Study Design: Original article. Objective: Guidelines for deciding whether to perform open or percutaneous surgery in burst fractures. Summary of Background Data: The authors propose an algorithm for deciding whether ...Study Design: Original article. Objective: Guidelines for deciding whether to perform open or percutaneous surgery in burst fractures. Summary of Background Data: The authors propose an algorithm for deciding whether to perform open surgery or percutaneous surgery with short fixation in patients with fractures of the thoracolumbar junction and lumbar spine. Methods: Between July 2005 and July 2009, 72 patients underwent surgical stabilization by posterior route for fractures of the thoracolumbar junction and lumbar spine. In 44 the lesion involved the thoracolumbar junction, in 28 the lumbar spine (L2 in6 cases, L3 in15 cases, L5 in7 cases). The fractures were assessed morphologically according to Magerl’s classification (52 type A, 12 type B, 8 type C). All patients were analyzed according to the algorithm proposed, according to which patients must fulfil certain criteria: the fracture must be Magerl type A.3, it must involve one level, McCormack score must be 6 or less, invasion of the spinal canal must be 25% or less according to Hashimoto’s formula, Magnetic Resonance Imating (MRI) must confirm discoligamentous integrity. Neurologically, the patient must be ASIA E. 25 patients (17 thoracolumbar junction, 8 lumbar spine) fulfilled these criteria and were treated by percutaneous short fixation. Results: The average length of the surgical procedure was 80 minutes and the loss of blood 10 cc. All patients were dismissed without brace and were submitted to follow-upComputed Tomography CTscan 3 and 6 months after surgery. Follow-up ranged from 6 months to 4 years. In all cases CT scan confirmed fusion and there were no cases of rupture of the device. None of the patients presented neurological deficits. Conclusion: The algorithm described permits a proper selection of patients with thoracolumbar fractures who can be treated by percutaneous short fixation, thus avoiding the risks connected with failure of the stabilization system.展开更多
Objective:To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar ...Objective:To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar fractures were selected as the subjects and they were randomly divided into observation group(50 cases)and control group(50 cases).The patients in the observation group were treated with minimally invasive singlesegment reduction and internal fixation.The patients in the control group were treated with short segmental fixation.The clinical effects of the two groups were compared.Results:There was no significant difference in the compression rate and Cobb angle between the two groups before and after operation(P>0.05).For all patients who were followed up for the last time,the Cobb angle was significantly lower in the observation group than in the control group(P<0.05).The social function,affective function and physical pain score of the observation group were significantly better than the control group(P<0.05).The amount of bleeding in the observation group was(250.4±41.0)ml,which was significantly lower than that in the control group(267.5±32.8)ml.The time required for the operation was(90.2±35.4)min,which was significantly lower than that of the control group(104.5±22.6)min(P<0.05).After treatment,the prognosis was 70.00%and the excellent and good rate was 98.00%,which was significantly higher than that of the control group(46.00%)and 78.00%(P<0.05).Conclusion:Thoracolumbar fractures in patients with dilated channel minimally invasive single-segment reduction and internal fixation treatment can effectively repair the patient's vertebral height and Cobb angle and the degree of correction after surgery was significantly better,safer and worthy of clinical recommended use.展开更多
BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segme...BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates.CASE SUMMARY We report a newborn baby with gut malrotation associated with jejuno-ileal atresia,congenital SBS and jejunal volvulus.Hematemesis and abdominal distention were noted.At laparotomy,malrotation associated with jejuno-ileal atresia,congenital SBS and jenunal volvulus was confirmed.The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm,including 18 cm necrotic segment below the Treitz’s ligament and 20 cm severe ischemic segment.The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter.Ladd’s procedure,necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed.The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure.Three months later,to restore the continuity of the isolated gut segment,end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed.The entire functional small bowel length increased to 80 cm.Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively.Twelve months later,her body weight was 9.5 kg.CONCLUSION Isolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.展开更多
