BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,e...BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.展开更多
BACKGROUND Subchorionic hematoma(SCH)is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane.SCH can lead to adverse pregnancy outcome...BACKGROUND Subchorionic hematoma(SCH)is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane.SCH can lead to adverse pregnancy outcomes such as miscarriage,preterm birth,and other complications.Early detection and accurate assessment of SCH are crucial for appropriate management and improved pregnancy outcomes.AIM To evaluate the diagnostic efficacy of virtual organ computer-assisted analysis(VOCAL)in measuring the volume ratio of SCH to gestational sac(GS)combined with serum progesterone on early pregnancy outcomes in patients with SCH.METHODS A total of 153 patients with SCH in their first-trimester pregnancies between 6 and 11 wk were enrolled.All patients were followed up until a gestational age of 20 wk.The parameters of transvaginal two-dimensional ultrasound,including the circumference of SCH(Cs),surface area of SCH(Ss),circumference of GS(Cg),and surface area of GS(Sg),and the parameters of VOCAL with transvaginal three-dimensional ultrasound,including the three-dimensional volume of SCH(3DVs)and GS(3DVg),were recorded.The size of the SCH and its ratio to the GS size(Cs/Cg,Ss/Sg,3DVs/3DVg)were recorded and compared.RESULTS Compared with those in the normal pregnancy group,the adverse pregnancy group had higher Cs/Cg,Ss/Sg,and 3DVs/3DVg ratios(P<0.05).When 3DVs/3DVg was 0.220,the highest predictive performance predicted adverse pregnancy outcomes,resulting in an AUC of 0.767,and the sensitivity,specificity were 70.2%,75%respectively.VOCAL measuring 3DVs/3DVg combined with serum progesterone gave a diagnostic AUC of 0.824 for early pregnancy outcome in SCH patients,with a high sensitivity of 82.1%and a specificity of 72.1%,which showed a significant difference between AUC.CONCLUSION VOCAL-measured 3DVs/3DVg effectively quantifies the severity of SCH,while combined serum progesterone better predicts adverse pregnancy outcomes.展开更多
The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scap...The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scaphoid fractures remains experimental.The related studies are scanty and most of them are cadaver researches.Some intrinsic defects from the registration procedure,scan and immobilization of limbs may inevitably result in deviations. Some deviations become more obvious with operations of small bones (such as scaphoid)although they are acceptable for spine and other orthopedic surgeries.We reviewed the current literatures on the applications of CAS for scaphoid operation and summarized technical principles,scan and registration methods,immobilization of limbs and their outcomes.On the basis of the data,we analyzed the limitations of this technique and envisioned its future development.展开更多
BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-bas...BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.展开更多
The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen analysis with those obtained by computer-assisted semen analysis (CASA) (Copenhagen R...The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen analysis with those obtained by computer-assisted semen analysis (CASA) (Copenhagen Rigshospitalet Image House Sperm Motility Analysis System (CRISMAS) 4.6 software) using semen samples from 166 young Danish men. The CRISMAS software identifies sperm concentration and classifies spermatozoa into three motility categories. To enable comparison of the two methods, the four motility stages obtained by conventional semen analysis were, based on their velocity classifications, divided into three stages, comparable to the three CRISMAS motility categories: rapidly progressive (A), slowly progressive (B) and non-progressive (C+ D). Differences between the two methods were large for all investigated parameters (P〈0.001). CRISMAS overestimated sperm concentration and the proportion of rapidly progressive spermatozoa and, consequently, underestimated the percentages of slowly progressive and non-progressive spermatozoa, compared to the conventional method. To investigate whether results drifted according to time of semen analysis, results were pooled into quarters according to date of semen analysis. CRISMAS motility results appeared more stable over time compared to the conventional analysis; however, neither method showed any trends. Apparently, CRISMAS CASA results and results from the conventional method were not comparable with respect to sperm concentration and motility analysis. This needs to be accounted for in clinics using this software and in studies of determinants of these semen characteristics.展开更多
Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium cata...Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium catalysis. Starting from the established X-ray structure of bovine GPX, all kinetically defined intermediates and enzyme substrate complexes were modelled. The models thus obtained support the hypothesis that the essential steps of the catalysis are three distinct redox changes of the active site selenium which, in the ground state, presents itself at the surface of selenoperoxidases as the center of a characteristic triad built by selenocysteine, glutarnine and tryptophan. In GPX, four arginine residues and a lysine residue provide an electrostatic architecture which, in each reductive step, directs the donor substrate GSH towards the catalytic center in such a way that 1ts sulfhydryl group must react with the selenium moiety. To this end, different equally efficient modes of substrate binding appear possible. The models are consistent with substrate specificity data, kinetic pattern and other functional characteristics of the enzyme. Comparison of molecular models of GPX with those of other members of the GPX superfamily reveals that the cosubstrate binding mechanisrns are unique for the classical type of cytosolic glutathione peroxidases but cannot operate e. g. in plasma GPX and phospholipid hydroperoxide GPX. The structural differences between the selenoperoxidases, shown to be relevant to their specificities, are discussed in terms of functional diversification within the GPX superfamily展开更多
