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Digital Twin Modeling and Simulation Optimization of Transmission Front and Middle Case Assembly Line
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作者 Xianfeng Cao Meihua Yao +2 位作者 Yahui Zhang Xiaofeng Hu Chuanxun Wu 《Computer Modeling in Engineering & Sciences》 SCIE EI 2024年第6期3233-3253,共21页
As the take-off of China’s macro economy,as well as the rapid development of infrastructure construction,real estate industry,and highway logistics transportation industry,the demand for heavy vehicles is increasing ... As the take-off of China’s macro economy,as well as the rapid development of infrastructure construction,real estate industry,and highway logistics transportation industry,the demand for heavy vehicles is increasing rapidly,the competition is becoming increasingly fierce,and the digital transformation of the production line is imminent.As one of themost important components of heavy vehicles,the transmission front andmiddle case assembly lines have a high degree of automation,which can be used as a pilot for the digital transformation of production.To ensure the visualization of digital twins(DT),consistent control logic,and real-time data interaction,this paper proposes an experimental digital twin modeling method for the transmission front and middle case assembly line.Firstly,theDT-based systemarchitecture is designed,and theDT model is created by constructing the visualization model,logic model,and data model of the assembly line.Then,a simulation experiment is carried out in a virtual space to analyze the existing problems in the current assembly line.Eventually,some improvement strategies are proposed and the effectiveness is verified by a new simulation experiment. 展开更多
关键词 Transmission front and middle case assembly line digital twin(DT) simulating optimization intelligent manufacturing
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Software Operational Profile Based Test Case Allocation Using Fuzzy Logic 被引量:1
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作者 K.Saravana Kumar Ravindra Babu Misra 《International Journal of Automation and computing》 EI 2007年第4期388-395,共8页
Software operational profile (SOP) is used in software reliability prediction, software quality assessment, performance analysis of software, test case allocation, determination of "when to stop testing," etc. Due... Software operational profile (SOP) is used in software reliability prediction, software quality assessment, performance analysis of software, test case allocation, determination of "when to stop testing," etc. Due to the limited data resources and large efforts required to collect and convert the gathered data into point estimates, reluctance is observed by the software professionals to develop the SOP. A framework is proposed to develop SOP using fuzzy logic, which requires usage data in the form of linguistics. The resulting profile is named fuzzy software operational profile (FSOP). Based on this work, this paper proposes a generalized approach for the allocation of test cases, in which occurrence probability of operations obtained from FSOP are combined with the criticality of the operations using fuzzy inference system (FIS). Traditional methods for the allocation of test cases do not consider the application in which software operates. This is intuitively incorrect. To solve this problem, allocation of test cases with respect to software application using the FIS model is also proposed in this paper. 展开更多
关键词 Software reliability software operational profile CRITICaLITY fuzzy logic test case allocation.
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Effect of CBL Combined with Case Analysis in the Teaching of Clinical Anesthesia 被引量:1
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作者 Yuming Zhang Fei Xue 《Journal of Contemporary Educational Research》 2021年第12期100-103,共4页
Objective:To evaluate the effect of CBL(case-based learning)combined with case analysis in the teaching of clinical anesthesia.Methods:From June 2018 to June 2020,a total of 100 clinical anesthesia interns in Shaanxi ... Objective:To evaluate the effect of CBL(case-based learning)combined with case analysis in the teaching of clinical anesthesia.Methods:From June 2018 to June 2020,a total of 100 clinical anesthesia interns in Shaanxi Provincial People’s Hospital were selected as the research subjects.They were divided into two groups,the reference group(50 interns)and the study group(50 interns),by random sampling method.The reference group was under the traditional teaching method,whereas for the study group,CBL combined with case analysis was implemented.The teaching satisfaction and achievement of the interns in both the groups were evaluated.Results:The teaching satisfaction of the study group was 98%,which was significantly higher than that of the reference group(86%)(P<0.05);before teaching,there was no significant difference in the theoretical and clinical practice scores between the two groups(P>0.05);however,after teaching,the theoretical and clinical practice scores of the two groups increased significantly,in which the change of the research group was significantly greater than that of the reference group(P<0.05).Conclusion:The application of CBL combined with case analysis in the teaching of clinical anesthesia has an ideal effect,improving the teaching satisfaction and achievement.It is a high-quality teaching method and is worthy of application. 展开更多
