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交互式数字叙事:加拿大Writing New Body Worlds阅读治疗新探索
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作者 牟晓青 于志涛 《图书馆论坛》 CSSCI 北大核心 2024年第4期222-230,F0003,共10页
文章基于相关研究文献与语料,对加拿大WNB阅读治疗实践进行梳理与归纳。WNB首次使用交互式数字叙事技术,构建面向公众的阅读治疗平台,以其交互式特征,融合了阅读和治疗引导两个过程,提供可访问的非临床方式,可面向大规模人群实现预防性... 文章基于相关研究文献与语料,对加拿大WNB阅读治疗实践进行梳理与归纳。WNB首次使用交互式数字叙事技术,构建面向公众的阅读治疗平台,以其交互式特征,融合了阅读和治疗引导两个过程,提供可访问的非临床方式,可面向大规模人群实现预防性健康干预。基于数据与计算的精准化阅读治疗是数字人文视角下的新变革,更具推广应用价值;以在线阅读平台建设为依托,推进实施平台化的阅读和治疗应成为未来发展方向之一;基于阅读形态与体验因技术赋能而改变的现状,图书馆应发挥引领作用,积极收集、创建或协助创建数字故事,推进阅读推广、服务与治疗的融合性发展,成为社区建设促进者、历史欣赏者和社区参与倡导者,也使阅读借助交互式数字叙事这一新载体,更好地发挥变革的力量,促进健康与幸福。 展开更多
关键词 交互式数字叙事 阅读治疗 writing New Body Worlds 加拿大
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以读促写,以写促读:北师大版初中英语新教材Writing Workshop的设计理念与实施路径
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作者 钱小芳 陈芳 朱文娟 《教学月刊(中学版)(外语教学)》 2024年第9期37-43,共7页
北师大版初中英语新教材中的Writing Workshop的设计遵循“从读听课输入到读写课输出,在单元中逐步生成写作能力”“采用读写结合模式,注重过程指导,提供多维写作支架”“从问题入手,贯穿‘学—思—用—创’一体化思路,以多元评价促学... 北师大版初中英语新教材中的Writing Workshop的设计遵循“从读听课输入到读写课输出,在单元中逐步生成写作能力”“采用读写结合模式,注重过程指导,提供多维写作支架”“从问题入手,贯穿‘学—思—用—创’一体化思路,以多元评价促学”的理念。它分两个课时进行教学:第一课时强调把握写作任务,由读到写;第二课时注重写作与评价共进,旨在切实提升学生的写作能力,发展学生的核心素养。 展开更多
关键词 北师大版新教材 writing Workshop 以读促写 以写促读
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Fostering Chinese National Unity:Advocating the National Common Language and Writing System for Heightened Community Awareness
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作者 Yuying Han 《Journal of Contemporary Educational Research》 2023年第12期301-307,共7页
The promotion of the national common language and writing system stands as a cornerstone in cultivating a sense of community among the Chinese nation.The national common language and writing system,serving as a potent... The promotion of the national common language and writing system stands as a cornerstone in cultivating a sense of community among the Chinese nation.The national common language and writing system,serving as a potent vehicle for cultural dissemination and linguistic communication,acts as a crucial bridge fostering unity,mutual support,cultural exchange,and cohesion among diverse ethnic groups.Its widespread promotion not only reinforces the cohesion of the Chinese nation but also plays a pivotal role in fortifying national and cultural identity.The advocacy and dissemination of the national common language and writing system contribute significantly to enhancing the sense of community within the Chinese nation.This concerted effort serves as an internal driving force,creating a positive feedback loop that strengthens both national identity and the cultural bonds shared by the Chinese people.The reciprocal relationship between the promotion and popularization of the national common language and writing system reinforces a mutual sense of assistance and reciprocity.This bidirectional dynamic propels a synergistic interplay,fostering a beneficial cycle in the promotion and widespread adoption of the national common language and writing system.In essence,the promotion and popularization of the national common language and writing system not only contribute to its advancement but also serve to deepen the sense of community within the Chinese nation.This reciprocal interaction between the two elements establishes a robust foundation for nurturing a strong and cohesive Chinese community. 展开更多
关键词 PROMOTION National common language and writing system Forging a sense of community
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Detecting LLM-assisted writing in scientific communication:Are we there yet?