BACKGROUND Obesity is an important factor to cause the obstructive sleep apnea-hypopnea syndrome(OSAHS).Higher body mass index(BMI)often results in more severe OSAHS.Currently,the common measures for controlling the w...BACKGROUND Obesity is an important factor to cause the obstructive sleep apnea-hypopnea syndrome(OSAHS).Higher body mass index(BMI)often results in more severe OSAHS.Currently,the common measures for controlling the weight mainly include diet control,increase exercise and so on.Motivational interviewing(MI)could explore the patient’s internal state and make the patient realize his/her ambivalence,resulting in the change in his/her behavior.This process emphasizes respecting the patient’s autonomy.AIM To evaluate the effect of MI on the weight control of patients with OSAHS.METHODS A randomized controlled study was conducted in 100 obese OSAHS patients undergoing surgical treatment at Shengjing Hospital of China Medical University.The patients were divided into an intervention group and a control group,with 50 cases each.The control group was given routine health education after the operation;in addition to the regular health education,the intervention group was given MI according to a predetermined plan.Obesity-related indicators,postoperative complications,and the sleep status of both groups were evaluated before and 6 mo after the intervention.RESULTS Patients in the intervention group had significantly improved body weight,BMI,and waist and neck circumferences compared with patients in the control group(P<0.05).Regarding complications at 6 mo after operation,the incidence of cough and reflux in patients in the intervention group was significantly lower than that in the control group(P<0.05).In addition,the Epworth Sleepiness Scale and Self-Rating Scale of Sleep scores of patients in the intervention group were significantly lower than those in the control group,and the sleep status of patients in the intervention group was improved(P<0.05).CONCLUSION MI intervention has a significant advantage over postoperative routine health education.It can greatly change the lifestyle,further control the postoperative weight,reduce the occurrence of complications,improve the quality of sleep,and improve long-term postoperative efficacy in OSAHS patients.展开更多
Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure ...Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital.Twenty-nine patients were in the intervention group,and 33 patients were in the control group.Patients in the intervention group received four sessions of motivational interviewing,whereas those in the control group received traditional health education.At 2,4,and 8 weeks post-discharge,the intervention group underwent telephone follow-up based on motivational interviewing,whereas the control group underwent routine telephone follow-up.Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months postdischarge.Results:Before intervention,the self-care behaviours scores were 79.00±48.80 in the intervention group and 88.68±29.26in the control group.No statistically significant differences were found between two groups in scores for each subscale and total scale(P>0.05).After intervention,the scores of self-care behaviours in the two groups were both improved at 155.13±35.65 for the intervention group and 115.44±22.82 for the control group with statistically significance(P<0.01).The score of self-care behaviours increased by 76.13 point in the intervention group on average,whereas 26.76 point in the control group.There was significant difference between increases in scores of self-care behaviours in two groups(P<0.01).Conclusions:The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.展开更多
Purpose:The aim of this study was to evaluate the impact of motivational interviewing(MI)on the quality of life and its related factors in type 2 diabetes mellitus(T2DM)patients with poor long-term glycemic control.De...Purpose:The aim of this study was to evaluate the impact of motivational interviewing(MI)on the quality of life and its related factors in type 2 diabetes mellitus(T2DM)patients with poor long-term glycemic control.Design and methods:One hundred tenT2DMpatientswithpoor long-termglycemic control that were hospitalized in our institution were enrolled in this study and randomly assigned to receive eitherMI or routine diabetes education intervention.Patients'body mass index values,Homeostatic Model Assessment-Insulin Resistance(HOMA-IR)scores,and levels of glycated hemoglobin(HbA1C),triglycerides,high-and low-density lipoproteincholesterols,Summary of Diabetes Self-management Activities and Diabetes Specific Quality of Life assessments were recorded before and six months after intervention.Results:Baseline scores for all measurements did not differ between patients in the control and MI groups.Although MI resulted in a significant reduction of HbA1c and serum lipid levels compared with the baseline,the effect was not significantly different from the control intervention.However,the improvement in HOMA-IR scores was significantly greater in the MI group compared with the control intervention(2.8±2.8 vs.5.7±4.7;p=0.000).Moreover,MI significantly elevated diabetes self-management activities ratings compared with the control intervention(13.2±3.4 vs.10.9±4.3;p=0.004).Conclusion:Compared to routine diabetes education,MI is a more effective approach for improving HOMA-IR and self-management of T2DM patients with poor long-term glycemic control.展开更多
BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures.Nove...BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures.Novel techniques are required to assist in planning and navigation.AIM To apply and evaluate the Hisense computer-assisted surgery(CAS)system in PCNL.METHODS A total of 60 patients with complex renal stones were included.Thirty patients in the CAS group had three-dimensional(3 D)virtual models constructed with the CAS system.The model assisted in planning and navigating in the CAS system.Thirty patients in the control group planned and navigated as standard PCNL,without the application of the CAS system.Success rate of one attempt,operation time,initial stone-free rate,decrease in hemoglobin,and complications were collected and analyzed.RESULTS There were no statistically significant differences in the baseline characteristics or planning characteristics.The success rate of one puncturing attempt(90%vs 67%,P=0.028)and the initial stone-free rate(87%vs 63%,P=0.037)were significantly higher in the CAS group.However,there were no statistically significant differences in the operation time(89.20±29.60 min vs 92.33±33.08 min,P=0.859)or in the decrease in hemoglobin(11.07±8.32 g/L vs 9.03±11.72 g/L,P=0.300)between the CAS group and the control group.No statistically significant differences in the incidence of complications(Clavien-Dindo grade≥2)were found.CONCLUSION Compared with standard PCNL,CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate.The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive,precise and convenient PCNL.展开更多