关键词 CBL case analysis Clinical anesthesia Teaching satisfaction Teaching achievement
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Case Analysis of a Pump-Driven Heat Pipe Heat Recovery Ventilator in an Existing Experiment Building
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作者 Zhun Li Zhengrong Ouyang +3 位作者 Tianbao Sun Qiang Li Xiaobo Zhao Rong Yu 《Energy Engineering》 EI 2022年第4期1393-1402,共10页
The building energy consumption is an important part among the total society energy consumption,in which the energy consumption for air conditioning occupies almost 70%.The energy consumption of the air conditioning s... The building energy consumption is an important part among the total society energy consumption,in which the energy consumption for air conditioning occupies almost 70%.The energy consumption of the air conditioning system for fresh air handling can be saved effectively when the exhaust air energy could be recovered to preheat or precool the fresh air.Considering the install locations requirements on field,the pump-driven heat pipes(PHP)were developed as heat recovery ventilators(HRVs)and used in an existing experiment building in Beijing Urban.The thermal performance of the PHP HRVs was tested in real operation time periods under winter running mode.Both the power and heat consumption of the modular air handling units with and without HRVs were monitored and obtained,as well as the hourly power and heat consumption.The energy savings of HRVs were analyzed.The results indicate that the PHP HRVs can work steadily and meet the energy recovery need well.The temperature effectiveness of the HRVs can be kept from 60%to 70%.The test total energy saving rate was 24.48%,and the average hourly heat consumption reduced by 28.54%.The daily energy consumption can be saved by 118 kWh,and the energy savings can reach to 9440 kWh for a whole winter. 展开更多
关键词 case analysis heat recovery ventilator pump-driven heat pipe temperature effectiveness energy saving
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PRIMARY MALIGNANT LYMPHOMA OF THE LUNG: REPORT OF A CASE AND REFERENCE TO DIAGNOSTIC CRITERIA
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作者 刘泽玲 顾月英 卢家祥 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 1993年第4期67-68,共2页
Although pulmonary involvement ofmalignant lymphoma is quite common, primarymalignant lymphoma of the lung is rare. Two caseswere reported by Chinese literature in 1985. Thispaper describes a case of primary pulmonary... Although pulmonary involvement ofmalignant lymphoma is quite common, primarymalignant lymphoma of the lung is rare. Two caseswere reported by Chinese literature in 1985. Thispaper describes a case of primary pulmonarymalignant lymphoma which has been remitted by 展开更多
关键词 LUNG PRIMaRY MaLIGNaNT LYMPHOMa OF THE LUNG REPORT OF a case aND REFERENCE TO DIaGNOSTIC CRITERIa
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Plasma exchange used in the treatment of emergency case and seriousness in clinica
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《中国输血杂志》 CAS CSCD 2001年第S1期396-,共1页
关键词 case Plasma exchange used in the treatment of emergency case and seriousness in clinica
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Public Participation in Land Use Planning:Values and Case Analysis
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作者 LIU Jian-sheng ZHAO Jian-ning LAI Yu-ying 《Asian Agricultural Research》 2012年第2期35-38,共4页
Objective:we want to explore values and methods of public participation in land use planning through analysis on values of public participation and case of Ji'an County in Jiangxi Province.Methods:document and dat... Objective:we want to explore values and methods of public participation in land use planning through analysis on values of public participation and case of Ji'an County in Jiangxi Province.Methods:document and data method,case analysis method,qualitative and quantitative combined methods.Results:public participation in land use plays a positive role in improving science and practice of planning.Conclusions:preparation and implementation of land use planning should manifest human-oriented,public participation,wisdom of the masses,scientific demonstration,and democratic decision-making. 展开更多
关键词 Land use planning Public participation Participation value case analysis
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China Court Cases on Intellectual Property Rights——First Chinese-English treatise on lP-related case analyses;hard cover,900 pages
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《中国专利与商标》 2002年第3期16-16,共1页
For the purpose of summarising the judicial experiencein adjudicating IP-related cases and familarising the readersin China and overseas with the practical situation of
关键词 In China Court cases on Intellectual Property Rights First Chinese-English treatise on lP-related case analyses hard cover 900 pages case
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Research on the Teaching Reform of Polymer Materials Foundation Course-Based on the Case Analysis Method