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作者 Teddy Lazebnik Ariel Rosenfeld 《Journal of Data and Information Science》 CSCD 2024年第3期4-13,共10页
Large Language Models(LLMs),exemplified by ChatGPT,have significantly reshaped text generation,particularly in the realm of writing assistance.While ethical considerations underscore the importance of transparently ac... Large Language Models(LLMs),exemplified by ChatGPT,have significantly reshaped text generation,particularly in the realm of writing assistance.While ethical considerations underscore the importance of transparently acknowledging LLM use,especially in scientific communication,genuine acknowledgment remains infrequent.A potential avenue to encourage accurate acknowledging of LLM-assisted writing involves employing automated detectors.Our evaluation of four cutting-edge LLM-generated text detectors reveals their suboptimal performance compared to a simple ad-hoc detector designed to identify abrupt writing style changes around the time of LLM proliferation.We contend that the development of specialized detectors exclusively dedicated to LLM-assisted writing detection is necessary.Such detectors could play a crucial role in fostering more authentic recognition of LLM involvement in scientific communication,addressing the current challenges in acknowledgment practices. 展开更多
关键词 LLM-assisted writing Scientific communication writing style
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Surgical strategies for challenging common bile duct stones in the endoscopic era: A comprehensive review of current evidence
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作者 Tharathorn Suwatthanarak Vitoon Chinswangwatanakul +4 位作者 Asada Methasate Chainarong Phalanusitthepha Minoru Tanabe Keiichi Akita Thawatchai Akaraviputh 《World Journal of Gastrointestinal Endoscopy》 2024年第6期305-317,共13页
While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known ... While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known as common bile duct exploration(CBDE),is still necessary in cases of difficult CBDS,failed endoscopic treatment,or altered anatomy.Recent evidence also supports CBDE in patients requesting single-step cholecystectomy and bile duct stone removal with comparable outcomes.This review elucidates relevant clinical anatomy,selection indications,and outcomes to enhance surgical understanding.The selection between trans-cystic(TC)vs trans-choledochal(TD)approaches is described,along with stone removal techniques and ductal closure.Detailed surgical techniques and strategies for both the TC and TD approaches,including instrument selection,is also provided.Additionally,this review comprehensively addresses operation-specific complications such as bile leakage,stricture,and entrapment,and focuses on preventive measures and treatment strategies.This review aims to optimize the management of CBDS through laparoscopic CBDE,with the goal of improving patient outcomes and minimizing risks. 展开更多
关键词 CHOLEDOCHOLITHIASIS common bile duct stone Difficult common bile duct stone common bile duct exploration Laparoscopic common bile duct exploration
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Distal-scanning common path probe for optical coherence tomography
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作者 Zhengyu Chen Bin He +8 位作者 Zichen Yin Zhangwei Hu Yejiong Shi Chengming Wang Xiao Zhang Ning Zhang Linkai Jing Guihuai Wang Ping Xue 《Journal of Innovative Optical Health Sciences》 SCIE EI CSCD 2024年第3期84-92,共9页
In this paper,we present a distal-scanning common path probe for optical coherence tomography(OCT)equipped with a hollow ultrasonic motor and a simple and specially designed beam-splitter.This novel probe proves to be... In this paper,we present a distal-scanning common path probe for optical coherence tomography(OCT)equipped with a hollow ultrasonic motor and a simple and specially designed beam-splitter.This novel probe proves to be able to effectively circumvent polarization and dispersion mismatch caused by fiber motion and is more robust to a variety of interfering factors during the imaging process,experimentally compared to a conventional noncommon path probe.Furthermore,our design counteracts the attenuation of backscattering with depth and the fall-off of the signal,resulting in a more balanced signal range and greater imaging depth.Spectral-domain OCT imaging of phantom and biological tissue is also demonstrated with a sensitivity of∼100dB and a lateral resolution of∼3μm.This low-cost probe offers simplified system configuration and excellent robustness,and is therefore particularly suitable for clinical diagnosis as one-off medical apparatus. 展开更多
关键词 common path optical coherence tomography endoscopic probe
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Do brood parasitic Common Cuckoos develop brood patches during the breeding season?
