BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require furt...BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.展开更多
Half-integer microwave induced steps(Shapiro steps)have been observed in many different Josephson junction systems,which have attracted a lot of attention because they signify the deviation of current phase relation(C...Half-integer microwave induced steps(Shapiro steps)have been observed in many different Josephson junction systems,which have attracted a lot of attention because they signify the deviation of current phase relation(CPR)and uncover many unconventional physical properties.In this article,we first report the discovery of half-integer Shapiro steps in MgB_(2)focused He ion beam(He-FIB)Josephson junctions.The half-integer steps'dependence on microwave frequency,temperature,microwave power,and magnetic field is also analyzed.We find that the existence of half-integer steps can be controlled by the magnetic field periodically,which is similar to that of high temperature superconductor(HTS)grain boundary junctions,and the similarity of the microstructures between gain boundary junctions and He-FIB junctions is discussed.As a consequence,we mainly attribute the physical origin of half-integer steps in MgB_(2)He-FIB junctions to the model that a He-FIB junction is analogous to a parallel junctions'array.Our results show that He-FIB technology is a promising platform for researching CPR in junctions made of different superconductors.展开更多
The writer aims to study on the four important ones from Deming's fourteen steps to Total Quality Management ( TQM) in classroom teaching,to analyze the steps from the aspect of classroom teaching and discuss the ...The writer aims to study on the four important ones from Deming's fourteen steps to Total Quality Management ( TQM) in classroom teaching,to analyze the steps from the aspect of classroom teaching and discuss the feasibility of the issues by providing various measures and by using different managing approaches.展开更多
Chinese nurse chooses to join a medical mission to Mali, just like her father Hong Min will never forget 18 July 2017. It was the day when the nurse received the medal of the Order of Health Merit of Mali for her serv...Chinese nurse chooses to join a medical mission to Mali, just like her father Hong Min will never forget 18 July 2017. It was the day when the nurse received the medal of the Order of Health Merit of Mali for her service in the country as part of the 24th Chinese medical team.The award, in the words of Samba Ousmane Sow, then minister of health and public hygiene.展开更多
为有效提高碳排放配额分配的合理性,并且避免年度结算时碳排放量超标导致环境污染加剧问题,提出基于奖惩因子的季节性碳交易机制,以园区综合能源系统(park integrated energy system,PIES)为对象进行低碳经济调度。首先,构建包含能量层...为有效提高碳排放配额分配的合理性,并且避免年度结算时碳排放量超标导致环境污染加剧问题,提出基于奖惩因子的季节性碳交易机制,以园区综合能源系统(park integrated energy system,PIES)为对象进行低碳经济调度。首先,构建包含能量层–碳流层–管理层的综合能源系统(integrated energy system,IES)运行框架,建立电气热多能流供需动态一致性模型;其次,分析系统内“日–季节–年度”碳排放特性,打破传统应用指标法的配额分配方法,采用灰色关联分析法建立碳排放配额分配模型,并基于奖惩阶梯碳价制定季节性碳交易机制;最后,以系统内全寿命周期运行成本及碳交易成本最小为目标,对执行季节性碳交易机制的PIES进行低碳经济调度,分析长时间尺度下季节性储能参与调度的减碳量。搭建IEEE 33节点电网5节点气网7节点热网的PIES,并基于多场景进行算例分析,验证此调度方法能够实现零碳经济运行,保证系统供能可靠性,为建立零碳园区奠定理论基础。展开更多
针对行人航位推算(pedestrian dead reckoning,PDR)室内信号易受到环境和多径效应干扰的问题,提出一种基于多模型融合的室内PDR优化建模方法.给出多模型融合的室内PDR建模方法系统模型,包括步数检测、步长推算、方向推算以及位置推算4...针对行人航位推算(pedestrian dead reckoning,PDR)室内信号易受到环境和多径效应干扰的问题,提出一种基于多模型融合的室内PDR优化建模方法.给出多模型融合的室内PDR建模方法系统模型,包括步数检测、步长推算、方向推算以及位置推算4个关键阶段.该方法在步数检测阶段融合了峰值检测算法、局部最大值算法以及提前过零检测算法;在步长推算阶段融合Weinberg方法和Kim方法,并利用卡尔曼滤波算法校正步数检测和步长推算的误差.基于不同场景从步数、步长、方向、位置误差方面与传统算法进行比较.结果表明,该组合模型结合了传统步数检测和步长推算算法的特征识别结果,可实现对步数检测、步长推算过程中信号特征的优化处理;在手持场景下,步数检测识别准确,步长推算中值误差在0.060 m以内,方向推算平均绝对误差最小为3.06°,位置推算平均误差为0.2353 m,取得较好的室内步行状态识别与定位性能.展开更多
基金Supported by Health Research Program of Anhui,No.AHWJ2022b032。
文摘BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.