The size and shape of the effective test area are crucial to consider when short-crested waves are created by segmented wavemakers. The range of the effective test area of short-crested waves simulated by two-sided se...The size and shape of the effective test area are crucial to consider when short-crested waves are created by segmented wavemakers. The range of the effective test area of short-crested waves simulated by two-sided segmented wavemakers is analyzed in this paper. The experimental investigation on the wave field distribution of short-crested waves generated by two-sided segmented wavemakers is conducted by using an array of wave gauges. Wave spectra and directional spreading function are analyzed and the results show that when the main direction is at a certain angle with the normal line of wave generators, the wave field of 3D short-crested waves generated by two-sided segmented wavemakers has good spatial uniformity within the model test area. The effective test area can provide good wave environments for seakeeping model tests of various ocean engineering structures in the deep ocean engineering basin.展开更多
AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE und...AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×80.The magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s classification.Then,a 0.5%solution of methylene blue(MB)was sprayed over columnar mucosa.The patterns of the magnified image and MB staining were analyzed.Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.RESULTS:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.展开更多
针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectiona...针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectional encoder representation from transformers)预训练语言模型进行文本向量化表示;通过双向长短时记忆网络(Bidirectional long short-term memory network,BiLSTM)获取上下文语义特征;由条件随机场(Conditional random field,CRF)输出全局最优标签序列。基于此,在CRF层后加入畜禽疫病领域词典进行分词匹配修正,减少在分词过程中出现的疫病名称及短语等造成的歧义切分,进一步提高了分词准确率。实验结果表明,结合词典匹配的BERT-BiLSTM-CRF模型在羊常见疫病文本数据集上的F1值为96.38%,与jieba分词器、BiLSTM-Softmax模型、BiLSTM-CRF模型、未结合词典匹配的本文模型相比,分别提升11.01、10.62、8.3、0.72个百分点,验证了方法的有效性。与单一语料相比,通用语料PKU和羊常见疫病文本数据集结合的混合语料,能够同时对畜禽疫病专业术语及疫病文本中常用词进行准确切分,在通用语料及疫病文本数据集上F1值都达到95%以上,具有较好的模型泛化能力。该方法可用于畜禽疫病文本分词。展开更多
文摘Study Design: Original article. Objective: Guidelines for deciding whether to perform open or percutaneous surgery in burst fractures. Summary of Background Data: The authors propose an algorithm for deciding whether to perform open surgery or percutaneous surgery with short fixation in patients with fractures of the thoracolumbar junction and lumbar spine. Methods: Between July 2005 and July 2009, 72 patients underwent surgical stabilization by posterior route for fractures of the thoracolumbar junction and lumbar spine. In 44 the lesion involved the thoracolumbar junction, in 28 the lumbar spine (L2 in6 cases, L3 in15 cases, L5 in7 cases). The fractures were assessed morphologically according to Magerl’s classification (52 type A, 12 type B, 8 type C). All patients were analyzed according to the algorithm proposed, according to which patients must fulfil certain criteria: the fracture must be Magerl type A.3, it must involve one level, McCormack score must be 6 or less, invasion of the spinal canal must be 25% or less according to Hashimoto’s formula, Magnetic Resonance Imating (MRI) must confirm discoligamentous integrity. Neurologically, the patient must be ASIA E. 25 patients (17 thoracolumbar junction, 8 lumbar spine) fulfilled these criteria and were treated by percutaneous short fixation. Results: The average length of the surgical procedure was 80 minutes and the loss of blood 10 cc. All patients were dismissed without brace and were submitted to follow-upComputed Tomography CTscan 3 and 6 months after surgery. Follow-up ranged from 6 months to 4 years. In all cases CT scan confirmed fusion and there were no cases of rupture of the device. None of the patients presented neurological deficits. Conclusion: The algorithm described permits a proper selection of patients with thoracolumbar fractures who can be treated by percutaneous short fixation, thus avoiding the risks connected with failure of the stabilization system.