Objective:The objective of this meta-analysis was to evaluate the effect of motivational interviewing(MI)on self-management in patients with type 2 diabetes.Methods:Randomised controlled trials that assessed the effec...Objective:The objective of this meta-analysis was to evaluate the effect of motivational interviewing(MI)on self-management in patients with type 2 diabetes.Methods:Randomised controlled trials that assessed the effects of MI on self-management and HbA1c levels in patients with type 2 diabetes were systematically reviewed using multiple electronic databases.Weighted mean differences with 95%confidence intervals were calculated for continuous data.Results:Ten trials were included in this meta-analysis.The self-management ability of patients with type 2 diabetes who underwent MI was significantly better than that of patients in the control group(WMD,2.37;95%CI,1.77e2.98;p<0.00001).Subgroup analysis showed that short-term MI(6 months)resulted in a significant decrease in the HbA1c level(p<0.05)but that this advantage was not present for relatively long-term MI(>6 months)(p>0.05).Conclusions:MI was associated with improved self-management abilities among patients with type 2 diabetes,and short-term MI(6 months)effectively decreased the HbA1c level.The effect of long-term MI(>6 months)on the HbA1c level remains uncertain.Large-scale,higher-quality randomised controlled trials are needed to confirm the present findings.展开更多
Aim: To explore and analyze the feasibility of establishing a program of complex intervention in Traditional Chinese Medicine (TCM) based on Text Mining and Interviewing method. Methods: According to MRC, Constructing...Aim: To explore and analyze the feasibility of establishing a program of complex intervention in Traditional Chinese Medicine (TCM) based on Text Mining and Interviewing method. Methods: According to MRC, Constructing the program of complex intervention in TCM by Text Mining and Interviewing method should include 4 steps: 1) establishment of interview framework via normalization of extraction of ancient documents and Effectiveness of collection of modern periodical literatures;2) materialization of interview outline based on Focus Group Interview;3) rudimentary construction of complex intervention program based on Semi-structured Interview;4) evaluation of curative effect of complex intervention. Conclusions: It is feasible and significative to establish a program of complex intervention in TCM based on Text Mining and Interviewing method.展开更多
BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing...BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion.However, surgical procedures for this disease are rarely reported.CASE SUMMARY Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour,the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.CONCLUSION Application of computer-assisted navigation can significantly improve accuracy,effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.展开更多
AIM: To introduce the navigation system of software and instruments designed specifically for revision total knee arthroplasty(TKA).METHODS: We present an imageless navigation system for revision TKA,with optical poin...AIM: To introduce the navigation system of software and instruments designed specifically for revision total knee arthroplasty(TKA).METHODS: We present an imageless navigation system for revision TKA,with optical point and tracker identification to assess kinematic and anatomical landmarks.The system automatically positions the cutting guides with a motorized cutting unit.The cutting unit is placed on the distal femur with a femoral clamp and acts as a rigid body and the base for all femoral cuts.The surgical technique for using the navigation system for revision TKA is based on the technique used in primary TKA.However,there are some important differences.The most notable are:(1) differences in estimation of the position of the primary implant relative to the bone and the mechanical axes;(2) the specific possibilities the revision navigation software offers in terms of optimal joint level positioning; and(3) the suggested "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are taken into account to find the optimal femoral component position.We assessed the surgical technique,and accompanying software procedural steps,of the system,identifying any advantages or disadvantages that they present.RESULTS: The system aims to visualize critical steps of the procedure and is intended as a tool to support the surgeon in surgical decision-making.Combining a computer-assisted cutting device with navigation makes it possible to carry out precise cuts without pinning.Furthermore,the femoral clamp provides a stable fixation mechanism for the motorized cutting unit.A stable clamp is paramount in the presence of periarticular bony defects.The system allows the position of the primary implant relative to the bone and mechanical axes to be estimated,at which point any malalignments can be corrected.It also offers an optimal joint level position for implantation,and suggests a "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are considered.The surgeon can therefore make decisions intraoperatively to maximise alignment and,hence,outcomes.Based on the intraoperative findings of joint stability,the surgeon can modify the preoperative plan and switch from a constrained condylar system to a hinged version,or vice versa.CONCLUSION: The system is flexible and easy to learn and allows improvements in workflow during TKA.展开更多
