Field observations illustrated that, right-turn vehicles stopped at various positions when proceeding within the right-turn lanes, while some of them trespassed on the crosswalks with multiple stops. In this case, ped...Field observations illustrated that, right-turn vehicles stopped at various positions when proceeding within the right-turn lanes, while some of them trespassed on the crosswalks with multiple stops. In this case, pedestrians and bikes (ped/bike) are encountered unsmooth and hazardous crossings when right-turn vehicles encroaching their lanes. Meanwhile, this also causes conflicts between right-turn and through vehicles at the crossing street. To better protect ped/bike at crossings with right-turn vehicles, this paper proposes a concept of “right-turn vehicle box” (RTVB) as a supplemental treatment within right-turn lanes. Sight distance, geometric conditions, and behaviors of vehicles and ped/bike are key factors to consider so as to set up the criteria and to design the suitable treatment. A case study was conducted at an intersection pair in Houston, USA to shape the idea of RTVB, together with driving simulator tests under relevant scenarios. The preliminary crosscheck examination shows that the right-turn vehicle box could possibly provide ped/ bike with smoother and safer crossings. In the interim, the safety and efficiency of right-turn operations were also improved. To further validate the effects, implementation studies should be conducted before the RTVB can make its debut in practice. Future works will focus on the complete warrants and design details of this treatment. Moreover, the concept of “vehicle box” could also be transplanted to other places where turning movement(s) needs assistance or improvements.展开更多
AIM To assess the usefulness of en bloc right hemicolectomy with pancreaticoduodenectomy(RHCPD) for locally advanced right-sided colon cancer(LARCC).METHODS We retrospectively reviewed the database of Saitama Medical ...AIM To assess the usefulness of en bloc right hemicolectomy with pancreaticoduodenectomy(RHCPD) for locally advanced right-sided colon cancer(LARCC).METHODS We retrospectively reviewed the database of Saitama Medical Center, Jichi Medical University, between January 2009 and December 2016. During this time, 299 patients underwent radical right hemicolectomy for right-sided colon cancer. Among them, 5 underwent RHCPD for LARCC with tumor infiltration to adjacent organs. Preoperative computed tomography(CT) was routinely performed to evaluate local tumor infiltration into adjacent organs. During the operation, we evaluated the resectability and the amount of infiltration into the adjacent organs without dissecting the adherent organs from the cancer. When we confirmed that radical resection was feasible and could lead to R0 resection, we performed RHCPD. The clinical data were carefully reviewed, and the demographic variables, intraoperative data, and postoperative parameters were recorded.RESULTS The median age of the 5 patients who underwent RHCPD for LARCC was 70 years. The tumors were located in the ascending colon(three patients) and transverse colon(two patients). Preoperative CT revealed infiltration of the tumor into the duodenum in all patients, the pancreas in four patients, the superior mesenteric vein(SMV) in two patients, and tumor thrombosis in the SMV in one patient. We performed RHCPD plus SMV resection in three patients. Major postoperative complications occurred in 3 patients(60%) as pancreatic fistula(grade B and grade C, according to International Study Group on Pancreatic Fistula Definition) and delayed gastric empty. None of the patients died during their hospital stay. A histological examination confirmed malignant infiltration into the duodenum and/or pancreas in 4 patients(80%), and no patients showed any malignant infiltration into the SMV. Two patients were histologically confirmed to have tumor thrombosis in the SMV. All of the tumors had clear resection margins(R0). The median follow-up time was 77 mo. During this period, two patients with tumor thrombosis died from liver metastasis. The overall survival rates were 80% at 1 year and 60% at 5 years. All patients with node-negative status(n = 2) survived for more than seven years.CONCLUSION This study showed that the long-term survival is possible for patients with LARCC if RHCPD is performed successfully, particularly in those with node-negative status.展开更多
Based on the ABCD matrix formalism,the propagation property of an Airy beam from right-handed material（RHM） to left-handed material（LHM） is investigated.The result shows that when the Airy beam propagates in the L...Based on the ABCD matrix formalism,the propagation property of an Airy beam from right-handed material（RHM） to left-handed material（LHM） is investigated.The result shows that when the Airy beam propagates in the LHM,the intensity self-bending due to its propagation in the RHM can be compensated.In particular,if the propagation distance in the RHM is equal to that in the LHM and the refractive index of the LHM is n L =-1,the transverse intensity distribution of the Airy beam can return to its original state.展开更多