文摘Objective:To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar fractures were selected as the subjects and they were randomly divided into observation group(50 cases)and control group(50 cases).The patients in the observation group were treated with minimally invasive singlesegment reduction and internal fixation.The patients in the control group were treated with short segmental fixation.The clinical effects of the two groups were compared.Results:There was no significant difference in the compression rate and Cobb angle between the two groups before and after operation(P>0.05).For all patients who were followed up for the last time,the Cobb angle was significantly lower in the observation group than in the control group(P<0.05).The social function,affective function and physical pain score of the observation group were significantly better than the control group(P<0.05).The amount of bleeding in the observation group was(250.4±41.0)ml,which was significantly lower than that in the control group(267.5±32.8)ml.The time required for the operation was(90.2±35.4)min,which was significantly lower than that of the control group(104.5±22.6)min(P<0.05).After treatment,the prognosis was 70.00%and the excellent and good rate was 98.00%,which was significantly higher than that of the control group(46.00%)and 78.00%(P<0.05).Conclusion:Thoracolumbar fractures in patients with dilated channel minimally invasive single-segment reduction and internal fixation treatment can effectively repair the patient's vertebral height and Cobb angle and the degree of correction after surgery was significantly better,safer and worthy of clinical recommended use.
文摘BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates.CASE SUMMARY We report a newborn baby with gut malrotation associated with jejuno-ileal atresia,congenital SBS and jejunal volvulus.Hematemesis and abdominal distention were noted.At laparotomy,malrotation associated with jejuno-ileal atresia,congenital SBS and jenunal volvulus was confirmed.The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm,including 18 cm necrotic segment below the Treitz’s ligament and 20 cm severe ischemic segment.The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter.Ladd’s procedure,necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed.The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure.Three months later,to restore the continuity of the isolated gut segment,end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed.The entire functional small bowel length increased to 80 cm.Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively.Twelve months later,her body weight was 9.5 kg.CONCLUSION Isolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.
基金financially supported by the National Natural Science Foundation of China(Grant No.51239007)
文摘The size and shape of the effective test area are crucial to consider when short-crested waves are created by segmented wavemakers. The range of the effective test area of short-crested waves simulated by two-sided segmented wavemakers is analyzed in this paper. The experimental investigation on the wave field distribution of short-crested waves generated by two-sided segmented wavemakers is conducted by using an array of wave gauges. Wave spectra and directional spreading function are analyzed and the results show that when the main direction is at a certain angle with the normal line of wave generators, the wave field of 3D short-crested waves generated by two-sided segmented wavemakers has good spatial uniformity within the model test area. The effective test area can provide good wave environments for seakeeping model tests of various ocean engineering structures in the deep ocean engineering basin.
文摘AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×80.The magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s classification.Then,a 0.5%solution of methylene blue(MB)was sprayed over columnar mucosa.The patterns of the magnified image and MB staining were analyzed.Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.RESULTS:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.
文摘针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectional encoder representation from transformers)预训练语言模型进行文本向量化表示;通过双向长短时记忆网络(Bidirectional long short-term memory network,BiLSTM)获取上下文语义特征;由条件随机场(Conditional random field,CRF)输出全局最优标签序列。基于此,在CRF层后加入畜禽疫病领域词典进行分词匹配修正,减少在分词过程中出现的疫病名称及短语等造成的歧义切分,进一步提高了分词准确率。实验结果表明,结合词典匹配的BERT-BiLSTM-CRF模型在羊常见疫病文本数据集上的F1值为96.38%,与jieba分词器、BiLSTM-Softmax模型、BiLSTM-CRF模型、未结合词典匹配的本文模型相比,分别提升11.01、10.62、8.3、0.72个百分点,验证了方法的有效性。与单一语料相比,通用语料PKU和羊常见疫病文本数据集结合的混合语料,能够同时对畜禽疫病专业术语及疫病文本中常用词进行准确切分,在通用语料及疫病文本数据集上F1值都达到95%以上,具有较好的模型泛化能力。该方法可用于畜禽疫病文本分词。