In the area of computer-assisted language learning(CALL),although a number of studies have adopted various CALL-based devices(e.g.,blogs,gaming,and synthetic environments)to foster second language(L2)acquisition,the v...In the area of computer-assisted language learning(CALL),although a number of studies have adopted various CALL-based devices(e.g.,blogs,gaming,and synthetic environments)to foster second language(L2)acquisition,the vital component of instruction has received little attention.The present study explored the usefulness of CALL-based communication in conjunction with instruction on EFL learners’L2 pragmatic development.Sixty-two EFL students from a university in China were recruited for the current research.The experimental group communicated with a native English speaker through synchronous messaging via Skype and had two instructional sessions pertinent to compliment responses,while the control group interacted with a native English speaker via Skype without having the teaching intervention.Findings from an independent samples t-test demonstrated that the experimental group produced significantly more proper compliment responses in the immediate posttest than the control group(p<.001).Moreover,a significant difference(p<.001)was found for the experimental group between the preintervention and delayed post-intervention mean scores,suggesting that CALL coupled with teaching intervention had a long-term impact on learners’L2 pragmatic development.These findings enrich our understanding of the beneficial and lasting influence of combining CALL with instruction on EFL students’pragmatic development.In addition,pedagogical implications for deploying CALL paired with L2 pragmatics instruction are provided.展开更多
CALL (computer-assisted language learning) has tremendously transformed the teaching of language, with its wide application in many aspects of language teaching. However, how to integrate CALL into the teaching of c...CALL (computer-assisted language learning) has tremendously transformed the teaching of language, with its wide application in many aspects of language teaching. However, how to integrate CALL into the teaching of culture is still rarely discussed. The purpose of the paper is to explore feasible models for teaching culture in CALL and their effects on students' acquisition process. Based on two fundamental pedagogical approaches (participatory pedagogy and multiliteracies pedagogy) for teaching culture, this paper proposes three pedagogical models (problem-posing model, web-quest model, and computer-supported collaborative learning model) for teaching culture in CALL. In the end, this paper illustrates a combination of the three models in real CALL setting by a cultural teaching case. A questionnaire survey and interviews are conducted to reflect on students' feedback, which gives an insight into possible adjustments in teaching models and the paper also proposes future possibilities in applying these models into teaching culture展开更多
BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon ...BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.展开更多
The purpose of this paper is to describe the challenges of elite interviewing and identify key factors that ensure success for qualitative researchers. The authors draw on their own experiences of interviewing powerfu...The purpose of this paper is to describe the challenges of elite interviewing and identify key factors that ensure success for qualitative researchers. The authors draw on their own experiences of interviewing powerful and influential members of government and various professions as well as tips from experienced researchers from the fields of social sciences and health. They identify five essential steps to successful interviewing: (1) identifying the key informants; (2) negotiating access; (3) background research and preparation; (4) site selection, presentation questioning approach, and execution; and (5) follow-up. Each of them is discussed in detail. The authors argue that the most important quality for the elite interviewer is self-management which involves developing an individual style of interviewing that is responsive to setbacks and unexpected opportunities展开更多
The paper is devoted to the description of possible approaches to designing materials for computer-assisted testing of metalinguistic competence of the intending foreign language teachers. By metalinguistic competence...The paper is devoted to the description of possible approaches to designing materials for computer-assisted testing of metalinguistic competence of the intending foreign language teachers. By metalinguistic competence we here mean the learners’ comprehension of such fundamental concepts of linguistic theory as: grammatical and lexical meanings and their types, the concepts of grammatical form and grammatical category, homonyms and synonyms,展开更多
This paper presents CACA (computer-assisted corpus analysis) conducted by using a compiled representative corpus. As a descriptive study, it explores the written communicative events produced by engineers in the pet...This paper presents CACA (computer-assisted corpus analysis) conducted by using a compiled representative corpus. As a descriptive study, it explores the written communicative events produced by engineers in the petroleum industry in Malaysia. Language use is commonly analyzed for competence and performance. Competence is best described as the internalized linguistic knowledge as acquired by the learners while the notion of"performance" is best defined as the external evidence of language competence. Therefore, the core of this paper is reflecting actual language use of the language learners in Malaysia. The data are drawn from a sample corpus compiled from the written communicative events in three companies of the petroleum industry in Malaysia. The methodology applied is fundamental as it tends to investigate the linguistic constitutions in the genre-specific corpus of the professional discourse produced. Computer-based syntactical studies are limited as they require hard work and long hours in order to key-in the data and then there is the complex analytic method of describing the findings. In contrast, this paper will demonstrate an uncomplicated method of analysis and also encourage the use of existing POS (part-of speech) tagging software available online.展开更多
基金Supported by National Natural Science Foundation of China,No.82293665Anhui Provincial Department of Education University Research Project,No.2023AH051763.
