Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery

BACKGROUND Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METHODS A retrospective analysis was performed on 98 patients who underwent hepato-biliary surgery and were admitted to our hospital from August 2021 to October 2023.They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions.The control group was treated with standard nursing and the observation group was treated with FTS concept nursing.The length of hospital stay,visual analog scale(VAS)score,wound complications,nursing satisfaction,self-rating scale(SAS)score,and SF-36 quality of life(QoL)score were compared between the two groups before and after care.RESULTS The duration of hospitalization,hospitalization cost,operation time,first im-plantation time,exhaust time,and first defecation time were shorter than the observation group(P<0.05).Additionally,the observation group showed a sig-nificant difference between the VAS and SAS scores on days 1,3,and 7(P<0.05).The complication rate in the observation group was 4.05%was significantly lower than the 18.36%in the control group,and the comparison groups were statistically significant(χ2=5.018,P=0.025).The observation group had a significantly higher level of nurse satisfaction(94.92%)than the control group(79.59%;χ2=6.078,P=0.014).Both groups showed higher QoL scores after nursing care,with higher scores in the observation group than in the control group(P=0.032).CONCLUSION FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood,QoL,and nursing sa-tisfaction;reduce wound complications;and accelerate patient rehabilitation.

Probabilistic Global Maximum Power Point Tracking Algorithm for Continuously Varying Partial Shading Conditions on Autonomous PV Systems

A photovoltaic (PV) string with multiple modules with bypass diodes frequently deployed on a variety of autonomous PV systems may present multiple power peaks under uneven shading. For optimal solar harvesting, there is a need for a control schema to force the PV string to operate at global maximum power point (GMPP). While a lot of tracking methods have been proposed in the literature, they are usually complex and do not fully take advantage of the available characteristics of the PV array. This work highlights how the voltage at operating point and the forward voltage of the bypass diode are considered to design a global maximum power point tracking (GMPPT) algorithm with a very limited global search phase called Fast GMPPT. This algorithm successfully tracks GMPP between 94% and 98% of the time under a theoretical evaluation. It is then compared against Perturb and Observe, Deterministic Particle Swarm Optimization, and Grey Wolf Optimization under a sequence of irradiance steps as well as a power-over-voltage characteristics profile that mimics the electrical characteristics of a PV string under varying partial shading conditions. Overall, the simulation with the sequence of irradiance steps shows that while Fast GMPPT does not have the best convergence time, it has an excellent convergence rate as well as causes the least amount of power loss during the global search phase. Experimental test under varying partial shading conditions shows that while the GMPPT proposal is simple and lightweight, it is very performant under a wide range of dynamically varying partial shading conditions and boasts the best energy efficiency (94.74%) out of the 4 tested algorithms.

Effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery: A systematic review

Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing on evaluation of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Two people independently screened literatures and extracted data according to the inclusion criteria. Then the available data were analyzed with RevMan software (version 5.3.0). Descriptive techniques were performed when no available data could be used. Results: A total of 8 studies were included, for a total sample of 635 patients. The results showed that fast track surgery care can improve Hospital for Special Surgery Knee score at 2 months, 3 months, 6 months, and 1 years after operation [after 2 months (weighted mean difference (WMD), 15.2;95%CI, 13.58 to 16.82;P < 0.01);after 3 months (WMD, 9.42;95%CI, 7.80 to 11.04;P < 0.01);after 6 months,(WMD, 11.01;95%CI, 9.73 to 12.28;P < 0.01);after 1 years (WMD, 10.78;95%CI, 9.33 to 12.24;P < 0.01)]. Fast track surgery care can improve the knee score of American Knee Society Knee Score(WMD, 9.23;95%CI,0.86 - 17.6;P < 0.05), and reduce the incidence of postoperative deep vein thrombosis, constipation, pulmonary infection, urinary tract infection and other complications. Conclusion: Fast track surgery care can promote knee joint function recovery, reduce postoperative deep venous thrombosis, constipation, pulmonary infection and urinary tract infection. However, rigorous large sample and multicenter randomized controlled trials are needed for further validation.