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作者 Yinjie Wang Jiping Liu +1 位作者 Jia Han Xingyan Xu 《Journal of Contemporary Educational Research》 2021年第10期126-130,共5页
In today's education and teaching reform,the traditional teaching method in the teaching of polymer materials has been gradually replaced with various new teaching methods.Among them,the case analysis method is a ... In today's education and teaching reform,the traditional teaching method in the teaching of polymer materials has been gradually replaced with various new teaching methods.Among them,the case analysis method is a very efective teaching method,which has been applied to the teaching of polymer materials.Through example-based teaching,students 125 participation can be effectively improved,and their theoretical knowledge can be fully utilized.This would have a positive role in promoting the improvement of students'knowledge system and their learning ability.In regard to this,this article analyzes the application of case analysis in the teaching of polymer materials so as to improve its efficiency and quality. 展开更多
关键词 Polymer materials foundation course case analysis method Classroom teaching Teaching reform
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Subgroup comparison of COVID-19 case and mortality with associated factors in Mississippi: findings from analysis of the first four months of public data 被引量:1
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作者 Lei Zhang Stephanie T.McLeod +3 位作者 Rodolfo Vargas Xiaojian Liu Dorthy K.Young Thomas E.Dobbs 《The Journal of Biomedical Research》 CAS CSCD 2020年第6期446-457,共12页
We compared subgroup differences in COVID-19 case and mortality and investigated factors associated with case and mortality rate(MR)measured at the county level in Mississippi.Findings were based on data published by ... We compared subgroup differences in COVID-19 case and mortality and investigated factors associated with case and mortality rate(MR)measured at the county level in Mississippi.Findings were based on data published by the Mississippi State Department of Health between March 11 and July 16,2020.The COVID-19 case rate and case fatality rate(CFR)differed by gender and race,while MR only differed by race.Residents aged 80 years or older and those who live in a non-metro area had a higher case rate,CFR,and MR.After controlling for selected factors,researchers found that the percent of residents who are obese,low income,or with certain chronic conditions were associated with the county COVID-19 case rate,CFR,and/or MR,though some were negatively related.The findings may help the state to identify counties with higher COVID-19 case rate,CFR,and MR based on county demographics and the degree of its chronic conditions. 展开更多
关键词 COVID-19 case rate case fatality rate mortality rate
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Case and Questions Design in Case- based Learning Used in Medical-nursing English Teaching
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作者 刘红霞 《海外英语》 2016年第6期241-242,244,共3页
Case-based learning(CBL) is gradually replacing the traditional lecturing-based learning in nursing English teaching.In the process of CBL, selecting and compiling a good case is key to the success of CBL. In the mean... Case-based learning(CBL) is gradually replacing the traditional lecturing-based learning in nursing English teaching.In the process of CBL, selecting and compiling a good case is key to the success of CBL. In the meantime, designing questions is an important factor for successful CBL. In this article, we discuss how to select and compile cases and how to design questions in CBL used in Medical-nursing English Teaching. 展开更多
关键词 case-based LEaRNING case QUESTIONS
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New analytical imaging algorithm for general case airborne bistatic SAR
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作者 Jianyun Zhang Jinhe Ran Yongjun Wu 《Journal of Systems Engineering and Electronics》 SCIE EI CSCD 2014年第5期786-793,共8页
This paper focuses on the general case (GC) airborne bistatic synthetic aperture radar (SAR) data processing, and a new analytical imaging algorithm based on the extended Loffeld's bistatic formula (ELBF) is pr... This paper focuses on the general case (GC) airborne bistatic synthetic aperture radar (SAR) data processing, and a new analytical imaging algorithm based on the extended Loffeld's bistatic formula (ELBF) is proposed. According to the bistatic SAR geometry, the track decoupling formulas that convert the bistatic geometry to the receiver-referenced geometry in a concise way are derived firstly. Then phase terms of ELBF are decomposed into two independent phase terms as the range phase term and the azimuth phase term in a new way. To get the focusing result, the bistatic deformation (BD) term is compensated in the two-dimensional (2- D) frequency domain, and the space-variances of the range phase term and the azimuth phase term are eliminated by chirp scaling (CS) and chirp z-transform (CZT), respectively. The effectiveness of the proposed algorithm is verified by the simulation results. 展开更多
关键词 track decoupling scaling factor general case (GC) bistatic synthetic aperture radar (SaR) imaging algorithm.
