AIM： To investigate the outcomes of early and delayed elective resection after initial antibiotic treatment in patients with complicated diverticulitis. METHODS： The study, a non-randomized comparison of the two app...AIM： To investigate the outcomes of early and delayed elective resection after initial antibiotic treatment in patients with complicated diverticulitis. METHODS： The study, a non-randomized comparison of the two approaches, included 421 consecutive patients who underwent surgical resection for complicated sigmoid diverticulitis （Hinchey classification I - II ） at the Department of Surgery, University Medical Center Hamburg-Eppendorf between 2004 and 2009. The operating procedure, duration of hospital and intensive care unit stay, outcome, complications and socioeconomic costs were analyzed, with comparison made between the early and delayed elective resection strategies. RESULTS： The severity of the diverticulitis and American Society of Anesthesiologists score were comparable for the two groups. Patients who underwent delayed elective resection had a shorter hospital stay and operating time, and the rate of successfully completed laparoscopic resections was higher （80% vs 75%）. Eight patients who were scheduled for delayed elective resection required urgent surgery because of complications of the diverticulitis, which resulted in a high rate of morbidity. Analysis of the socioeconomic effects showed that hospitalization costs were significantly higher for delayed elective resection compared with early elec- tive resection （9296 ± 694 vs 8423 ± 968 ; P = 0.001）. Delayed elective resection showed a trend toward lower complications, and the operation appeared simpler to perform than early elective resection. Nevertheless, delayed elective resection carries a risk of complications occurring during the period of 6-8 wk that could necessitate an urgent resection with its consequent high morbidity, which counterbalanced many of the advantages.展开更多
Smooth support vector machine （SSVM） changs the normal support vector machine （SVM） into the unconstrained op- timization by using the smooth sigmoid function. The method can be solved under the Broyden-Fletcher-G...Smooth support vector machine （SSVM） changs the normal support vector machine （SVM） into the unconstrained op- timization by using the smooth sigmoid function. The method can be solved under the Broyden-Fletcher-Goldfarb-Shanno （BFGS） algorithm and the Newdon-Armijio （NA） algorithm easily, however the accuracy of sigmoid function is not as good as that of polyno- mial smooth function. Furthermore, the method cannot reduce the influence of outliers or noise in dataset. A fuzzy smooth support vector machine （FSSVM） with fuzzy membership and polynomial smooth functions is introduced into the SVM. The fuzzy member- ship considers the contribution rate of each sample to the optimal separating hyperplane and makes the optimization problem more accurate at the inflection point. Those changes play a positive role on trials. The results of the experiments show that those FSSVMs can obtain a better accuracy and consume the shorter time than SSVM and lagrange support vector machine （LSVM）.展开更多
文摘AIM： To investigate the outcomes of early and delayed elective resection after initial antibiotic treatment in patients with complicated diverticulitis. METHODS： The study, a non-randomized comparison of the two approaches, included 421 consecutive patients who underwent surgical resection for complicated sigmoid diverticulitis （Hinchey classification I - II ） at the Department of Surgery, University Medical Center Hamburg-Eppendorf between 2004 and 2009. The operating procedure, duration of hospital and intensive care unit stay, outcome, complications and socioeconomic costs were analyzed, with comparison made between the early and delayed elective resection strategies. RESULTS： The severity of the diverticulitis and American Society of Anesthesiologists score were comparable for the two groups. Patients who underwent delayed elective resection had a shorter hospital stay and operating time, and the rate of successfully completed laparoscopic resections was higher （80% vs 75%）. Eight patients who were scheduled for delayed elective resection required urgent surgery because of complications of the diverticulitis, which resulted in a high rate of morbidity. Analysis of the socioeconomic effects showed that hospitalization costs were significantly higher for delayed elective resection compared with early elec- tive resection （9296 ± 694 vs 8423 ± 968 ; P = 0.001）. Delayed elective resection showed a trend toward lower complications, and the operation appeared simpler to perform than early elective resection. Nevertheless, delayed elective resection carries a risk of complications occurring during the period of 6-8 wk that could necessitate an urgent resection with its consequent high morbidity, which counterbalanced many of the advantages.
基金supported by the National Natural Science Foundation of China (60974082)
文摘Smooth support vector machine （SSVM） changs the normal support vector machine （SVM） into the unconstrained op- timization by using the smooth sigmoid function. The method can be solved under the Broyden-Fletcher-Goldfarb-Shanno （BFGS） algorithm and the Newdon-Armijio （NA） algorithm easily, however the accuracy of sigmoid function is not as good as that of polyno- mial smooth function. Furthermore, the method cannot reduce the influence of outliers or noise in dataset. A fuzzy smooth support vector machine （FSSVM） with fuzzy membership and polynomial smooth functions is introduced into the SVM. The fuzzy member- ship considers the contribution rate of each sample to the optimal separating hyperplane and makes the optimization problem more accurate at the inflection point. Those changes play a positive role on trials. The results of the experiments show that those FSSVMs can obtain a better accuracy and consume the shorter time than SSVM and lagrange support vector machine （LSVM）.