Fast-track rehabilitation program vs conventional care after colorectal resection:A randomized clinical trial

AIM:To compare the fast-track rehabilitation program and conventional care for patients after resection of colorectal cancer.METHODS:One hundred and six consecutive patients who underwent fast-track rehabilitation program were encouraged to have early oral feeding and movement for early discharge,while 104 consecutive patients underwent conventional care after resection of colorectal cancer.Their gastrointestinal functions,postoperative complications and hospital stay time were recorded.RESULTS:The restoration time of gastrointestinal functions in the patients was significantly faster after fasttrack rehabilitation program than after conventional care(2.1 d vs 3.2 d,P < 0.01).The percentage of patients who developed complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care(13.2% vs 26.9%,P < 0.05).Also,the percentage of patients who had general complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care(6.6% vs 15.4%,P < 0.05).The postoperative hospital stay time of the patients was shorter after fast-track rehabilitation program than after conventional care(5 d vs 7 d,P < 0.01).No significant difference was observed in the readmission rate 30 d after fast-track rehabilitation program and conventional care(3.8% vs 8.7%).CONCLUSION:The fast-track rehabilitation program can significantly decrease the complications and shorten the time of postoperative hospital stay of patients after resection colorectal cancer.

Fast track clinical pathway implications in esophagogastrectomy

AIM： To investigate the feasibility of fast track clinica pathway for esophageal tumor resections. METHODS： One hundred and fourteen patients with esophageal carcinoma who underwent esophagogastrectomy from January 2006 to October 2007 in our department were studied. Fast track clinical pathway included analgesia control, fluid infusion volume control, early ambulation and enteral nutrition. Nasogastric tube was removed 3 d after operation and chest tube was removed 4 d after operation as a routine, and full liquid diet 5 d after operation. RESULTS： Among 114 patients （84 men and 30 women）, 26 patients underwent fast track surgery, including 17 patients over 65 years old and 9 under 65 （P = 0.014）; 18 patients who had preoperative complications could not bear fast track surgery （P 〈 0.001）. No significant differences in tolerance of fast track surgery were attributed to differences in gender, differentiated degree or stage of tumor, pathological type of tumor, or operative incision. The median length of hospital stay was 7 d （5-28 d）, 4% patients were readmitted to hospital within 30 d of discharge. Three patients died and postoperative mortality was 2.6%. All 3 patients had no determinacy to fast track surgery approach.CONCLUSION： The majority of patients with esophageal carcinoma can tolerate fast track surgery. Patients younger than 65 or who have no preoperative diseases have the best results. Median length of hospital stay has been reduced to 7 d.

Impact of centralization of pancreaticoduodenectomy coupled with fast track recovery protocol:a comparative study from India

BACKGROUND: Fast track strategy in the management of patients undergoing intra-abdominal surgery of various types has emerged as a landmark approach to reduce surgical stress and accelerate recovery. This study was to evaluate the effect of fast track strategy on patients subjected to pancreaticoduo-denectomy (PD) from an individual unit during transit from low to a high volume center. METHODS: A total of 142 PD patients who had been subjected to fast track strategy between June 2008 and September 2012 were compared with 46 patients who had received convention-al surgery between January 2006 and May 2008. Comparative analysis was made of postoperative complications, postopera-tive recovery, length of hospital stay and patient readmission requirement. RESULTS: The patients subjected to fast track strategy had a faster recovery and a shorter hospital stay than those who were treated conventionally (7.8 vs 12.1 days). The intraoperative events like operative blood loss (417.9±83.8 vs 997.4 ±151.8 mL, P<0.001), blood transfused (a median of 0 vs 1 unit,P<0.001) and operative time taken (125 vs 245 minutes,P<0.001) were signiifcantly lower in the fast track group. The frequency of pancreatic ifstula (4.9% vs 13.0%) and delayed gastric empty-ing (7.0% vs 17.4%) was also signiifcantly reduced with fast track treatment. Nevertheless, the readmission rate (11.3% vs 6.5%) was found relatively higher within the fast track group. However, increased readmission rates in this study seem to be independent of fast track protocol. CONCLUSIONS: This preliminary analysis suggests that the fast track approach might be beneifcial to the well-being of the patients after PD, for it accelerates the immediate clinical recovery of patients and signiifcantly shortens their length of hospital stay.

APEC ON FAST TRACK

The 1993 Seattle First Informal Leaders Meeting elevated it from a ministerialmeeting to a cooperative mechanism at the summit level.The 1994 Bogor Dec-laration then ushered it into a de facto regular mechanism.The 1995 Osaka ActionPlan went a step further to initiate the transition of its function from working outprograms of intent into their enforcement.The forthcoming 1996 Subic Bay Meet-ing will eventually launch it out on fast track.

