BACKGROUND In laparoscopic proximal gastrectomy(LPG),the prolapse of the hepatic left lateral lobe near the lesser curvature and esophageal hiatus can obstruct the field of vision and operation.Therefore,it is necessa...BACKGROUND In laparoscopic proximal gastrectomy(LPG),the prolapse of the hepatic left lateral lobe near the lesser curvature and esophageal hiatus can obstruct the field of vision and operation.Therefore,it is necessary to retract or obstruct the hepatic left lateral lobe to ensure a clear field of vision.AIM To investigate the safety and clinical efficacy of the modified hepatic left lateral lobe inversion technique for LPG.METHODS A retrospective analysis was conducted on the clinical data of 13 consecutive patients with early-stage upper gastric adenocarcinoma or adenocarcinoma of the esophagogastric junction treated with LPG from January to December 2023 at the Department of Gastrointestinal Surgery,Second Affiliated Hospital of Fujian Medical University.The modified hepatic left lateral lobe inversion technique was used to expose the surgical field in all patients,and short-term outcomes were observed.RESULTS In all 13 patients,the modified hepatic left lateral lobe inversion technique was successful during surgery without the need for re-retraction or alteration of the liver traction method.There were no instances of esophageal hiatus occlusion,eliminating the need for forceps to assist in exposure.There was no occurrence of intraoperative hepatic hemorrhage,hepatic vein injury,or hepatic congestion.No postoperative digestive complications of Clavien-Dindo grade≥II occurred wi-thin 30 days after surgery,except for a single case of pulmonary infection.Some patients experienced increases in alanine aminotransferase and aspartate aminotransferase levels on the first day after surgery,which significantly decreased by the third day and returned to normal by the seventh day after surgery.CONCLUSION The modified hepatic left lateral lobe inversion technique has demonstrated satisfactory results,offering ad-vantages in terms of facilitating surgical procedures,reducing surgical trauma,and protecting the liver.展开更多
BACKGROUND A limited number of studies have demonstrated that sleeping in the left lateral decubitus(LLD)decreases nocturnal reflux in patients with gastroesophageal reflux disease(GERD)compared to right lateral decub...BACKGROUND A limited number of studies have demonstrated that sleeping in the left lateral decubitus(LLD)decreases nocturnal reflux in patients with gastroesophageal reflux disease(GERD)compared to right lateral decubitus(RLD)and supine.AIM This systematic review summarizes the association between sleeping in the LLD position and nocturnal reflux in patients with GERD.METHODS Studies published up to July 17,2023,in MEDLINE,EMBASE,and CENTRAL were searched.Eligible studies were randomized and nonrandomized studies assessing the effect of sleeping in LLD compared to RLD and supine in reducing nocturnal reflux in GERD patients.Outcomes include the acid exposure time(AET)(%time in pH<4),acid clearance time(ACT)(in sec/episode),number of reflux episodes,and improvement in N-GSSIQ scores.RESULTS Two nonrandomized studies showed decreased AET and ACT in LLD sleep position in comparison to RLD(mean difference[MD]-2.03[95%CI:-3.62 to-0.45];-81.84[95%CI:-127.48 to-36.20],respectively)and supine position(MD-2.71[95%CI:-4.34 to-1.09];-74.47[95%CI:-116.26 to-32.69],respectively).There was no difference in AET and ACT between RLD sleep position and supine.Furthermore,one randomized controlled trial investigating the use of electronic sleep positional therapy,which increased the duration of LLD sleep and decreased the duration of RLD sleep compared to sham,showed nocturnal symptoms improvement(improved N-GSSIQ score,increased reflux-free nights,and resolution of nocturnal reflux symptoms).CONCLUSION Current evidence suggests that sleeping on the left side could reduce nocturnal reflux and improve GERD-related quality of life,therefore warranting interventions that promote LLD sleep position.展开更多
AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular car...AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular carcinoma (HCC) in the left lateral segments.展开更多
We are reporting a long-time magnetic resonance imaging(MRI) follow-up in a rare case of cardiac left lateral wall hypertrophy. Hypertrophic cardiomyopathy(HCM) is the most common genetic cardiovascular disorder and a...We are reporting a long-time magnetic resonance imaging(MRI) follow-up in a rare case of cardiac left lateral wall hypertrophy. Hypertrophic cardiomyopathy(HCM) is the most common genetic cardiovascular disorder and a significant cause of sudden cardiac death. Cardiac magnetic resonance(CMR) imaging can be a valuable tool for assessment of detailed information on size,localization,and tissue characteristics of hypertrophied myocardium. However,there is still little knowledge of long-term evolution of HCM as visualized by magnetic resonance imaging. Recently,our group reported a case of left lateral wall HCM as a rare variant of the more common forms,such as septal HCM,or apical HCM. As we now retrieved an old cardiac MRI acquired in this patient more than 20 years ago,we are able to provide the thrilling experience of an ultra-long MRI followup presentation in this rare case of left lateral wall hypertrophy. Furthermore,this case outlines the tremendous improvements in imaging quality within the last two decades of CMR imaging.展开更多
