Risk factors of gastroparesis syndrome after abdominal nongastroduodenal operation and its prevention

Objective:To investigate risk factors of gastroparesis syndrome(PGS) after abdominal nongastroduodenal operation and its prevention.Methods:Clinical data of 22 patients with PGS after abdominal non-gastroduodenal operation was analyzed retrospectively,and compared with the patients of non-PGS after abdominal non-gastroduodenal operation during the same time.The possible influencing factors of PCS were analyzed by single factor analysis and logistic regression analysis.Results:All t3 selected factors related with PGS,including age,disease category (benign and malignant),operation time,intraoperative blood loss,postoperative analgesic pump, postoperative enteral nutrition time,postoperative parenteral nutrition time,perioperative blood glucose level,perioperative nutrition status(anaemia or lower proleinemia),pylorus obstruction before surgery,intra-abdominal infection after surgery,and spiritual factor were related with PGS.The statistical analysis showed that the difference was statistical significant(P【0.05),and gender had no correlation with PCS(P】0.05);non-conditional multivariate analysis showed that malignant tumor,perioperative nutrition status,pylorus obstruction,operation time,blood loss, intra-abdominal infection after surgery,and mental factor were significant related with PGS as dependent variable and related risk factors in single factor analysis as independent variables (P 【0.05).Conclusions:PGS is a result of multiple factors,and among these factors,malignant tumor,poor nutrition status,pylorus obstruction before surgery,longer operation—time,more blood loss,intra-abdominal infection after surgery,and mental factor are major risk factors of PGS.

Clinical analysis of abdominal aorta block in operation of gynecologic tumor

Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.

Effects of general anesthesia on coagulation function, stress response and other correlation factors in patients undergoing abdominal operation

Objective:To study the effects of general anesthesia on coagulation function, stress response and other correlation factors in patients undergoing abdominal operation.Methods: To select 94 cases of patients undergoing abdominal operation in our hospital from February 2016 to April 2018, divided into the control group and observation group, 47 cases in each group. On the basis of the same pre-processing, the patients in the control group were given epidural anesthesia, and the patients in the observation group received general anesthesia, to detect and compare the coagulation function, stress response and other correlation factors.Results:At T1, the levels of coagulation function (D-Dimer, APTT, PT, PLT), stress response (COR, ACTH, CRP, ET-1) and other correlation factors (IL-23, IL-32, M-CSF, PRL, PCT, NO, TNF-α) between the two groups had no statistical difference (P>0.05). At T2 and T3, the levels of coagulation function(D-Dimer), stress response (COR, ACTH, CRP, ET-1) and other correlation factors (IL-23, IL-32, M-CSF, PRL, PCT, NO, TNF-α) between the two groups had statistical difference (P<0.05).Conclusion:Application of general anesthesia in abdominal endoscopic operation, there was no significant change in coagulation function compared with epidural anesthesia, it could maintain stable coagulation function, but it had a better stabilizing effect on stress response index and other correlation factor such as IL-23, IL-32, M-CSF, PRL, PCT, NO and TNF-α, it was worthy of further clinical study.

Clinical observation of traditional Chinese medicine nursing on recovery of gastrointestinal function in patients after abdominal operation

Objective: To observe the clinical effect of traditional Chinese medicine nursing on the recovery of gastrointestinal function after abdominal operation. Methods: A total of 148 patients undergoing abdominal surgery from June 2013 to June 2014 in our hospital were randomly divided into observation group and control group, 74 cases in each group. The control group received routine nursing and the observation group was treated with the pointer, acupuncture and external application of abdominal treatment on the basis of routine nursing, which is 2 times a day,7 days for a course of treatment. Results: The recovery time of bowel sound, the first anal exhaust defecation time the in the observation group and the hospital day was less than the control group. With the comparison of two groups, the difference between the two groups was statistically significant (P < 0.05). The incidence of abdominal pain, abdominal distension, nausea, vomiting and constipation in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: On the basis of routine nursing, the implementation of traditional Chinese medicine characteristic nursing can effectively promote the recovery of gastrointestinal function, reduce the occurrence of complications, shorten the length of stay and improve the clinical effect.