Fast Track Surgery and Its Outcome in Colorectal Surgery in a Tertiary Care Hospital

Background: Fast track surgery is an evidence-based multidisciplinary approach. The underlying principle is to enable patients to recover from surgery and leave the hospital sooner by minimizing the stress responses on the body during surgery. Our aim was to compare the outcome of fast-track protocol and conventional methods in colorectal surgery. Method: It was an observational cross-sectional study carried out at the Department of Surgery in different tertiary level hospitals, Dhaka Bangladesh during the period January 2014 to December 2017. Among this population, 50 patients were placed in the fast-track program (Group A) from January 2014 to December 2015 and 50 patients were in the conventional method (Group B), from January 2016 to December 2017. The fast-track patients were selected after receiving ethical approval from the Bangladesh College of Physician & Surgeons. Data analysis was done using the statistical package for social science (SPSS) for windows version 20. Results: The average age of the patients was 45.24 ± 16.65 years (range: 11 - 70 years) in the fast track group (Group A) and 43.24 ± 17.76 years in the conventional method (Group B). The majority were female between two groups, with 56% in group A and 52% in group B. General and surgical complications occurred in 9 (18%) patients and 11 (22%) patients respectively in group A. On the other hand in group B general and surgical complications occurred in 10 (20%) patients and 13 (26%) patients respectively. The average hospital stay was 9.24 ± 5.99 days in group A and the average hospital stay was 10.10 ± 6.04 days in group B. Conclusion: Making the decision to adopt fast-track surgery will challenge current traditional practice for all members of the multidisciplinary team across the whole local health community.

Nanjing on the Fast Track

Boasting top-notch infrastructure and dynamic economic growth,Nanjing is pushing towards an exhibition limelight in the Yangtze River Delta.

某伺服跟踪系统的机械结构设计和仿真

针对现有伺服系统对快速目标的跟踪性能和稳定性存在的问题,设计了一种能够快速稳定跟踪伺服系统的机械结构。采用模块化独立功能和扩展能力设计伺服系统时,各结构件均留有足够的强度裕度,保证了伺服系统在过载或非正常运行时的结构强度和稳定性。同时,系统结构还设置有锁紧、限位、开关等多种保护措施。仿真结果、产品实测和外场试验表明,该快速稳定跟踪伺服系统可以对目标进行快速、稳定跟踪。

基于改进模糊滑模控制的列车速度跟踪研究

列车运行过程具有强耦合、非线性等特征,且往往存在较大且不可观测的外界干扰,这些特性加大了列车运行控制的难度,针对列车运行速度跟踪控制问题,提出一种新的模糊滑模控制器设计方法。首先基于模糊滑模控制,引入全局快速终端滑模控制,使系统在有限时间内达到稳态;然后构造以李亚普洛夫函数导数的绝对值为补偿的自适应干扰估计项,对外界干扰进行准确估计,进而提出一种双层递阶指数趋近全局快速终端模糊滑模控制器,并且引入指数趋近率来调节滑模面的动态品质,该控制器能快速收敛到稳定状态,且有效地消除了控制器的抖振情况;最后通过仿真算例验证了所提方法的有效性,且提高了列车运行控制系统性能。

基于快速轨道测量系统无砟轨道线型测量精度分析

为验证快速轨道测量系统在运营高铁无砟轨道测量应用的可靠性及可行性,基于某段高速铁路无砟轨道分别选用快速轨道测量系统GRP1000 IMS和常规轨道检测系统GRP1000,采用多点绝对设站的模式,按照设定方案进行轨道线型测量。综合对平面偏差、高程偏差、轨距、超高偏差、轨向和长短波等轨道参数进行对比分析,结果显示利用快速轨道测量系统可以大幅度提高无砟轨道线型测量效率,且能满足高速铁路无砟轨道线型测量精度要求。

Research on improved active disturbance rejection control of continuous rotary motor electro-hydraulic servo system

In order to meet the precision requirements and tracking performance of the continuous rotary motor electro-hydraulic servo system under unknown strong non-linear and uncertain strong disturbance factors,such as dynamic uncertainty and parameter perturbation,an improved active disturbance rejection control(ADRC)strategy was proposed.The state space model of the fifth order closed-loop system was established based on the principle of valve-controlled hydraulic motor.Then the three parts of ADRC were improved by parameter perturbation and external disturbance;the fast tracking differentiator was introduced into linear and non-linear combinations;the nonlinear state error feedback was proposed using synovial control;the extended state observer was determined by nonlinear compensation.In addition,the grey wolf algorithm was used to set the parameters of the three parts.The simulation and experimental results show that the improved ADRC can realize the system frequency 12 Hz when the tracking accuracy and response speed meet the requirements of double ten indexes,which lay foundation for the motor application.