文摘BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.
文摘BACKGROUND Subchorionic hematoma(SCH)is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane.SCH can lead to adverse pregnancy outcomes such as miscarriage,preterm birth,and other complications.Early detection and accurate assessment of SCH are crucial for appropriate management and improved pregnancy outcomes.AIM To evaluate the diagnostic efficacy of virtual organ computer-assisted analysis(VOCAL)in measuring the volume ratio of SCH to gestational sac(GS)combined with serum progesterone on early pregnancy outcomes in patients with SCH.METHODS A total of 153 patients with SCH in their first-trimester pregnancies between 6 and 11 wk were enrolled.All patients were followed up until a gestational age of 20 wk.The parameters of transvaginal two-dimensional ultrasound,including the circumference of SCH(Cs),surface area of SCH(Ss),circumference of GS(Cg),and surface area of GS(Sg),and the parameters of VOCAL with transvaginal three-dimensional ultrasound,including the three-dimensional volume of SCH(3DVs)and GS(3DVg),were recorded.The size of the SCH and its ratio to the GS size(Cs/Cg,Ss/Sg,3DVs/3DVg)were recorded and compared.RESULTS Compared with those in the normal pregnancy group,the adverse pregnancy group had higher Cs/Cg,Ss/Sg,and 3DVs/3DVg ratios(P<0.05).When 3DVs/3DVg was 0.220,the highest predictive performance predicted adverse pregnancy outcomes,resulting in an AUC of 0.767,and the sensitivity,specificity were 70.2%,75%respectively.VOCAL measuring 3DVs/3DVg combined with serum progesterone gave a diagnostic AUC of 0.824 for early pregnancy outcome in SCH patients,with a high sensitivity of 82.1%and a specificity of 72.1%,which showed a significant difference between AUC.CONCLUSION VOCAL-measured 3DVs/3DVg effectively quantifies the severity of SCH,while combined serum progesterone better predicts adverse pregnancy outcomes.
基金the National Natural Science Foundation of China(No.51675036)the Innovation and Development Project of Intelligent Manufacturing Technique from Beijing Municipal Science and Technology Commission(No.Z161100001516012).
文摘The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scaphoid fractures remains experimental.The related studies are scanty and most of them are cadaver researches.Some intrinsic defects from the registration procedure,scan and immobilization of limbs may inevitably result in deviations. Some deviations become more obvious with operations of small bones (such as scaphoid)although they are acceptable for spine and other orthopedic surgeries.We reviewed the current literatures on the applications of CAS for scaphoid operation and summarized technical principles,scan and registration methods,immobilization of limbs and their outcomes.On the basis of the data,we analyzed the limitations of this technique and envisioned its future development.
基金the National Key R&D Program of China,No.2018YFC1313103the National Natural Science Foundation of China,No.81670473 and No.81873546+1 种基金the“Shu Guang”Project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation,No.19SG30the Key Area Research and Development Program of Guangdong Province,China,No.2018B010111001.
文摘BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.
文摘The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen analysis with those obtained by computer-assisted semen analysis (CASA) (Copenhagen Rigshospitalet Image House Sperm Motility Analysis System (CRISMAS) 4.6 software) using semen samples from 166 young Danish men. The CRISMAS software identifies sperm concentration and classifies spermatozoa into three motility categories. To enable comparison of the two methods, the four motility stages obtained by conventional semen analysis were, based on their velocity classifications, divided into three stages, comparable to the three CRISMAS motility categories: rapidly progressive (A), slowly progressive (B) and non-progressive (C+ D). Differences between the two methods were large for all investigated parameters (P〈0.001). CRISMAS overestimated sperm concentration and the proportion of rapidly progressive spermatozoa and, consequently, underestimated the percentages of slowly progressive and non-progressive spermatozoa, compared to the conventional method. To investigate whether results drifted according to time of semen analysis, results were pooled into quarters according to date of semen analysis. CRISMAS motility results appeared more stable over time compared to the conventional analysis; however, neither method showed any trends. Apparently, CRISMAS CASA results and results from the conventional method were not comparable with respect to sperm concentration and motility analysis. This needs to be accounted for in clinics using this software and in studies of determinants of these semen characteristics.
