AIM:To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel.METHODS:Sixty patients with grade Ⅲ or Ⅳ hemorrhoids were prospectively randomized t...AIM:To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel.METHODS:Sixty patients with grade Ⅲ or Ⅳ hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by bipolar diathermy(group 1) or hemorrhoidectomy with the ultrasonic scalpel(group 2).Operative data were recorded,and patients were followed at 1,3,and 6 wk to evaluate complications.Independent assessors were assigned to obtain postoperative pain scores,oral analgesic requirement and satisfaction scores.RESULTS:Reduced intraoperative blood loss median 0.9 mL(95% CI:0.8-3.7) vs 4.6 mL(95% CI:3.8-7.0),P = 0.001 and a short operating time median 16(95% CI:14.6-18.2) min vs 31(95% CI:28.1-35.3) min,P < 0.0001 was observed in group 1 compared with group 2.There was a trend towards lower postoperative pain scores on day 1 group 1 median 2(95% CI:1.8-3.5) vs group 2 median 3(95% CI:2.6-4.2),P = 0.135.Reduced oral analgesic requirement during postoperative 24 h after operation median 1(95% CI:0.4-0.9) tablet vs 1(95% CI:0.9-1.3) tablet,P = 0.006 was observed in group 1 compared with group 2.There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications.CONCLUSION:Bipolar diathermy hemorrhoidectomy is quick and bloodless and,although as painful as closed hemorrhoidectomy with the ultrasonic scalpel,is associated with a reduced analgesic requirement immediately after operation.展开更多
Latest advances in network sensor technology and state of the art of mobile robotics and artificial intelligence research can be applied to develop autonomous and distributed monitoring systems. Intelligent Space （iS...Latest advances in network sensor technology and state of the art of mobile robotics and artificial intelligence research can be applied to develop autonomous and distributed monitoring systems. Intelligent Space （iSpace） is an environmental system, which is able to support human in informative and physical ways. iSpace observing the space with distributed sensors, extracts useful information from the obtained data and provides various services to users. This means that essential functions of iSpace are ＂observation＂, ＂recognition＂ and ＂actuation.＂ In this paper, we focus on the observation function of iSpace. And we describe observation systems to get information of both human and mobile agents in the space to show new results.展开更多
Background：China has achieved universal health insurance coverage.This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the...Background：China has achieved universal health insurance coverage.This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes.Methods：The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing.We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives.Results：Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates.Under plans with an annual ceiling for insurance coverage,patients spent significantly more in the second half of the year than in the first half of the year.The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider.Conclusions：Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers.Reformation is necessary to reduce those incentives,and improve equity and efficiency in healthcare use.展开更多
文摘AIM:To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel.METHODS:Sixty patients with grade Ⅲ or Ⅳ hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by bipolar diathermy(group 1) or hemorrhoidectomy with the ultrasonic scalpel(group 2).Operative data were recorded,and patients were followed at 1,3,and 6 wk to evaluate complications.Independent assessors were assigned to obtain postoperative pain scores,oral analgesic requirement and satisfaction scores.RESULTS:Reduced intraoperative blood loss median 0.9 mL(95% CI:0.8-3.7) vs 4.6 mL(95% CI:3.8-7.0),P = 0.001 and a short operating time median 16(95% CI:14.6-18.2) min vs 31(95% CI:28.1-35.3) min,P < 0.0001 was observed in group 1 compared with group 2.There was a trend towards lower postoperative pain scores on day 1 group 1 median 2(95% CI:1.8-3.5) vs group 2 median 3(95% CI:2.6-4.2),P = 0.135.Reduced oral analgesic requirement during postoperative 24 h after operation median 1(95% CI:0.4-0.9) tablet vs 1(95% CI:0.9-1.3) tablet,P = 0.006 was observed in group 1 compared with group 2.There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications.CONCLUSION:Bipolar diathermy hemorrhoidectomy is quick and bloodless and,although as painful as closed hemorrhoidectomy with the ultrasonic scalpel,is associated with a reduced analgesic requirement immediately after operation.
文摘Latest advances in network sensor technology and state of the art of mobile robotics and artificial intelligence research can be applied to develop autonomous and distributed monitoring systems. Intelligent Space （iSpace） is an environmental system, which is able to support human in informative and physical ways. iSpace observing the space with distributed sensors, extracts useful information from the obtained data and provides various services to users. This means that essential functions of iSpace are ＂observation＂, ＂recognition＂ and ＂actuation.＂ In this paper, we focus on the observation function of iSpace. And we describe observation systems to get information of both human and mobile agents in the space to show new results.
文摘Background：China has achieved universal health insurance coverage.This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes.Methods：The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing.We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives.Results：Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates.Under plans with an annual ceiling for insurance coverage,patients spent significantly more in the second half of the year than in the first half of the year.The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider.Conclusions：Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers.Reformation is necessary to reduce those incentives,and improve equity and efficiency in healthcare use.