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作者 Jun-Seo Go Hae-Ni Kim +3 位作者 Sue-Jeong Jin Myeong-Chan Cha Heesoo Lee Jin-Won Lee 《Avian Research》 SCIE CSCD 2024年第3期363-368,共6页
Many birds develop brood patches on their ventral apterium under hormonal regulation to effectively transmit body heat to eggs during incubation.The developed patch has several characteristics,including de-feathering,... Many birds develop brood patches on their ventral apterium under hormonal regulation to effectively transmit body heat to eggs during incubation.The developed patch has several characteristics,including de-feathering,vascularization,and edema.However,little is known about whether avian brood parasites that do not incubate their eggs exhibit brood patch development during the breeding season.In this study,we measured the size of the ventral apterium in 114 Common Cuckoos(Cuculus canorus)captured in the field throughout the breeding season and examined the appearance of the ventral apterium to confirm the development of brood patches.We also examined whether morphological traits and various factors correlated with the size of the ventral apterium(sternal apterium and abdominal apterium)and how it changed during the breeding season.We found no clear signs of brood patch development in Common Cuckoos captured throughout the breeding season,indicating that they likely did not develop brood patches on the ventral apterium during this period.We also found that ventral apterium size was positively correlated with wing length and body weight.In addition,Common Cuckoos with newly growing feathers on the boundary of the ventral apterium with pteryla were frequently observed as seasons progressed to the end.In conclusion,Common Cuckoos exhibit neither brood patch development nor the vestigial characteristics of ancestral brood patches,except for the growth of feathers on boundary the ventral apterium.Further studies examining brood patches across different groups of avian brood parasites are valuable for enhancing our understanding of the developmental and physiological adaptations of avian brood parasites. 展开更多
关键词 Brood parasitism Brood patch common Cuckoo Pterylosis Re-feathering Ventral apterium
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Results of Surgical Management of Malignant Obstruction of the Common Bile Duct in Yaoundé
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作者 Eric Patrick Savom Gaël Tsanga Nomo +5 位作者 Richard II Mbele Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang Arthur Essomba 《Surgical Science》 2024年第4期265-277,共13页
Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical tre... Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores. 展开更多
关键词 Malignant Obstruction common Bile Duct Palliative Treatment MORBIDITY MORTALITY
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Oriental Reed Warblers do not abandon Common Cuckoo chicks during prolonged nestling periods
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作者 Hanlin Yan Huahua Zhao +3 位作者 Haixia Luo Longwu Wang Laikun Ma Wei Liang 《Avian Research》 SCIE CSCD 2024年第3期369-373,共5页
The Oriental Reed Warbler(Acrocephalus orientalis)is one of the most commonly used hosts for the parasitic Common Cuckoo(Cuculus canorus).However,as hosts that feed unrelated parasitic nestlings may suffer extra repro... The Oriental Reed Warbler(Acrocephalus orientalis)is one of the most commonly used hosts for the parasitic Common Cuckoo(Cuculus canorus).However,as hosts that feed unrelated parasitic nestlings may suffer extra reproductive costs,they may be less willing to care for nestlings that have prolonged nestling periods.To test this hypothesis,the duration of feeding by Oriental Reed Warblers under natural conditions for their own nestlings was compared with the duration of feeding under natural conditions for Common Cuckoo nestlings and for artificially prolonged cuckoo nestlings.The results showed that Oriental Reed Warblers did not starve,drive away,or desert any of the nestlings in the experiment,and neither parent was left alone.Our experimental study indicates that both Oriental Reed Warbler parents were willing to care for nestlings with a prolonged nestling period(up to 30 days,twice the average duration time that the Oriental Reed Warblers fed their own chicks in natural conditions).However,further experiments and observations are required in other host bird species to examine whether both parents or one of the parents may exhibit the behavior of abandoning nestlings with a prolonged nestling period. 展开更多
关键词 Brood parasitism common Cuckoo Deserted nestling Oriental Reed Warbler Prolonged nestling period
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Digital Infrastructure and Common Prosperity: An Influence Mechanism and Effect Test
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作者 Deng Liyuan Wang Shuo Tang Daisheng 《Contemporary Social Sciences》 2024年第5期1-25,共25页