文摘Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium catalysis. Starting from the established X-ray structure of bovine GPX, all kinetically defined intermediates and enzyme substrate complexes were modelled. The models thus obtained support the hypothesis that the essential steps of the catalysis are three distinct redox changes of the active site selenium which, in the ground state, presents itself at the surface of selenoperoxidases as the center of a characteristic triad built by selenocysteine, glutarnine and tryptophan. In GPX, four arginine residues and a lysine residue provide an electrostatic architecture which, in each reductive step, directs the donor substrate GSH towards the catalytic center in such a way that 1ts sulfhydryl group must react with the selenium moiety. To this end, different equally efficient modes of substrate binding appear possible. The models are consistent with substrate specificity data, kinetic pattern and other functional characteristics of the enzyme. Comparison of molecular models of GPX with those of other members of the GPX superfamily reveals that the cosubstrate binding mechanisrns are unique for the classical type of cytosolic glutathione peroxidases but cannot operate e. g. in plasma GPX and phospholipid hydroperoxide GPX. The structural differences between the selenoperoxidases, shown to be relevant to their specificities, are discussed in terms of functional diversification within the GPX superfamily
基金Supported by the School of Nursing Research Project at China Medical University,No.2017HL-21.
文摘BACKGROUND Obesity is an important factor to cause the obstructive sleep apnea-hypopnea syndrome(OSAHS).Higher body mass index(BMI)often results in more severe OSAHS.Currently,the common measures for controlling the weight mainly include diet control,increase exercise and so on.Motivational interviewing(MI)could explore the patient’s internal state and make the patient realize his/her ambivalence,resulting in the change in his/her behavior.This process emphasizes respecting the patient’s autonomy.AIM To evaluate the effect of MI on the weight control of patients with OSAHS.METHODS A randomized controlled study was conducted in 100 obese OSAHS patients undergoing surgical treatment at Shengjing Hospital of China Medical University.The patients were divided into an intervention group and a control group,with 50 cases each.The control group was given routine health education after the operation;in addition to the regular health education,the intervention group was given MI according to a predetermined plan.Obesity-related indicators,postoperative complications,and the sleep status of both groups were evaluated before and 6 mo after the intervention.RESULTS Patients in the intervention group had significantly improved body weight,BMI,and waist and neck circumferences compared with patients in the control group(P<0.05).Regarding complications at 6 mo after operation,the incidence of cough and reflux in patients in the intervention group was significantly lower than that in the control group(P<0.05).In addition,the Epworth Sleepiness Scale and Self-Rating Scale of Sleep scores of patients in the intervention group were significantly lower than those in the control group,and the sleep status of patients in the intervention group was improved(P<0.05).CONCLUSION MI intervention has a significant advantage over postoperative routine health education.It can greatly change the lifestyle,further control the postoperative weight,reduce the occurrence of complications,improve the quality of sleep,and improve long-term postoperative efficacy in OSAHS patients.
文摘Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital.Twenty-nine patients were in the intervention group,and 33 patients were in the control group.Patients in the intervention group received four sessions of motivational interviewing,whereas those in the control group received traditional health education.At 2,4,and 8 weeks post-discharge,the intervention group underwent telephone follow-up based on motivational interviewing,whereas the control group underwent routine telephone follow-up.Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months postdischarge.Results:Before intervention,the self-care behaviours scores were 79.00±48.80 in the intervention group and 88.68±29.26in the control group.No statistically significant differences were found between two groups in scores for each subscale and total scale(P>0.05).After intervention,the scores of self-care behaviours in the two groups were both improved at 155.13±35.65 for the intervention group and 115.44±22.82 for the control group with statistically significance(P<0.01).The score of self-care behaviours increased by 76.13 point in the intervention group on average,whereas 26.76 point in the control group.There was significant difference between increases in scores of self-care behaviours in two groups(P<0.01).Conclusions:The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.
文摘Purpose:The aim of this study was to evaluate the impact of motivational interviewing(MI)on the quality of life and its related factors in type 2 diabetes mellitus(T2DM)patients with poor long-term glycemic control.Design and methods:One hundred tenT2DMpatientswithpoor long-termglycemic control that were hospitalized in our institution were enrolled in this study and randomly assigned to receive eitherMI or routine diabetes education intervention.Patients'body mass index values,Homeostatic Model Assessment-Insulin Resistance(HOMA-IR)scores,and levels of glycated hemoglobin(HbA1C),triglycerides,high-and low-density lipoproteincholesterols,Summary of Diabetes Self-management Activities and Diabetes Specific Quality of Life assessments were recorded before and six months after intervention.Results:Baseline scores for all measurements did not differ between patients in the control and MI groups.Although MI resulted in a significant reduction of HbA1c and serum lipid levels compared with the baseline,the effect was not significantly different from the control intervention.However,the improvement in HOMA-IR scores was significantly greater in the MI group compared with the control intervention(2.8±2.8 vs.5.7±4.7;p=0.000).Moreover,MI significantly elevated diabetes self-management activities ratings compared with the control intervention(13.2±3.4 vs.10.9±4.3;p=0.004).Conclusion:Compared to routine diabetes education,MI is a more effective approach for improving HOMA-IR and self-management of T2DM patients with poor long-term glycemic control.