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Case Analysis of Environmental Friendliness of Green Buildings
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作者 ZHANG Yu MA Li DONG Li 《Journal of Landscape Research》 2020年第5期9-12,共4页
During the process of construction and maintenance, buildings have had many negativeeffects on the environment, such as destruction of the ecological environment, consumption of naturalresources, air pollution and gen... During the process of construction and maintenance, buildings have had many negativeeffects on the environment, such as destruction of the ecological environment, consumption of naturalresources, air pollution and generation of large amounts of construction waste. The development of greenbuildings has greatly improved the negative impact of buildings on the environment. In the whole life cycleof construction and maintenance of buildings, the consumption of natural resources is reduced, and thedamage to the environment is reduced. In this article, the representative green buildings in Asia are analyzedfrom the aspects of regional humanity, land saving measures, energy-saving measures, behavior-guidedgreen design strategies, building materials, effective greening measures and smart city strategies, and theexcellent design strategies are summarized, in order to provide reference for future architectural practice. 展开更多
关键词 Environmental friendliness Green building Environmental resource case study
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Complete Fusion of the Maxillamandibular: Report of a Rare Case and Review of the Literature
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作者 Hakim Chabbak Amine Rafik Abdessamad Chlihi 《International Journal of Otolaryngology and Head & Neck Surgery》 2015年第3期220-223,共4页
The maxillomandibular fusion is a very rare condition, with no more than forty cases described in the literature. Adhesions of bone and/or soft tissue between the mandible and maxilla manifest themselves in the inabil... The maxillomandibular fusion is a very rare condition, with no more than forty cases described in the literature. Adhesions of bone and/or soft tissue between the mandible and maxilla manifest themselves in the inability to open the mouth added to impacts on mandibular growth, nutrition and speech. This condition can be isolated or, when congenital, associated with other anomalies such as cleft lip and palate, aglossia, or Van der Woude syndrome. In the present paper, we report a case of maxillomandibular fusion treated in our department at University Hospital, between February 2011 and June 2014. The case is a congenital maxillomandibular fusion in a two-year-old infant, associated with a syndrome of Van der Woude. We discuss the diagnostic and treatment difficulties on the anaesthetic and surgical levels and the action to be taken to avoid recurrence. To date, some classifications have been suggested in the literature, but there is no standard treatment protocol. Early treatment is necessary to allow freedom of the upper airway, and ensure proper nutrition and good growth of facial bones. The success of surgery is conditioned by an adequate physiotherapy follow-up likely to guarantee the non-recurrence of the lesion. 展开更多
关键词 COMPLETE FUSION of the Maxillamandibular: REPORT of a RaRE case and Review of the LITERaTURE
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Design Method and Classic Case Analysis of Low Carbon Community
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作者 CHEN Yue YANG Xin ZHANG Qi 《Journal of Landscape Research》 2022年第4期1-4,10,共5页
Realizing “carbon peaking” and “carbon neutrality” is a major strategic decision made by China to coordinate domestic and international situations.In order to achieve the “double carbon” goal,it is also necessar... Realizing “carbon peaking” and “carbon neutrality” is a major strategic decision made by China to coordinate domestic and international situations.In order to achieve the “double carbon” goal,it is also necessary for relevant practitioners to actively put into practice to improve the participation of residents and advocate low carbon life while formulating the policy action plan.Community is an important place for human activities and one of the main spatial types of carbon emissions in cities.Doing a good job in planning energy conservation and emission reduction in the community plays an important role in achieving the “double carbon” goal.Through the analysis of classic low carbon community practice cases at home and abroad,6 planning and design methods for low carbon community are concluded,and the development status of low carbon community in China is reflected and summarized. 展开更多
关键词 “Double carbon”goal Low carbon community Planning and design method Classic case
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Metastatic clear cell sarcoma of the pancreas:A rare case report 被引量:3
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作者 Yu-Jing Liu Chen Zou Yong-You Wu 《World Journal of Clinical Cases》 SCIE 2024年第8期1448-1453,共6页
BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone an... BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone and brain;however,pancreatic metastasis is relatively rare.CASE SUMMARY We report on a rare case of CCS with pancreatic metastasis in a 47-year-old man.The patient had a relevant medical history 3 years ago,with abdominal pain as the main clinical manifestation.No abnormalities were observed on physical examination and the tumor was found on abdominal computed tomography.Based on the medical history and postoperative pathology,the patient was diagnosed with CCS with pancreatic metastasis.The patient was successfully treated with surgical interventions,including distal pancreatectomy and sple-nectomy.CONCLUSION This report summarizes the available treatment modalities for CCS and the importance of regular postoperative follow-up for patients with CCS. 展开更多
关键词 Clear cell sarcoma PaNCREaS METaSTaSIS FOLLOW-UP case report
