and T-type tube drainage is applicable in carefully selected patients and can be effectively and safely used for the treatment of the abdominal pain of chronic pancreatitis.
基金Supported by the National Natural Science Foundation of China(21422603,U166212)the National Science and Technology Support Program of China(2011BAC06B01)
文摘Simulations were performed to examine the effects of a coiled tube after a T-junction on the mixing and flow characteristics. A coiled tube was found to have two effects: inducing a radial flow and flattening the axial velocity distribution, which enhances and weakens the mixing, respectively. In the straight tube section connecting the Tjunction and coiled tube, the latter may dominate and cause the mixing to deteriorate. An experiment was performed with the Villermaux/Dushman method to verify the simulation results. Based on a mixing performance simulation with various fluid and geometric structure parameters, a dimensionless correlation was obtained that can be used to determine the mixing intensity along the coiled tube with a deviation of less than 1.5%.These results provide guidance for designing a coiled tube or optimizing the operating conditions to meet the mixing requirements of specific chemical processes.
文摘Treatment of nucleos(t)ide antiviral drugs for decompensated HBV-related cirrhosis can significantly improve the prognosis. But those patients with refractory ascites possibly deteriorate due to the complications of ascites before any benefit from anti-viral drugs could be observed. Therefore, it is important to find a way to help the patients with HBV-related cirrhosis and refractory ascites to receive the full benefits from antiviral therapy. Peritoneovenous shunt(PVS) using Denver tube enables ascites to continuously bypass into systemic circulation, thereby reducing ascites and albumin input and improving quality of life. We report herein 3 cases of decompensated HBV-related cirrhosis with refractory ascites, PVS using Denver tube was combined with lamivudine for antiviral treatment before and after. Then, ascites was alleviated significantly or disapeared and viral responsed well. All patients achieved a satisfactory long-term survival from 6.7 to 14.7 years. It was suggested that the Denver shunt could be used as an adjuvant method to antiviral drugs for decompensated HBV-related cirrhosis with refractory ascites to help the patients reap the full benefits and maximize efficacy of antiviral treatment.
文摘This paper proposed a T- Y tube model to simulate foe input impedance of arterial system. It improves and extends the asymmetric T-tube model which was firstproposed by O' Rourke[1] and developed laier by Liu et al.[2]. Based on foe asymmetricT-tube model. a T-Y tube model was proposed by adding branching tubes whichrepresem the iliac arteries.All the tubes are considered to be uniform,viscoelasticlongitudinally tethered cylindrical tubes.The upper tube terminates with a windkesselmodel, while the terminal arterioles of the lowr tube are expressed as a resistance.After proper eraluation of the parameters.the impedance of the arterial system iscalculated under normal physiological and hypertensive condition.The model canpredict impedance in good agreement with the experimentally obtained data no matterin normal physiological condition or in pathological condition In comparison with theasymmeric T-tube model,T- Y tube model is closer to anatomy structure of the human arlerial system and at the sametime much simpler than the extremely complex multiplebranching tube model Therefore it will be a valuable model in studying the influencesof various parameters on aorta impedance and ventricular-vascular coupling.
文摘The out-of-plane distortion induced in a multi-pass circumferential fillet welding of tube to pipe under different weld sequences and directions was studied using Finite Element Method(FEM) based Sysweld software and verified experimentally. The FEM analyses consisted of thermal and mechanical analyses.Thermal analysis was validated with experimental transient temperature measurements. In the mechanical analysis, three different weld sequences and directions were considered to understand the mechanism of out-of-plane distortion in the tube to pipe T-joints. It was learnt that the welding direction plays a major role in minimizing the out-of-plane distortion. Further, during circumferential fillet welding of the tube to pipe component, the out-of-plane distortion generated in the x direction was primarily influenced by heat input due to the start and stop points, whereas the distortion in the z direction was influenced by time lag and welding direction. The FEM predicted distortion was compared with experimental measurements and the mechanism of out-of-plane distortion was confirmed.