基金Supported by the Science and Technology Program in Chinese Medicine of Shandong Province,No.2020M074。
文摘BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures.Novel techniques are required to assist in planning and navigation.AIM To apply and evaluate the Hisense computer-assisted surgery(CAS)system in PCNL.METHODS A total of 60 patients with complex renal stones were included.Thirty patients in the CAS group had three-dimensional(3 D)virtual models constructed with the CAS system.The model assisted in planning and navigating in the CAS system.Thirty patients in the control group planned and navigated as standard PCNL,without the application of the CAS system.Success rate of one attempt,operation time,initial stone-free rate,decrease in hemoglobin,and complications were collected and analyzed.RESULTS There were no statistically significant differences in the baseline characteristics or planning characteristics.The success rate of one puncturing attempt(90%vs 67%,P=0.028)and the initial stone-free rate(87%vs 63%,P=0.037)were significantly higher in the CAS group.However,there were no statistically significant differences in the operation time(89.20±29.60 min vs 92.33±33.08 min,P=0.859)or in the decrease in hemoglobin(11.07±8.32 g/L vs 9.03±11.72 g/L,P=0.300)between the CAS group and the control group.No statistically significant differences in the incidence of complications(Clavien-Dindo grade≥2)were found.CONCLUSION Compared with standard PCNL,CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate.The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive,precise and convenient PCNL.
文摘Objective:The objective of this meta-analysis was to evaluate the effect of motivational interviewing(MI)on self-management in patients with type 2 diabetes.Methods:Randomised controlled trials that assessed the effects of MI on self-management and HbA1c levels in patients with type 2 diabetes were systematically reviewed using multiple electronic databases.Weighted mean differences with 95%confidence intervals were calculated for continuous data.Results:Ten trials were included in this meta-analysis.The self-management ability of patients with type 2 diabetes who underwent MI was significantly better than that of patients in the control group(WMD,2.37;95%CI,1.77e2.98;p<0.00001).Subgroup analysis showed that short-term MI(6 months)resulted in a significant decrease in the HbA1c level(p<0.05)but that this advantage was not present for relatively long-term MI(>6 months)(p>0.05).Conclusions:MI was associated with improved self-management abilities among patients with type 2 diabetes,and short-term MI(6 months)effectively decreased the HbA1c level.The effect of long-term MI(>6 months)on the HbA1c level remains uncertain.Large-scale,higher-quality randomised controlled trials are needed to confirm the present findings.
文摘Aim: To explore and analyze the feasibility of establishing a program of complex intervention in Traditional Chinese Medicine (TCM) based on Text Mining and Interviewing method. Methods: According to MRC, Constructing the program of complex intervention in TCM by Text Mining and Interviewing method should include 4 steps: 1) establishment of interview framework via normalization of extraction of ancient documents and Effectiveness of collection of modern periodical literatures;2) materialization of interview outline based on Focus Group Interview;3) rudimentary construction of complex intervention program based on Semi-structured Interview;4) evaluation of curative effect of complex intervention. Conclusions: It is feasible and significative to establish a program of complex intervention in TCM based on Text Mining and Interviewing method.
基金Supported by Ninth People's Hospital affiliated to Shanghai Jiao Tong University,School of Medicine "Multi-Disciplinary Team" Clinical Research Project,No.201701011
文摘BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion.However, surgical procedures for this disease are rarely reported.CASE SUMMARY Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour,the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.CONCLUSION Application of computer-assisted navigation can significantly improve accuracy,effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.
基金Supported by Smith and Nephew Gmb H,Marl,Germany
文摘AIM: To introduce the navigation system of software and instruments designed specifically for revision total knee arthroplasty(TKA).METHODS: We present an imageless navigation system for revision TKA,with optical point and tracker identification to assess kinematic and anatomical landmarks.The system automatically positions the cutting guides with a motorized cutting unit.The cutting unit is placed on the distal femur with a femoral clamp and acts as a rigid body and the base for all femoral cuts.The surgical technique for using the navigation system for revision TKA is based on the technique used in primary TKA.However,there are some important differences.The most notable are:(1) differences in estimation of the position of the primary implant relative to the bone and the mechanical axes;(2) the specific possibilities the revision navigation software offers in terms of optimal joint level positioning; and(3) the suggested "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are taken into account to find the optimal femoral component position.We assessed the surgical technique,and accompanying software procedural steps,of the system,identifying any advantages or disadvantages that they present.RESULTS: The system aims to visualize critical steps of the procedure and is intended as a tool to support the surgeon in surgical decision-making.Combining a computer-assisted cutting device with navigation makes it possible to carry out precise cuts without pinning.Furthermore,the femoral clamp provides a stable fixation mechanism for the motorized cutting unit.A stable clamp is paramount in the presence of periarticular bony defects.The system allows the position of the primary implant relative to the bone and mechanical axes to be estimated,at which point any malalignments can be corrected.It also offers an optimal joint level position for implantation,and suggests a "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are considered.The surgeon can therefore make decisions intraoperatively to maximise alignment and,hence,outcomes.Based on the intraoperative findings of joint stability,the surgeon can modify the preoperative plan and switch from a constrained condylar system to a hinged version,or vice versa.CONCLUSION: The system is flexible and easy to learn and allows improvements in workflow during TKA.