Common prosperity is an important goal of China’s modernization efforts,and narrowing the income gap among different regions and populations is crucial to achieving common prosperity.The construction of digital infra... Common prosperity is an important goal of China’s modernization efforts,and narrowing the income gap among different regions and populations is crucial to achieving common prosperity.The construction of digital infrastructure has significantly boosted productivity and facilitated the diffusion of technology in less developed regions,leading to notable changes in labor employment and the income gap,which aligns with the goal of common prosperity.This paper explores the mechanism through which digital infrastructure influences common prosperity with a focus on employment,using panel data from 30 provinces in China between 2011 and 2021 for an empirical test.The research finds that digital infrastructure significantly promotes common prosperity.By expanding employment and increasing labor remuneration,the influence of digital infrastructure on common prosperity exhibits regional heterogeneity and a nonlinear threshold effect.The research suggests that the government should enhance investment in and construction of digital infrastructure,reduce the digital divide through policy support in rural areas,promote digital employment and skills training,and encourage industrial integration and enterprise participation. 展开更多
关键词 digital infrastructure income gap employment scale labor remuneration common prosperity
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Accelerating the Digitalization Process in Rural China and Promoting Common Prosperity
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作者 Zhongxiong LAI Xiaoqiong XU 《Asian Agricultural Research》 2024年第3期8-13,共6页
Under the historical background of promoting agricultural and rural modernization in an all-round way,this paper deeply analyzes the practical significance of digital construction in rural China,and explores the probl... Under the historical background of promoting agricultural and rural modernization in an all-round way,this paper deeply analyzes the practical significance of digital construction in rural China,and explores the problems in the digitalization level of rural infrastructure,farmers digitalization awareness and accomplishment,and agricultural digital system.Countermeasures and suggestions are put forward from four aspects:digital village construction policy system,rural digital infrastructure construction,rural digital talent cultivation system,and agricultural digital system,and the rural digital construction of Huzhou City is taken as an example,in order to further realize the goal of empowering rural farmers with digital technology for common prosperity. 展开更多
关键词 DIGITAL VILLAGE DIGITAL technology Rural FARMER common PROSPERITY
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Deep-subwavelength single grooves prepared by femtosecond laser direct writing on Si
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作者 叶瑞熙 黄敏 《Chinese Physics B》 SCIE EI CAS CSCD 2024年第8期108-115,共8页
It is well known that femtosecond laser pulses can easily spontaneously induce deep-subwavelength periodic surface structures on transparent dielectrics but not on non-transparent semiconductors.Nevertheless,in this s... It is well known that femtosecond laser pulses can easily spontaneously induce deep-subwavelength periodic surface structures on transparent dielectrics but not on non-transparent semiconductors.Nevertheless,in this study,we demonstrate that using high-numerical-aperture 800 nm femtosecond laser direct writing with controlled pulse energy and scanning speed in the near-damage-threshold regime,polarization-dependent deep-subwavelength single grooves with linewidths of~180 nm can be controllably prepared on Si.Generally,the single-groove linewidth increases slightly with increase in the pulse energy and decrease in the scanning speed,whereas the single-groove depth significantly increases from~300 nm to~600 nm with decrease in the scanning speed,or even to over 1μm with multi-processing,indicating the characteristics of transverse clamping and longitudinal growth of such deep-subwavelength single grooves.Energy dispersive spectroscopy composition analysis of the near-groove region confirms that single-groove formation tends to be an ultrafast,non-thermal ablation process,and the oxidized deposits near the grooves are easy to clean up.Furthermore,the results,showing both the strong dependence of groove orientation on laser polarization and the occurrence of double-groove structures due to the interference of pre-formed orthogonal grooves,indicate that the extraordinary field enhancement of strong polarization sensitivity in the deep-subwavelength groove plays an important role in single-groove growth with high stability and collimation. 展开更多