基金supported by the National Natural Science Foundation of China (Grant No.12104016)the National Key Research and Development Program of China (Grant No.2020YFF01014706)。
文摘Half-integer microwave induced steps(Shapiro steps)have been observed in many different Josephson junction systems,which have attracted a lot of attention because they signify the deviation of current phase relation(CPR)and uncover many unconventional physical properties.In this article,we first report the discovery of half-integer Shapiro steps in MgB_(2)focused He ion beam(He-FIB)Josephson junctions.The half-integer steps'dependence on microwave frequency,temperature,microwave power,and magnetic field is also analyzed.We find that the existence of half-integer steps can be controlled by the magnetic field periodically,which is similar to that of high temperature superconductor(HTS)grain boundary junctions,and the similarity of the microstructures between gain boundary junctions and He-FIB junctions is discussed.As a consequence,we mainly attribute the physical origin of half-integer steps in MgB_(2)He-FIB junctions to the model that a He-FIB junction is analogous to a parallel junctions'array.Our results show that He-FIB technology is a promising platform for researching CPR in junctions made of different superconductors.
文摘The writer aims to study on the four important ones from Deming's fourteen steps to Total Quality Management ( TQM) in classroom teaching,to analyze the steps from the aspect of classroom teaching and discuss the feasibility of the issues by providing various measures and by using different managing approaches.
文摘Chinese nurse chooses to join a medical mission to Mali, just like her father Hong Min will never forget 18 July 2017. It was the day when the nurse received the medal of the Order of Health Merit of Mali for her service in the country as part of the 24th Chinese medical team.The award, in the words of Samba Ousmane Sow, then minister of health and public hygiene.
文摘为有效提高碳排放配额分配的合理性,并且避免年度结算时碳排放量超标导致环境污染加剧问题,提出基于奖惩因子的季节性碳交易机制,以园区综合能源系统(park integrated energy system,PIES)为对象进行低碳经济调度。首先,构建包含能量层–碳流层–管理层的综合能源系统(integrated energy system,IES)运行框架,建立电气热多能流供需动态一致性模型;其次,分析系统内“日–季节–年度”碳排放特性,打破传统应用指标法的配额分配方法,采用灰色关联分析法建立碳排放配额分配模型,并基于奖惩阶梯碳价制定季节性碳交易机制;最后,以系统内全寿命周期运行成本及碳交易成本最小为目标,对执行季节性碳交易机制的PIES进行低碳经济调度,分析长时间尺度下季节性储能参与调度的减碳量。搭建IEEE 33节点电网5节点气网7节点热网的PIES,并基于多场景进行算例分析,验证此调度方法能够实现零碳经济运行,保证系统供能可靠性,为建立零碳园区奠定理论基础。
文摘针对行人航位推算(pedestrian dead reckoning,PDR)室内信号易受到环境和多径效应干扰的问题,提出一种基于多模型融合的室内PDR优化建模方法.给出多模型融合的室内PDR建模方法系统模型,包括步数检测、步长推算、方向推算以及位置推算4个关键阶段.该方法在步数检测阶段融合了峰值检测算法、局部最大值算法以及提前过零检测算法;在步长推算阶段融合Weinberg方法和Kim方法,并利用卡尔曼滤波算法校正步数检测和步长推算的误差.基于不同场景从步数、步长、方向、位置误差方面与传统算法进行比较.结果表明,该组合模型结合了传统步数检测和步长推算算法的特征识别结果,可实现对步数检测、步长推算过程中信号特征的优化处理;在手持场景下,步数检测识别准确,步长推算中值误差在0.060 m以内,方向推算平均绝对误差最小为3.06°,位置推算平均误差为0.2353 m,取得较好的室内步行状态识别与定位性能.