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High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report 被引量:2
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作者 Nao Furuya Atsushi Yamaguchi +13 位作者 Naohiro Kato Syuhei Sugata Takuro Hamada Takeshi Mizumoto Yuzuru Tamaru Ryusaku Kusunoki Toshio Kuwai Hirotaka Kouno Kazuya Kuraoka Yoshiyuki Shibata Sho Tazuma Takeshi Sudo Hiroshi Kohno Shiro Oka 《World Journal of Clinical Cases》 SCIE 2024年第8期1487-1496,共10页
BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most ... BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation. 展开更多
关键词 Pancreatic cancer Pancreatic intraepithelial neoplasm High-grade pancreatic intraepithelial neoplasm Magnetic resonance cholangiopancreatography Carcinoma in situ case report
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Patient satisfaction and follow-up adherence to glaucoma case management clinic in China 被引量:1
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作者 Hao Lin Hu-Jie Lu +3 位作者 Wen-Zhe Zhou Shu-Shu Zuo Yan-Yan Chen Shao-Dan Zhang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第1期73-81,共9页
AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota... AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals. 展开更多
关键词 GLaUCOMa patient satisfaction follow-up adherence case management
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Mechanical upper bowel obstruction caused by a large trichobezoar in a young woman: A very unusual case report 被引量:1
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作者 Magdalena Scherrer Peter Kornprat +2 位作者 Robert Sucher Johanna Muehlsteiner Doris Wagner 《World Journal of Clinical Cases》 SCIE 2024年第4期777-781,共5页
BACKGROUND Bezoars usually compile human fibers and debris.A special form of bezoar in case of psychologically altered individuals is the trichobezoar.It consists of voluntarily swallowed hair bulks and is normally re... BACKGROUND Bezoars usually compile human fibers and debris.A special form of bezoar in case of psychologically altered individuals is the trichobezoar.It consists of voluntarily swallowed hair bulks and is normally removed via gastroscopy.Trichobezoars leading to ileus have rarely been reported.CASE SUMMARY A 24-year-old female patient presented to the emergency room with abdominal pain,nausea,and vomiting for 3 d.Her previous medical and psychiatric history was unremarkable.Laboratory analysis showed iron deficiency anemia,leukocytosis,and elevated liver enzymes.An abdominal CT scan revealed a dense structure in the patients’stomach which turned out to be a huge trichobezoar completely obstructing the pylorus.The trichobezoar had to be removed surgi-cally.During her postoperative course,a subcutaneous seroma formed.After a single puncture,the rest of the recovery process was unremarkable,and the patient recovered fully.CONCLUSION A mechanical bowel obstruction is a potentially life-threatening event for every patient.In our case a young female was suffering from severe symptoms of an obstruction which might have resulted in serious harm without successful surgical management. 展开更多
关键词 Rapunzel syndrome Hair ingestion GaSTROSCOPY BEZOaR case report
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Perforated gastric ulcer causing mediastinal emphysema: A case report 被引量:1
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作者 Zhi-Cheng Dai Xun-Wu Gui +2 位作者 Feng-He Yang Hao-Yuan Zhang Wen-Feng Zhang 《World Journal of Clinical Cases》 SCIE 2024年第4期859-864,共6页
BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of reasons.It can be spontaneous or secondary to chest trauma,es... BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of reasons.It can be spontaneous or secondary to chest trauma,esophageal perforation,medi-cally induced factors,etc.Its common symptoms are chest pain,tightness in the chest,and respiratory distress.Most mediastinal emphysema patients have mild symptoms,but severe mediastinal emphysema can cause respiratory and circulatory failure,resulting in serious consequences.CASE SUMMARY A 75-year-old man,living alone,presented with sudden onset of severe epigastric pain with chest tightness after drinking alcohol.Due to the remoteness of his residence and lack of neighbors,the patient was found by his nephew and brought to the hospital the next morning after the disease onset.Computed tomography(CT)showed free gas in the abdominal cavity,mediastinal emph-ysema,and subcutaneous pneumothorax.Upper gastrointestinal angiography showed that the esophageal mucosa was intact and the gastric antrum was perforated.Therefore,we chose to perform open gastric perforation repair on the patient under thoracic epidural anesthesia combined with intravenous anesthesia.An operative incision of the muscle layer of the patient's abdominal wall was made,and a large amount of subperitoneal gas was revealed.And a continued incision of the peritoneum revealed the presence of a perforation of approx-imately 0.5 cm in the gastric antrum,which we repaired after pathological examination.Postoperatively,the patient received high-flow oxygen and cough exercises.Chest CT was performed on the first and sixth postoperative days,and the mediastinal and subcutaneous gas was gradually reduced.CONCLUSION After gastric perforation,a large amount of free gas in the abdominal cavity can reach the mediastinum through the loose connective tissue at the esophageal hiatus of the diaphragm,and upper gastrointestinal angiography can clarify the site of perforation.In patients with mediastinal emphysema,open surgery avoids the elevation of the diaphragm caused by pneumoperitoneum compared to laparoscopic surgery and avoids increasing the mediastinal pressure.In addition,thoracic epidural anesthesia combined with intravenous anesthesia also avoids pressure on the mediastinum from mechanical ventilation. 展开更多
关键词 Gastric ulcer Perforated Mediastinal emphysema case report
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