Clinical Application of Primary Suture Following Three-Port Laparoscopic Common Bile Duct Exploration: A Report of 176 Cases

Objective: To investigate the feasibility, safety and the clinical value of primary suture following 3-port laparoscopic common bile duct exploration (LCBDE). Methods: From January 2012 to September 2014, 176 patients suffered from choledocholithiasis were treated with primary suture following 3-port LCBDE and the clinical data were retrospectively analyzed. Results: All cases were operated successfully and none was converted to open surgery. The duration of operation was 92.2 ± 18.8 min and the length of postoperative hospital stay was 4.4 ± 3.7 d. Postoperative bile leakage occurred in 2 cases and these patients recovered by simple drainage for 3 to 7 days without re-operation. All patients recovered smoothly without any serious complications. Conclusions: Primary suture following 3-port LCBDE is safe, effective and mini-invasive, which is worthy of further clinical application.

Comparison of the body pain and trauma degree between uni-portal and three-portal video-assisted thoracoscopic surgery for the treatment of lung cancer

Objective:To study the differences in the body pain and trauma degree between uniportal and three-portal video-assisted thoracoscopic surgery for the treatment of lung cancer.Methods:A total of 108 patients with non-small cell lung cancer who received radical operation in our hospital between February 2013 and February 2016 were selected and divided into the uniportal group (n=52) who received uniportal video-assisted thoracoscopic surgery and the three-portal group (n=56) who received three-portal video-assisted thoracoscopic surgery after the operation methods and related laboratory results were reviewed. Before operation and 24 h after operation, the differences in serum levels of pain mediators, oxidative stress indexes and inflammation indexes were compared between the two groups of patients.Results: Before operation, the differences in serum levels of pain mediators, oxidative stress indexes and inflammation indexes were not statistically significant between the two groups of patients. 24 h after operation, serum pain mediators NE, DA and 5-HT levels of observation group were lower than those of control group;oxidative stress indexes MDA and O2- levels were lower than those of control group while SOD and GSH-Px levels were higher than those of control group;inflammation indexes IL-6, IL-8, CRP and TNF-α levels were lower than those of control group.Conclusion: Uniportal video-assisted thoracoscopic surgery for the treatment of lung cancer causes less surgery trauma, and patients' postoperative pain and systemic inflammatory stress response are lighter.

A novel approach for 25-gauge transconjunctival sutureless vitrectomy to evaluate vitreous substitutes in rabbits

AIM:To improve the standard three-port vitrectomy for establishing and evaluating an endotamponade model in rabbits.METHODS:Three ports were prepared near the third eyelid of rabbits,and the infusion port was placed at the inferior nasal quadrant with the inserted cannula linking with a self-designed handheld rigid infusion catheter.All right eyes of rabbits underwent a modified 25-gauge vitrectomy and were subsequently filled with balanced salt solution,silicone oil,and eight-arm polyethylene glycols(8-arm PEGs)hydrogel separately for comparison.Ophthalmic examinations were performed regularly to record the changes after the surgery.RESULTS:Successful vitrectomy was achieved among 44 chinchilla rabbits.The mean operation time was 4.51±1.25min.Four eyes(9.1%)presented limited lens touch and two eyes(4.5%)showed retinal touch during surgery.Incision leakage was found in three eyes(6.8%)after surgery.There was no endophthalmitis,hemorrhage,or retinal detachment during the observation period and ophthalmic examinations after the implantation of vitreous substitutes.CONCLUSION:The modified technique of the standard vitrectomy applied in the endotamponade model in rabbits shows excellent safety and practicality.

A Large Dynamic Range Floating Memristor Emulator With Equal Port Current Restriction

In this paper, a large dynamic range floating memristor emulator(LDRFME) with equal port current restriction is proposed to be achieved by a large dynamic range floating voltage-controlled linear resistor(VCLR). Since real memristors have not been largely commercialized until now, the application of a LDRFME to memristive systems is reasonable. Motivated by this need, this paper proposes an achievement of a LDRFME based on a feasible transistor model. A first circuit extends the voltage range of the triode region of an ordinary junction field effect transistor(JFET). The idea is to use this JFET transistor as a tunable linear resistor. A second memristive non-linear circuit is used to drive the resistance of the first JFET transistor. Then those two circuits are connected together and, under certain conditions, the obtained "resistor" presents a hysteretic behavior,which is considered as a memristive effect. The electrical characteristics of a LDRFME are validated by software simulation and real measurement, respectively.

Novel integrated three-port DC/DC converter for different operating modes between renewable energy,electrolyser and fuel cell/battery

Due to the slow dynamic power-regulation characteristics of the electrolyser(EL),a novel integrated three-port DC/DC converter topology based on a phase-shifted full-bridge converter and dual active-bridge converter is proposed in this paper.Especially,the proposed converter can achieve a fast auxiliary response to the EL.This topology has the features of single-stage conversion,high system integration and compatibility with multiple operation modes.The operational principles and a hybrid modulation scheme of the proposed converter are analysed in detail.In addition,the power-transmission characteristics of each port and the soft-switching range are researched.On these bases,six operation modes suitable for a hydrogen energy-storage system are designed.The simulation and a 2-kW scaled-down experimental prototype are established to verify the feasibility and effectiveness of the proposed topology in different operation modes.

A Three-state Dual-inductance Bi-directional Converter and Its Control in Pulse-loaded Three-port Converters

The current-pulse load is generally characterized by wide frequency band and pulse variation,when it is directly connected to the power supply bus.The load power is presented as the instantaneous power.In order to balance the instantaneous power difference between the pulse load and the DC bus,a bi-directional DC/DC converter is usually connected in parallel to compensate for the current fluctuation caused by the characteristics of the pulse load.However,there is a large current spike in the bus current in the pre-stage when the pulse load is changed between light and heavy load.In this paper,a three-state dual-inductance bi-directional converter is proposed.In addition,the load current waveform is directly used to control the inductive branch switches,and an adaptive current feedback control strategy based on the valley voltage loop is proposed to control the power switches.The control method is applicable to the arbitrary change of the frequency and power of the pulse load.Finally,the experimental results show that the threestate dual-inductance bi-directional converter not only eliminates excessive bus current spikes,but also improves the transient response of the three-port power supply system.

Recurrence quantification analysis on pulse morphological changes in patients with coronary heart disease

OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （RQA） was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease （CHD） and 37 normal subjects （controls）. An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine （SVM） classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS： RQA measures can be divided into two groups. One group of measures [ecurrence rate（RR）, determinism （DEL）, average diagonal line length （L）, maximum length of diagonal structures （Lmax）, Shannon entropy of the frequency distribu- tion of diagonal line lengths （ENTR）, laminarity （LAM）, average length of vertical structures （TT）, maximum length of vertical structures （Vmax）] showed significantly higher values for patients with CHD than for normal subjects （P〈0.0S）. The other measures （RR_std, L_std, Lmaxstd, TT_std, Vmax_std） showed significantly lower values for the CHD group than for normal subjects （P〈0.05）. SVM classification accuracy was higher with RQA measures： With RQA （16 parameters） accuracy was at 88.21%, and with RQA（12 parameters） accuracy was at 84.11%. In contrast, with classic time-do- main （15 parameters） accuracy was 75.73%, and with time-domain （7 parameters） accuracy was 74.7O%. CONCLUSION： Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.