Objectives: This study aimed to evaluate operative benefits of artificial pnuemothorax in thoracoscopic esophagectomy in the left lateral decubitus position. Methods: We retrospectively analyzed short-term surgical ou...Objectives: This study aimed to evaluate operative benefits of artificial pnuemothorax in thoracoscopic esophagectomy in the left lateral decubitus position. Methods: We retrospectively analyzed short-term surgical outcomes including learning curve of 60 consecutive patients who underwent thoracoscopic esophagectomy with artificial pnuemothorax in the left lateral decubitus position between April 2010 and November 2012 in our department. Results: The median operation time and intraoperative blood loss were 443 min and 220 ml, respectively, and these values were 174 min and 95 ml, respectively, in the thoracic phase of surgery. The median number of harvested lymph node was 37. Only 1 patient required conversion to open esophagectomy. The postoperative 30-day mortality rate was 1.7%. The thoracic operation time significantly decreased after an experience of 10 cases and intraoperative blood loss during thoracic phasesignificantly decreased after an experience of 20 cases (p < 0.05), and operation time remained constant for the following cases. The number of harvested lymph nodes did not exhibit significant changes with an increase in the number of case experienced. Conclusions: Artificial pneumothorax provided the shorting of learning curve at the thoracoscopic esophagectomy in the left lateral decubitus position.展开更多
The magnetic levitation transportation system is one of the potential applications of high-Tc superconducting (HTS) maglev system. The prototype HTS magnetic levitation system is composed of one HTS bulk and a permane...The magnetic levitation transportation system is one of the potential applications of high-Tc superconducting (HTS) maglev system. The prototype HTS magnetic levitation system is composed of one HTS bulk and a permanent magnet railway (PMR). The maglev transportation system performance is influenced by the maximum levitation force, the maximum guidance force and the maximum of external applied magnetic flux density. The applied magnetic field distribution also needs to be considered carefully. In the paper, the magnetic levitation force of cylindrical HTS bulk over PMR is experimentally studied. During the experiment, symmetrical PMR and Halbach PMR are used separately. The levitation force-gap loops of different lateral offset of the HTS bulk above PMRs are obtained experimentally. The results show that the HTS bulk levitation performance is tightly relative to the external applied magnetic field distribution. The maximum magnetic levitation forces of HTS bulk above symmetrical PMR decrease linearly with the lateral offset increasing. When the lateral offset changes from 0 mm to 25 mm, the maximum magnetic levitation forces of HTS bulk above Halbach PMR increase with the lateral offset increasing. When the lateral offset exceeds the center of the Halbach PMR by 25 mm, the maximum force decreases rapidly with the increase of the lateral offset of the bulk sample.展开更多
We read with great interest the systematic review on modified grafts for pediatric liver transplantation by Gavriilidis et al.(1)recently published in Hepatobiliary Surgery and Nutrition.The authors aimed to review ex...We read with great interest the systematic review on modified grafts for pediatric liver transplantation by Gavriilidis et al.(1)recently published in Hepatobiliary Surgery and Nutrition.The authors aimed to review existing literature related to liver transplantation(LT)in small pediatric recipients using modified left lateral segment(LLS)grafts-reduced/hyper-reduced LLS or monosegments-and how comparable these techniques are to the standard practice using LLS.We congratulate the authors on their publication and would like to highlight some important findings of this study.Gavriilidis et al.’s(1)systematic review included a final cohort of 330 small pediatric recipients of modified LLS over two decades.The discrepancy between years evaluated and number of reported cases included in the systematic review is striking,and somehow not surprising.In the Unites States alone,the pre-transplant mortality amongst candidates younger than 1 year is reported to be 21.7 deaths per 100 patient-years(2).展开更多
Left-turning traffic without a protected left-turn signal is one of the major safety concerns at urban intersections. Though an average of only l0% - 15% of all approaching traffic turns left, significantly a large pr...Left-turning traffic without a protected left-turn signal is one of the major safety concerns at urban intersections. Though an average of only l0% - 15% of all approaching traffic turns left, significantly a large proportion of left-turn crashes occur involving 21% of all intersection fatal crashes. Where traditional safety countermeasures of signal timing-phasing and use of flashing yellow light have reportedly failed to significantly reduce the rate of crashes, an in-vehicle advance collision warning message can be helpful to reduce left-turn collisions at intersections. In this study, an in-vehicle audio warning application has been designed by providing two safety warning messages (Advance Warning Message and Safe Left-turn Maneuver Message) under the vehicle to vehicle (V2V) communication system, which is triggered based on the acceptable gaps of oncoming opposing vehicles for a safe left-turn. A driving simulator test has been conducted with 30 participants to investigate the impacts of warning messages on performance measures such as speed and acceleration profiles, collision records, brake reaction distance, and intersection clearance time. Statistical results showed that with the help of these messages, all participants were able to reduce speeds and accelerations and chose suitable gaps without potential conflicts. Moreover, the results of questionnaire analysis provide a positive acceptability especially for the Safe Left-turn Maneuver Message. Based on the performance measurements, this type of safety warning messages can be recommended for possible real-road tests for practical applications.展开更多
基金Key Clinical Specialty Discipline Construction Program of Fujian,Fujian Health Medicine and Politics,No.[2022]884.