Risk Factors for the Development of Adhesive Small Bowel Obstruction after Abdominal and Pelvic Operations

Introduction: Adhesive small bowel obstruction (SBO) is a disease process that has been difficult to prevent. Mechanical barriers and chemical agents exist to disrupt the formation of adhesions following surgery but each associated with medical risk and financial burden. Identifying risk factors for developing SBO in patients post laparotomy would aid in the appropriate use of such agents. We hypothesize that there might be additional risk factors that are associated with a higher likelihood of SBO. Methods: A retrospective analysis from 2008 to 2012 was performed. Cases of SBO following previous laparotomy were compared to those without SBO. Results: 468 medical records were reviewed (57% male). Operations that caused the highest risks for SBO included gynecological, colorectal and hernia operations with prosthetic materials. 66% percent of patients underwent a prior abdominal or pelvic high-risk procedure. The average time from surgery to the development of SBO was 24 months (median 19 months). Patients who developed SBO had a median age of 58.4 years on initial surgery, average previous operative time of 4.3 hours, and an av-erage of two prior operations. For every hour of operative time, the odds of developing SBO increased by 33% (p 3 decreased the odds of SBO (p = 0.05). Conclusions: Longer operative times are associated with post-operative adhesive small bowel obstruction. Patients with an ASA score greater than or equal to 3 appear to have a reduced risk of adhesive small bowel obstruction.

Bo’s abdominal acupuncture treatment for adult-onset Still's disease:A case report

BACKGROUND Adult-onset Still's disease(AOSD)is a rare autoinflammatory disease charac-terized by nonspecific symptoms such as fever,rash,sore throat and arthralgia.This paper reports a clinical case of AOSD successfully treated with Bo’s abdo-minal acupuncture(BAA).CASE SUMMARY We report a 20-year-old man who suffered from cold exposure,presenting with high fever,rash,sore throat,arthralgia,and elevated erythrocyte sedimentation rate,leukocytosis with neutrophilic predominance,elevated ferritin,elevated C-reactive protein,and negative rheumatoid factors.He was diagnosed with AOSD based on the Yamaguchi criteria.After treatment with traditional Chinese medi-cine(TCM)decoction and prednisone acetate tablets,there was some alleviation of sore throat,joint and muscle pain,and fever,but he still had persistent low-grade fever,rash,sore throat and arthralgia.He went to the TCM acupuncture outpatient department to receive BAA.Abdominal acupoints Zhongwan(CV12),Xiawan(CV10),0.5 cm below Xiawan(CV10),Qihai(CV6),Guanyuan(CV4),bilateral Qixue(KI13),bilateral Huaroumen(ST24),bilateral Shangfengshidian(AB1)and bilateral Daheng(SP15)were selected.After 3 months treatment,all symptoms disappeared,and the laboratory examination returned to normal levels.He did not take glucocorticoids or nonsteroidal anti-inflammatory drugs afterwards,and no relapse was observed during the 3-year follow-up period.CONCLUSION BAA can be used as a complementary medical approach for treatment of AOSD.

Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report

BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side effects.This case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA repair.CASE SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain control.The patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without complications.By preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular surgeries.CONCLUSION Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.

JR East aims for driverless Shinkansen operation

East Japan Railway Company(JR East)is aiming to“realize driverless train operation”as one of the key measures to respond to rapid changes in the business environment.Currently,Automatic Train Operation(ATO)equipment is not installed on the Shinkansen,but there are plans to introduce ATO or driverless operation in the near future.From 2018-2021,the Ministry of Land,Infrastructure,Transport and Tourism(MLIT)held the“ATO Technology Study Group for Railways”in which the concept of technical requirements necessary for driverless operation was discussed.In 2021,JR East conducted the GOA4 demonstration test on the Joetsu Shinkansen.In this test,we were able to confirm the basic functions of Shinkansen vehicles such as automatic departure control,speed control,fixed position stop control,and remote stop control using ATO.We aim to realize unattended operation(GOA4)for deadhead trains between Niigata Station and the Niigata Shinkansen Rolling Stock Center by the end of the 2020 s,and driverless operation(GOA3)for passenger trains of the Joetsu Shinkansen by the mid-2030s and continue to develop the necessary technologies and build systems.