关键词 femtosecond-laser direct writing of Si deep-subwavelength single grooves polarization dependence high numerical aperture ultrafast non-thermal ablation
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Undifferentiated high-grade pleomorphic sarcoma of the common bile duct:A case report and review of literature
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作者 Li-Ping Zheng Wen-Yan Shen +4 位作者 Chun-Dong Hu Chun-Hua Wang Xu-Jian Chen Jing Wang Yi-Yu Shen 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第5期2253-2260,共8页
BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of ... BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis.Here we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such cases.CASE SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk.Her laboratory data suggested significantly elevated hepatorenal function levels.The imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal CBD.After endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were performed.The frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was performed.Finally,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.CONCLUSION This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies. 展开更多
关键词 Undifferentiated pleomorphic sarcoma Soft tissue sarcoma common bile duct Extrahepatic bile duct IMMUNOHISTOCHEMISTRY Case report
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Analyzing the Essay Writing Patterns of Iranian Intermediate-Level Korean Language Learners: A Study Based on the TOPIK Exam
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作者 Vahid Reza Nasrollahi 《Sino-US English Teaching》 2024年第8期354-371,共18页
This study examines the writing abilities of Iranian intermediate Korean learners,specifically their performance in the compositional writing section of the Test of Proficiency in Korean(TOPIK).By utilizing the many F... This study examines the writing abilities of Iranian intermediate Korean learners,specifically their performance in the compositional writing section of the Test of Proficiency in Korean(TOPIK).By utilizing the many FACETS-Rasch Model,we meticulously analyzed nine writing samples from the 52nd TOPIK.These samples were evaluated using a modified rubric ranging from 0 to 3 based on predefined criteria for written composition.The results underscored that the sections on“appropriateness of spacing and spelling,”“relevance of vocabulary,”and“content diversity”presented the most significant challenges for the learners.On the other hand,“the quantity of writing”emerged as the least challenging aspect.These findings reveal substantial disparities in various aspects of writing proficiency among learners.The study not only pinpoints issue areas in writing skills,but also underscores the necessity of customized teaching strategies within the TOPIK framework to address these weaknesses.Consequently,it offers valuable insights that could bolster the effectiveness of teaching writing to Korean language learners.The findings of this study are not only significant for the field of language education,but also contribute to a deeper understanding of the challenges faced by intermediate learners and provide a roadmap for improving language instruction. 展开更多
关键词 TOPIK writing evaluation Iranian intermediate Korean learners multinational research analysis writing challenges language education strategies
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Security Vulnerability Analyses of Large Language Models (LLMs) through Extension of the Common Vulnerability Scoring System (CVSS) Framework
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作者 Alicia Biju Vishnupriya Ramesh Vijay K. Madisetti 《Journal of Software Engineering and Applications》 2024年第5期340-358,共19页
Large Language Models (LLMs) have revolutionized Generative Artificial Intelligence (GenAI) tasks, becoming an integral part of various applications in society, including text generation, translation, summarization, a... Large Language Models (LLMs) have revolutionized Generative Artificial Intelligence (GenAI) tasks, becoming an integral part of various applications in society, including text generation, translation, summarization, and more. However, their widespread usage emphasizes the critical need to enhance their security posture to ensure the integrity and reliability of their outputs and minimize harmful effects. Prompt injections and training data poisoning attacks are two of the most prominent vulnerabilities in LLMs, which could potentially lead to unpredictable and undesirable behaviors, such as biased outputs, misinformation propagation, and even malicious content generation. The Common Vulnerability Scoring System (CVSS) framework provides a standardized approach to capturing the principal characteristics of vulnerabilities, facilitating a deeper understanding of their severity within the security and AI communities. By extending the current CVSS framework, we generate scores for these vulnerabilities such that organizations can prioritize mitigation efforts, allocate resources effectively, and implement targeted security measures to defend against potential risks. 展开更多