文摘BACKGROUND In laparoscopic proximal gastrectomy(LPG),the prolapse of the hepatic left lateral lobe near the lesser curvature and esophageal hiatus can obstruct the field of vision and operation.Therefore,it is necessary to retract or obstruct the hepatic left lateral lobe to ensure a clear field of vision.AIM To investigate the safety and clinical efficacy of the modified hepatic left lateral lobe inversion technique for LPG.METHODS A retrospective analysis was conducted on the clinical data of 13 consecutive patients with early-stage upper gastric adenocarcinoma or adenocarcinoma of the esophagogastric junction treated with LPG from January to December 2023 at the Department of Gastrointestinal Surgery,Second Affiliated Hospital of Fujian Medical University.The modified hepatic left lateral lobe inversion technique was used to expose the surgical field in all patients,and short-term outcomes were observed.RESULTS In all 13 patients,the modified hepatic left lateral lobe inversion technique was successful during surgery without the need for re-retraction or alteration of the liver traction method.There were no instances of esophageal hiatus occlusion,eliminating the need for forceps to assist in exposure.There was no occurrence of intraoperative hepatic hemorrhage,hepatic vein injury,or hepatic congestion.No postoperative digestive complications of Clavien-Dindo grade≥II occurred wi-thin 30 days after surgery,except for a single case of pulmonary infection.Some patients experienced increases in alanine aminotransferase and aspartate aminotransferase levels on the first day after surgery,which significantly decreased by the third day and returned to normal by the seventh day after surgery.CONCLUSION The modified hepatic left lateral lobe inversion technique has demonstrated satisfactory results,offering ad-vantages in terms of facilitating surgical procedures,reducing surgical trauma,and protecting the liver.
文摘BACKGROUND A limited number of studies have demonstrated that sleeping in the left lateral decubitus(LLD)decreases nocturnal reflux in patients with gastroesophageal reflux disease(GERD)compared to right lateral decubitus(RLD)and supine.AIM This systematic review summarizes the association between sleeping in the LLD position and nocturnal reflux in patients with GERD.METHODS Studies published up to July 17,2023,in MEDLINE,EMBASE,and CENTRAL were searched.Eligible studies were randomized and nonrandomized studies assessing the effect of sleeping in LLD compared to RLD and supine in reducing nocturnal reflux in GERD patients.Outcomes include the acid exposure time(AET)(%time in pH<4),acid clearance time(ACT)(in sec/episode),number of reflux episodes,and improvement in N-GSSIQ scores.RESULTS Two nonrandomized studies showed decreased AET and ACT in LLD sleep position in comparison to RLD(mean difference[MD]-2.03[95%CI:-3.62 to-0.45];-81.84[95%CI:-127.48 to-36.20],respectively)and supine position(MD-2.71[95%CI:-4.34 to-1.09];-74.47[95%CI:-116.26 to-32.69],respectively).There was no difference in AET and ACT between RLD sleep position and supine.Furthermore,one randomized controlled trial investigating the use of electronic sleep positional therapy,which increased the duration of LLD sleep and decreased the duration of RLD sleep compared to sham,showed nocturnal symptoms improvement(improved N-GSSIQ score,increased reflux-free nights,and resolution of nocturnal reflux symptoms).CONCLUSION Current evidence suggests that sleeping on the left side could reduce nocturnal reflux and improve GERD-related quality of life,therefore warranting interventions that promote LLD sleep position.
文摘AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular carcinoma (HCC) in the left lateral segments.
基金Supported by The German Research Foundation(DFG)the University of Wuerzburg in the funding programme Open Access Publishing
文摘We are reporting a long-time magnetic resonance imaging(MRI) follow-up in a rare case of cardiac left lateral wall hypertrophy. Hypertrophic cardiomyopathy(HCM) is the most common genetic cardiovascular disorder and a significant cause of sudden cardiac death. Cardiac magnetic resonance(CMR) imaging can be a valuable tool for assessment of detailed information on size,localization,and tissue characteristics of hypertrophied myocardium. However,there is still little knowledge of long-term evolution of HCM as visualized by magnetic resonance imaging. Recently,our group reported a case of left lateral wall HCM as a rare variant of the more common forms,such as septal HCM,or apical HCM. As we now retrieved an old cardiac MRI acquired in this patient more than 20 years ago,we are able to provide the thrilling experience of an ultra-long MRI followup presentation in this rare case of left lateral wall hypertrophy. Furthermore,this case outlines the tremendous improvements in imaging quality within the last two decades of CMR imaging.