Timing of surgical operation for patients with intra-abdominal infection:A systematic review and meta-analysis

BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria have emerged,making the treatment of abdominal infections more challenging.Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications.However,available evidence regarding the optimal timing of IAI surgery is still weak.In study,we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.AIM To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI,in terms of overall mortality.METHODS A systematic literature search was performed using PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Ovid,and ScienceDirect.The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method.Based on the timing of the surgical operation,we divided the literature into two groups:Early surgery and delayed surgery.For the early and delayed surgery groups,the intervention was performed with and after 12 h of the initial surgical intervention,respectively.The main outcome measure was the mortality rate.The literature search was performed from May 5 to 20,2021.We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20,2021,for ongoing trials.This study was registered with the International Prospective Register of Systematic Reviews.RESULTS We identified nine eligible trial comparisons.Early surgical exploration of patients with IAIs(performed within 12 h)has significantly reduced the mortality and complications of patients,improved the survival rate,and shortened the hospital stay.CONCLUSION Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.

Palliative long-term abdominal drains vs large volume paracenteses for the management of refractory ascites in end-stage liver disease

BACKGROUND Long-term abdominal drains(LTAD)are a cost-effective palliative measure to manage malignant ascites in the community,but their use in patients with end-stage chronic liver disease and refractory ascites is not routine practice.The safety and cost-effectiveness of LTAD are currently being studied in this setting,with preliminary positive results.We hypothesised that palliative LTAD are as effective and safe as repeat palliative large volume paracentesis(LVP)in patients with cirrhosis and refractory ascites and may offer advantages in patients’quality of life.AIM To compare the effectiveness and safety of palliative LTAD and LVP in refractory ascites secondary to end-stage chronic liver disease.METHODS A retrospective,observational cohort study comparing the effectiveness and safety outcomes of palliative LTAD and regular palliative LVP as a treatment for refractory ascites in consecutive patients with end-stage chronic liver disease followed-up at our United Kingdom tertiary centre between 2018 and 2022 was conducted.Fisher’s exact tests and the Mann-Whitney U test were used to compare qualitative and quantitative variables,respectively.Kaplan-Meier survival estimates were generated to stratify time-related outcomes according to the type of drain.RESULTS Thirty patients had a total of 35 indwelling abdominal drains and nineteen patients underwent regular LVP.The baseline characteristics were similar between the groups.Prophylactic antibiotics were more frequently prescribed in patients with LTAD(P=0.012),while the incidence of peritonitis did not differ between the two groups(P=0.46).The incidence of acute kidney injury(P=0.014)and ascites/drain-related hospital admissions(P=0.004)were significantly higher in the LVP group.The overall survival was similar in the two groups(log-rank P=0.26),but the endpoint-free survival was significantly shorter in the LVP group(P=0.003,P<0.001,P=0.018 for first ascites/drain-related admission,acute kidney injury and drain-related complications,respectively).CONCLUSION The use of LTAD in the management of refractory ascites in palliated end-stage liver disease is effective,safe,and may reduce hospital admissions and utilisation of healthcare resources compared to LVP.

Effects of spot size on the operation mode of Ga As photoconductive semiconductor switch employing extrinsic photoconductivity

To guide the illuminating design to improve the on-state performances of gallium arsenide(GaAs)photoconductive semiconductor switch(PCSS),the effect of spot size on the operation mode of GaAsPCSS based on a semi-insulating wafer with a thickness of 1 mm,triggered by a 1064-nm extrinsic laser beam with the rectangular spot,has been investigated experimentally.It is found that the variation of the spot size in length and width can act on the different parts of the output waveform integrating the characteristics of the linear and nonlinear modes,and then significantly boosts the PCSS toward different operation modes.On this basis,a two-channel model containing the active and passive parts is introduced to interpret the relevant influencing mechanisms.Results indicate that the increased spot length can peak the amplitude of static domains in the active part to enhance the development of the nonlinear switching,while the extended spot width can change the distribution of photogenerated carriers on both parts to facilitate the linear switching and weaken the nonlinear switching,which have been proved by comparing the domain evolutions under different spot sizes.