关键词 common Vulnerability Scoring System (CVSS) Large Language Models (LLMs) DALL-E Prompt Injections Training Data Poisoning CVSS Metrics
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Scoring and Consequential Validity Evidence of Computer-and Paper-Based Writing Tests in Times of Change
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作者 María GUAPACHA-CHAMORRO Orlando CHAVES-VARÓN 《Chinese Journal of Applied Linguistics》 2024年第3期450-480,525,共32页
Little is known about how the assessment modality,i.e.,computer-based(CB)and paper-based(PB)tests,affects language teachers’scorings,perceptions,and preferences and,therefore,the validity and fairness of classroom wr... Little is known about how the assessment modality,i.e.,computer-based(CB)and paper-based(PB)tests,affects language teachers’scorings,perceptions,and preferences and,therefore,the validity and fairness of classroom writing assessments.The present mixed-methods study used Shaw and Weir’s(2007)sociocognitive writing test validation framework to examine the scoring and consequential validity evidence of CB and PB writing tests in EFL classroom assessment in higher education.Original handwritten and word-processed texts of 38 EFL university students were transcribed to their opposite format and assessed by three language lecturers(N=456 texts,152 per teacher)to examine the scoring validity of CB and PB tests.The teachers’perceptions of text quality and preferences for assessment modality accounted for the consequential validity evidence of both tests.Findings revealed that the assessment modality impacted teachers’scorings,perceptions,and preferences.The teachers awarded higher scores to original and transcribed handwritten texts,particularly text organization and language use.The teachers’perceptions of text quality differed from their ratings,and physical,psychological,and experiential characteristics influenced their preferences for assessment modality.The results have implications for the validity and fairness of CB and PB writing tests and teachers’assessment practices. 展开更多
关键词 scoring validity consequential validity CB and PB writing tests classroom assessment
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Clinical efficacy of laparoscopic cholecystectomy combined with endoscopic papillary balloon dilation in treatment of gallbladder stones with common bile duct stones: A retrospective study
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作者 Hong-Dan Liu Qi Zhang +1 位作者 Wen-Si Xu Shuang Jin 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第6期1700-1708,共9页
BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic ... BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery. 展开更多
关键词 Gallbladder stone common bile duct stone Endoscopic papillary balloon dilation Laparoscopic cholecystectomy Endoscopic sphincterotomy
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Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrenceassociated risk factors
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作者 Jia-Hua Liao Ju-Shi Li +1 位作者 Tie-Long Wang Wen-Shen Liu 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第11期3511-3519,共9页
BACKGROUND There remain controversies regarding the surgical treatment of extrahepatic bile duct stones(EHBDSs)in clinical practice.AIM To explore the curative effect of laparoscopic cholecystectomy(LC)plus common bil... BACKGROUND There remain controversies regarding the surgical treatment of extrahepatic bile duct stones(EHBDSs)in clinical practice.AIM To explore the curative effect of laparoscopic cholecystectomy(LC)plus common bile duct exploration(CBDE)for the surgical treatment of EHBDSs and to analyze the risk factors that affect postoperative stone recurrence.METHODS Eighty-two patients with EHBDSs admitted between March 2017 and March 2023 were selected.Among them,patients treated with open choledocholithotomy plus LC or open cholecystectomy(OC)were set as the control group(n=40),and those treated with LC plus CBDE served as the observation group(n=42).The surgical outcomes of the two groups were compared,the surgical complications and Gas-trointestinal Quality of Life Index(GIQLI)scores were counted,and the one-year prognostic recurrence was recorded.Independent factors for postoperative re-currence were determined using univariate and multivariate analyses.RESULTS The two groups were comparable in the stone residual rate(P>0.05).The ope-ration time(P<0.05),intraoperative bleeding(P<0.05),and total complication rate(P=0.005)were lower in the observation group than in the control group.The observation group exhibited a marked increase in the GIQLI score,which was higher than the control group(P<0.05).A lower one-year recurrence rate was determined in the observation group vs the control group(P=0.027).Sphincter of Oddi dysfunction[odds ratio(OR)=5.712,P=0.007]and the treatment scheme of open choledocholithotomy plus LC or OC(OR=6.771,P=0.008)were the independent risk factors for one-year recurrence in patients after surgery.CONCLUSION LC plus CBDE for patients with EHBDSs can reduce stone residuals,intraoperative bleeding,complications,and postoperative recurrence. 展开更多