文摘In the area of computer-assisted language learning(CALL),although a number of studies have adopted various CALL-based devices(e.g.,blogs,gaming,and synthetic environments)to foster second language(L2)acquisition,the vital component of instruction has received little attention.The present study explored the usefulness of CALL-based communication in conjunction with instruction on EFL learners’L2 pragmatic development.Sixty-two EFL students from a university in China were recruited for the current research.The experimental group communicated with a native English speaker through synchronous messaging via Skype and had two instructional sessions pertinent to compliment responses,while the control group interacted with a native English speaker via Skype without having the teaching intervention.Findings from an independent samples t-test demonstrated that the experimental group produced significantly more proper compliment responses in the immediate posttest than the control group(p<.001).Moreover,a significant difference(p<.001)was found for the experimental group between the preintervention and delayed post-intervention mean scores,suggesting that CALL coupled with teaching intervention had a long-term impact on learners’L2 pragmatic development.These findings enrich our understanding of the beneficial and lasting influence of combining CALL with instruction on EFL students’pragmatic development.In addition,pedagogical implications for deploying CALL paired with L2 pragmatics instruction are provided.
文摘CALL (computer-assisted language learning) has tremendously transformed the teaching of language, with its wide application in many aspects of language teaching. However, how to integrate CALL into the teaching of culture is still rarely discussed. The purpose of the paper is to explore feasible models for teaching culture in CALL and their effects on students' acquisition process. Based on two fundamental pedagogical approaches (participatory pedagogy and multiliteracies pedagogy) for teaching culture, this paper proposes three pedagogical models (problem-posing model, web-quest model, and computer-supported collaborative learning model) for teaching culture in CALL. In the end, this paper illustrates a combination of the three models in real CALL setting by a cultural teaching case. A questionnaire survey and interviews are conducted to reflect on students' feedback, which gives an insight into possible adjustments in teaching models and the paper also proposes future possibilities in applying these models into teaching culture
基金Supported by Qingdao Civic Science and Technology Program,No.17-3-3-8-nsh.
文摘BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.
文摘The purpose of this paper is to describe the challenges of elite interviewing and identify key factors that ensure success for qualitative researchers. The authors draw on their own experiences of interviewing powerful and influential members of government and various professions as well as tips from experienced researchers from the fields of social sciences and health. They identify five essential steps to successful interviewing: (1) identifying the key informants; (2) negotiating access; (3) background research and preparation; (4) site selection, presentation questioning approach, and execution; and (5) follow-up. Each of them is discussed in detail. The authors argue that the most important quality for the elite interviewer is self-management which involves developing an individual style of interviewing that is responsive to setbacks and unexpected opportunities
文摘The paper is devoted to the description of possible approaches to designing materials for computer-assisted testing of metalinguistic competence of the intending foreign language teachers. By metalinguistic competence we here mean the learners’ comprehension of such fundamental concepts of linguistic theory as: grammatical and lexical meanings and their types, the concepts of grammatical form and grammatical category, homonyms and synonyms,
文摘This paper presents CACA (computer-assisted corpus analysis) conducted by using a compiled representative corpus. As a descriptive study, it explores the written communicative events produced by engineers in the petroleum industry in Malaysia. Language use is commonly analyzed for competence and performance. Competence is best described as the internalized linguistic knowledge as acquired by the learners while the notion of"performance" is best defined as the external evidence of language competence. Therefore, the core of this paper is reflecting actual language use of the language learners in Malaysia. The data are drawn from a sample corpus compiled from the written communicative events in three companies of the petroleum industry in Malaysia. The methodology applied is fundamental as it tends to investigate the linguistic constitutions in the genre-specific corpus of the professional discourse produced. Computer-based syntactical studies are limited as they require hard work and long hours in order to key-in the data and then there is the complex analytic method of describing the findings. In contrast, this paper will demonstrate an uncomplicated method of analysis and also encourage the use of existing POS (part-of speech) tagging software available online.