基于RFID技术的快速无感知考勤系统在国际特大型项目建设中的应用研究

针对国际特大型建设项目中传统考勤系统存在的效率低、出错率高及管理不便等问题,文章提出了一种基于RFID技术的快速无感知考勤系统设计方案。其中详细介绍了系统设计的核心思路,包括硬件组件(如RFID标签与阅读器)的选择与部署、软件平台的构建。同时,通过对某一国际特大型建设项目实施案例的深入分析,展示了RFID考勤系统在实际应用中的显著成效。研究结果表明,该系统不仅大幅提高了考勤管理的效率与精确度,还有效降低了项目建设成本,为国际特大型建设项目中的智能化管理提供了新的视角与参考。

一种北斗三号短报文终端的快速捕获算法

北斗三号全球短报文通信系统可以满足全球、全天候、长远距离、高动态的使用需求。针对北斗三号短报文终端产品高动态使用环境的需求,文中提出一种快速的捕获跟踪算法,采用并行相关+FFT的传统架构,通过大量的仿真数据验证不同的并行路数和FFT点数下的捕获性能,最终实现12 km/s使用条件下的快速捕获。

Real-time tracking of deformable objects based on MOK algorithm

The traditional oriented FAST and rotated BRIEF（ORB） algorithm has problems of instability and repetition of keypoints and it does not possess scale invariance. In order to deal with these drawbacks, a modified ORB（MORB） algorithm is proposed. In order to improve the precision of matching and tracking, this paper puts forward an MOK algorithm that fuses MORB and Kanade-Lucas-Tomasi（KLT）. By using Kalman, the object＇s state in the next frame is predicted in order to reduce the size of search window and improve the real-time performance of object tracking. The experimental results show that the MOK algorithm can accurately track objects with deformation or with background clutters, exhibiting higher robustness and accuracy on diverse datasets. Also, the MOK algorithm has a good real-time performance with the average frame rate reaching 90.8 fps.

Fast track system optimization of emergency departments:Insights from a computer simulation study

Healthcare systems engineering in emergency departments(EDs)are developing rapidly in the world nowadays.Fast track(FT)as a rapid treatment system is considered to facilitate ED patient flow.To know how FT can improve the performance of ED,one should study the best configuration of resources for implementation of FT.This research presents a pattern for implementation of FT systems in hospital EDs using healthcare simulation paradigms.Simulation-based optimization model uses modeling and simulation capabilities to generate configurations of FT resources and its patient prioritization pattern with Arena r
simulation software.A decision making method is used to select the optimal configuration based on pre-specified performance indicators.The results imply that the proposed FT implementation pattern is efficient and capable of improving patient flow.

快速审稿和发表

快速审稿和发表是一些国际主流医学刊物采取的快速发表重要临床及科研成果的一种机制。适合快速发表的稿件经过常规的同行审稿 ,注重原始性、科学性、实用性。稿件从登记之日到发表在 1～ 1.5月之内 ,由于时间紧 ,作者、编辑、审稿人、出版人员必须密切配合 ,通过网络等方法 。

美国快速通道与突破性疗法模式的比较研究与借鉴

目的 :比较研究美国快速通道和突破性疗法模式,为我国完善药品审评审批制度提供参考经验。方法 :对比分析快速通道与突破性疗法的设置背景、准入标准、资格认证流程、加速机制及实施绩效,总结两种模式的共同点及各自特点。结果 :现阶段,我国设立了新药优先审评模式,审评逐步向具有临床价值的新药倾斜,但是对于临床试验阶段的研发指导尚不足。结论 :建议借鉴美国快速通道和突破性疗法的审评理念,并在完善现有优先审评模式基础上,强化对临床试验阶段的研发指导,提高疗效突破创新药的可获得性。

论新时代我国绿色专利快速审查制度的再确立

绿色专利快速审查制度通过加快绿色技术的专利授权而延长绿色专利权的生效时间,对绿色技术创新与应用推广具有正向激励作用。《专利优先审查管理办法》的实施使我国绿色专利快速审查制度从虚设回到几无。面对问题重重的现实,从合法性与合理性的视角分析了绿色专利快速审查制度重新确立的基本依据,并运用实证分析与比较研究的方法考察了其他国家绿色专利快速审查制度取得的成效与运行存在的问题,发现制度设立的差异产生了截然不同的绿色专利创造激励效果。建议我国构建与世界"和而不同"的绿色专利快速审查制度,分三步走建立"不同"的新时代中国特色绿色专利快速审查制度,进而与世界相"和"。