关键词 Laparoscopic cholecystectomy common bile duct exploration Extrahepatic bile duct stones Stone recurrence
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Risk factors for recurrence of common bile duct stones after surgical treatment and effect of ursodeoxycholic acid intervention
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作者 Wei-Hong Yuan Zheng Zhang +2 位作者 Qi Pan Bo-Neng Mao Tao Yuan 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期103-112,共10页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve choles... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concen-tration in bile.Despite these treatment options,there are still patients who experience stone recurrence.The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People’s Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected.According to the post-ERCP treatment plan,100 patients were classified into UDCA(n=47)and control(n=53)groups.We aimed to assess the clinical efficacy and rate of relapse in the two patient populations.We then collected information(basic demographic data,clinical characteristics,and serum biochemical indicators)and determined the factors contributing to relapse using logistic regression analysis.Our secondary goal was to determine the effects of UDCA on liver function after ERCP.Compared to the control group,the UDCA group demonstrated a higher clinical effectiveness rate of 92.45%vs 78.72%(P<0.05).No significant differences were observed in liver function indices,including total bilirubin,direct bilirubin,gamma-glutamyl transpeptidase,alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase,between the two groups before treatment.After treatment,all liver function indices were significantly reduced.Comparing the control vs UDCA groups,the UDCA group exhibited significantly lower levels of all indices(55.39±6.53 vs 77.31±8.52,32.10±4.62 vs 45.39±5.69,142.32±14.21 vs 189.63±16.87,112.52±14.25 vs 149.36±15.36,122.61±16.00 vs 171.33±22.09,96.98±10.44 vs 121.35±11.57,respectively,all P<0.05).The stone recurrence rate was lower in the UDCA group(13.21%)in contrast with the control group(44.68%).Periampullary diverticula(OR:6.00,95%CI:1.69-21.30),maximum stone diameter(OR:1.69,95%CI:1.01-2.85),stone quantity>3(OR:4.23,95%CI:1.17-15.26),and positive bile culture(OR:7.61,95%CI:2.07-27.91)were independent factors that influenced the relapse of common bile duct stones after ERCP(P<0.05).Furthermore,postoperative UDCA was identified as a preventive factor(OR:0.07;95%CI:0.08-0.09).CONCLUSION The intervention effect of UDCA after ERCP for common bile duct stones is adequate,providing new research directions and references for the prevention and treatment of stone recurrence. 展开更多
关键词 Endoscopic retrograde cholangiopancreatography RECURRENCE Ursodeoxycholic acid common bile duct stones Clinical effective rate Risk factors
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Research on Intergenerational Writing in Contemporary German Immigrant Literature
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作者 ZHOU Lei 《Sino-US English Teaching》 2024年第7期303-308,共6页
With the deepening of globalization,immigration and pluralism have become increasingly common social phenomena.The research of the resulting immigrant literature is an important way to understand the mental journey of... With the deepening of globalization,immigration and pluralism have become increasingly common social phenomena.The research of the resulting immigrant literature is an important way to understand the mental journey of immigrant groups and their construction of cultural identity.In the German-speaking area,immigrant literature has gradually taken center stage over the years,becoming an important part of the German language literature,and immigrant writers have also frequently won various literary prizes,which can be described as particularly dazzling.Meanwhile,generations of writers have been thinking about and exploring the intergenerational relationships and differences among immigrant groups in the context of their own experiences.This paper will focus on some outstanding immigrant writers and discuss the intergenerational writing in immigrant literature by means of their works. 展开更多
关键词 immigrant literature immigrant writers intergenerational writing
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