文摘Objectives: This study aimed to evaluate operative benefits of artificial pnuemothorax in thoracoscopic esophagectomy in the left lateral decubitus position. Methods: We retrospectively analyzed short-term surgical outcomes including learning curve of 60 consecutive patients who underwent thoracoscopic esophagectomy with artificial pnuemothorax in the left lateral decubitus position between April 2010 and November 2012 in our department. Results: The median operation time and intraoperative blood loss were 443 min and 220 ml, respectively, and these values were 174 min and 95 ml, respectively, in the thoracic phase of surgery. The median number of harvested lymph node was 37. Only 1 patient required conversion to open esophagectomy. The postoperative 30-day mortality rate was 1.7%. The thoracic operation time significantly decreased after an experience of 10 cases and intraoperative blood loss during thoracic phasesignificantly decreased after an experience of 20 cases (p < 0.05), and operation time remained constant for the following cases. The number of harvested lymph nodes did not exhibit significant changes with an increase in the number of case experienced. Conclusions: Artificial pneumothorax provided the shorting of learning curve at the thoracoscopic esophagectomy in the left lateral decubitus position.
文摘The magnetic levitation transportation system is one of the potential applications of high-Tc superconducting (HTS) maglev system. The prototype HTS magnetic levitation system is composed of one HTS bulk and a permanent magnet railway (PMR). The maglev transportation system performance is influenced by the maximum levitation force, the maximum guidance force and the maximum of external applied magnetic flux density. The applied magnetic field distribution also needs to be considered carefully. In the paper, the magnetic levitation force of cylindrical HTS bulk over PMR is experimentally studied. During the experiment, symmetrical PMR and Halbach PMR are used separately. The levitation force-gap loops of different lateral offset of the HTS bulk above PMRs are obtained experimentally. The results show that the HTS bulk levitation performance is tightly relative to the external applied magnetic field distribution. The maximum magnetic levitation forces of HTS bulk above symmetrical PMR decrease linearly with the lateral offset increasing. When the lateral offset changes from 0 mm to 25 mm, the maximum magnetic levitation forces of HTS bulk above Halbach PMR increase with the lateral offset increasing. When the lateral offset exceeds the center of the Halbach PMR by 25 mm, the maximum force decreases rapidly with the increase of the lateral offset of the bulk sample.
文摘We read with great interest the systematic review on modified grafts for pediatric liver transplantation by Gavriilidis et al.(1)recently published in Hepatobiliary Surgery and Nutrition.The authors aimed to review existing literature related to liver transplantation(LT)in small pediatric recipients using modified left lateral segment(LLS)grafts-reduced/hyper-reduced LLS or monosegments-and how comparable these techniques are to the standard practice using LLS.We congratulate the authors on their publication and would like to highlight some important findings of this study.Gavriilidis et al.’s(1)systematic review included a final cohort of 330 small pediatric recipients of modified LLS over two decades.The discrepancy between years evaluated and number of reported cases included in the systematic review is striking,and somehow not surprising.In the Unites States alone,the pre-transplant mortality amongst candidates younger than 1 year is reported to be 21.7 deaths per 100 patient-years(2).
文摘Left-turning traffic without a protected left-turn signal is one of the major safety concerns at urban intersections. Though an average of only l0% - 15% of all approaching traffic turns left, significantly a large proportion of left-turn crashes occur involving 21% of all intersection fatal crashes. Where traditional safety countermeasures of signal timing-phasing and use of flashing yellow light have reportedly failed to significantly reduce the rate of crashes, an in-vehicle advance collision warning message can be helpful to reduce left-turn collisions at intersections. In this study, an in-vehicle audio warning application has been designed by providing two safety warning messages (Advance Warning Message and Safe Left-turn Maneuver Message) under the vehicle to vehicle (V2V) communication system, which is triggered based on the acceptable gaps of oncoming opposing vehicles for a safe left-turn. A driving simulator test has been conducted with 30 participants to investigate the impacts of warning messages on performance measures such as speed and acceleration profiles, collision records, brake reaction distance, and intersection clearance time. Statistical results showed that with the help of these messages, all participants were able to reduce speeds and accelerations and chose suitable gaps without potential conflicts. Moreover, the results of questionnaire analysis provide a positive acceptability especially for the Safe Left-turn Maneuver Message. Based on the performance measurements, this type of safety warning messages can be recommended for possible real-road tests for practical applications.