Numerical analysis for the free-boundary current reversal equilibrium in the AC plasma current operation in a tokamak

In recent decades, tokamak discharges with zero total toroidal current have been reported in tokamak experiments, and this is one of the key problems in alternating current(AC) operations.An efficient free-boundary equilibrium code is developed to investigate such advanced tokamak discharges with current reversal equilibrium configuration. The calculation results show that the reversal current equilibrium can maintain finite pressure and also has considerable effects on the position of the X-point and the magnetic separatrix shape, and hence also on the position of the strike point on the divertor plates, which is extremely useful for magnetic design, MHD stability analysis, and experimental data analysis etc. for the AC plasma current operation on tokamaks.

Continuous wave and active Q-switched operation of Watt-level LED-pumped two-rod Nd,Ce:YAG laser

A high-performance LED-side-pumped two-rod Nd,Ce:YAG laser with continuous-wave(CW) and acousto–optical(A-O) Q-switched operation is demonstrated in this work. A symmetrically shaped flat–flat cavity with two identical LEDside-pumped laser modules is employed for power scalability. In the CW regime, the maximum output average power of laser at 1064 nm is 4.41 W, corresponding to a maximum optical conversion efficiency of 5.3% and a slope efficiency is 12.4%. In the active Q-switched regime, the pulse energy of laser reaches as high as 0.89 m J at a repetition rate of 800 Hz with a pulse width of 457.2 ns, the corresponding highest peak output power is 1.94 k W and the M~2 factor is measured to be about 8.8. To the best of the authors' knowledge, this is the first demonstration and the highest performance of a CW LED-side-pumped two-rod laser Nd,Ce:YAG with Watt-level output reported so far.

Review of Fault-tolerant Control for Motor Inverter Failure with Operational Quality Considered

In recent years,motor drive systems have garnered increasing attention due to their high efficiency and superior control performance.This is especially apparent in aerospace,marine propulsion,and electric vehicles,where high performance,efficiency,and reliability are crucial.The ability of the drive system to maintain long-term fault-tolerant control(FTC)operation after a failure is essential.The likelihood of inverter failures surpasses that of other components in the drive system,highlighting its critical importance.Long-term FTC operation ensures the system retains its fundamental functions until safe repairs or replacements can be made.The focus of developing a FTC strategy has shifted from basic FTC operations to enhancing the post-fault quality to accommodate the realities of prolonged operation post-failure.This paper primarily investigates FTC strategies for inverter failures in various motor drive systems over the past decade.These strategies are categorized into three types based on post-fault operational quality:rescue,remedy,and reestablishment.The paper discusses each typical control strategy and its research focus,the strengths and weaknesses of various algorithms,and recent advancements in FTC.Finally,this review summarizes effective FTC techniques for inverter failures in motor drive systems and suggests directions for future research.

A Cross-Sectional Study on the Impact of Operation Triple Zero (OTZ) Program on Viral Load Suppression amongst Members of the Adolescent Club in 68 Nigerian Army Reference Hospital Yaba Lagos, Nigeria

Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.

A Planning Method for Operational Test of UAV Swarm Based on Mission Reliability

The unmanned aerial vehicle(UAV)swarm plays an increasingly important role in the modern battlefield,and the UAV swarm operational test is a vital means to validate the combat effectiveness of the UAV swarm.Due to the high cost and long duration of operational tests,it is essential to plan the test in advance.To solve the problem of planning UAV swarm operational test,this study considers the multi-stage feature of a UAV swarm mission,composed of launch,flight and combat stages,and proposes a method to find test plans that can maximize mission reliability.Therefore,a multi-stage mission reliability model for a UAV swarm is proposed to ensure successful implementation of the mission.A multi-objective integer optimization method that considers both mission reliability and cost is then formulated to obtain the optimal test plans.This study first constructs a mission reliability model for the UAV swarm in the combat stage.Then,the launch stage and flight stage are integrated to develop a complete PMS(Phased Mission Systems)reliability model.Finally,the Binary Decision Diagrams(BDD)and Multi Objective Quantum Particle Swarm Optimization(MOQPSO)methods are proposed to solve the model.The optimal plans considering both reliability and cost are obtained.The proposed model supports the planning of UAV swarm operational tests and represents a meaningful exploration of UAV swarm test planning.

Galvanic Skin Response—Extinction Biofeedback Training for Psychogenic Abdominal Pain: A Validation Protocol

Abdominal and pelvic pain of psychogenic origin is a widespread, disabling, difficult to identify, and often inadequately treated medical condition. This condition is often associated with poor quality of life due to high pain interference with daily activities. Cognitive behavioral psychological therapy and neuromodulation with biofeedback are validated therapies for the treatment of this condition. Aim of the present research work is the validation of a therapeutic protocol that involves the use of both techniques in combination. 20 patients diagnosed with psychogenic abdominal pain, of both sexes, aged between 18 and 60 years who had not benefited from pharmacological therapies were enrolled. 10 patients were randomly assigned to the control group (psychological treatment only), another 10 patients were assigned to the study group (neuromodulation with biofeedback-Galvanic skin response-extinction in combination with psychological therapy). For both groups, the pain score, interference of pain with daily living activities, pain relief, and the share of anxiety associated with the pain condition were evaluated (pre- and post-treatment). The patients who underwent the combined treatment achieved statistically significant better scores than patients in the control group, respectively −4.9 ± 0.9 vs −1.0 ± 0.4 for Pain;−5.1 ± 1.1 vs −0.9 ± 0.3 for Interference with life;−7.2 ± 3.7 vs −2.2 ± 2.1 for HAMA;4.6 ± 1.2 vs 1.1 ± 0.6 for Relief.

Improving the operational stability of perovskite solar cells with cesium-doped graphene oxide interlayer

Perovskite solar cells(PSCs)have made great advances in terms of power conversion efficiency(PCE),yet their subpar stability continues to hinder their commercialization.The interface between the perovskite layer and the charge-carrier transporting layers plays a crucial role in undermining the stability of PSCs.In this work,we propose a strategy to stabilize high-performance PSCs with PCE over 23%by introducing a cesium-doped graphene oxide(GO-Cs)as an interlayer between the perovskite and hole-transporting material.The GO-Cs treated PSCs exhibit excellent operational stability with a projected T80(the time where the device PCE reduces to 80%of its initial value)of 2143 h of operation at the maximum powering point under one sun illumination.

A coordinated operation method of wind-PV-hydrogenstorage multi-agent energy system

Wind-photovoltaic(PV)-hydrogen-storage multi-agent energy systems are expected to play an important role in promoting renewable power utilization and decarbonization.In this study,a coordinated operation method was proposed for a wind-PVhydrogen-storage multi-agent energy system.First,a coordinated operation model was formulated for each agent considering peer-to-peer power trading.Second,a coordinated operation interactive framework for a multi-agent energy system was proposed based on the theory of the alternating direction method of multipliers.Third,a distributed interactive algorithm was proposed to protect the privacy of each agent and solve coordinated operation strategies.Finally,the effectiveness of the proposed coordinated operation method was tested on multi-agent energy systems with different structures,and the operational revenues of the wind power,PV,hydrogen,and energy storage agents of the proposed coordinated operation model were improved by approximately 59.19%,233.28%,16.75%,and 145.56%,respectively,compared with the independent operation model.

Mission-oriented capability evaluation for combat network based on operation loops OA

With continuous growth in scale,topology complexity,mission phases,and mission diversity,challenges have been placed for efficient capability evaluation of modern combat systems.Aiming at the problems of insufficient mission consideration and single evaluation dimension in the existing evaluation approaches,this study proposes a mission-oriented capability evaluation method for combat systems based on operation loop.Firstly,a combat network model is given that takes into account the capability properties of combat nodes.Then,based on the transition matrix between combat nodes,an efficient algorithm for operation loop identification is proposed based on the Breadth-First Search.Given the mission-capability satisfaction of nodes,the effectiveness evaluation indexes for operation loops and combat network are proposed,followed by node importance measure.Through a case study of the combat scenario involving space-based support against surface ships under different strategies,the effectiveness of the proposed method is verified.The results indicated that the ROI-priority attack method has a notable impact on reducing the overall efficiency of the network,whereas the O-L betweenness-priority attack is more effective in obstructing the successful execution of enemy attack missions.