AIM To explore the differences in the responses of left-sided colorectal cancer(LSCRC) and right-sided colon cancer(RSCC) to traditional Chinese medicine(TCM).METHODS Patients with postoperative stage I-III colorectal...AIM To explore the differences in the responses of left-sided colorectal cancer(LSCRC) and right-sided colon cancer(RSCC) to traditional Chinese medicine(TCM).METHODS Patients with postoperative stage I-III colorectal cancer(CRC) were enrolled and divided into the LSCRC with or without TCM and RSCC with or without TCM groups depending on the primary tumor side and TCM administration. Patients in the TCM group were given TCM for at least 6 mo. Our research adopted diseasefree survival(DFS) as the primary endpoint. We applied a Cox proportional hazards regression model for the multivariate factor analysis using Stata 12.0 and SPSS 22.0 software for data analysis.RESULTS Of the 817 patients included in our study, 617 had LSCRC(TCM group, n = 404; Non-TCM group, n = 213), and 200 had RSCC(TCM group, n = 132; NonTCM group, n = 68). The 6-year DFS for patients with LSCRC was 56.95% in the TCM group and 41.50% in the Non-TCM group(P = 0.000). For patients with RSCC, the 6-year DFS was 52.92% in the TCM group and 37.19% in the Non-TCM group(P = 0.003). Differences between LSCRC and RSCC were not statistically significant regardless of TCM ingestion.CONCLUSION Patients with either LSCRC or RSCC and who took TCM experienced longer DFS; furthermore, patients with RSCC benefited more from TCM in DFS.展开更多
BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surg...BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain unclear.AIM To determine the appropriate management approach for right-sided malignant colonic obstruction.METHODS Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the study.We compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents(SEMS). The primary outcome was the overall survival duration(OS) and the secondary endpoints were the diseasefree survival(DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat basis.RESULTS There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group(5-year OS rate; decompression tube 79.5%,SEMS 32%, P = 0.043). Multivariate analysis revealed that the bridge to surgery using a decompression tube was significantly associated with the OS(hazard ratio, 17.41; P = 0.004). The 3-year DFS rate was significantly higher in thedecompression tube group than in the SEMS group(68.9% vs 45.9%; log-rank test,P = 0.032). A propensity score–adjusted analysis also demonstrated that the prognosis was significantly better in the decompression tube group than in the SEMS group.CONCLUSION The bridge to surgery using trans-nasal and trans-anal decompression tubes for right-sided malignant colonic obstruction is safe and may improve long-term outcomes.展开更多
BACKGROUND: Controversy exists over whether living donor liver transplantation (LDLT) should be offered to patients with high Model for End-stage Liver Disease (MELD) scores. This study tried to determine whether a hi...BACKGROUND: Controversy exists over whether living donor liver transplantation (LDLT) should be offered to patients with high Model for End-stage Liver Disease (MELD) scores. This study tried to determine whether a high MELD score would result in inferior outcomes of right-lobe LDLT. METHODS: Among 411 consecutive patients who received right-lobe LDLT at our center, 143 were included in this study. The patients were divided into two groups according to their MELD scores: a high-score group (MELD score ≥25; n=75) and a low-score group (MELD score 【25; n=68). Their demographic data and perioperative conditions were compared. Univariable and multivariable analyses were performed to identify risk factors affecting patient survival. RESULTS: In the high-score group, more patients required preoperative intensive care unit admission (49.3% vs 2.9%; P【0.001), mechanical ventilation (21.3% vs 0%; P【0.001), or hemodialysis (13.3% vs 0%; P=0.005); the waiting time before LDLT was shorter (4 vs 66 days; P【0.001); more blood was transfused during operation (7 vs 2 units; P【0.001); patients stayed longer in the intensive care unit (6 vs 3 days; P【0.001) and hospital (21 vs 15 days; P=0.015) after transplantation;more patients developed early postoperative complications (69.3% vs 50.0%; P=0.018); and values of postoperative peak blood parameters were higher. However, the two groups had comparable hospital mortality. Graft survival and patient overall survival at one year (94.7% vs 95.6%; 95.9% vs 96.9%), three years (91.9% vs 92.6%; 93.2% vs 95.3%), and five years (90.2% vs 90.2%; 93.2% vs 95.3%) were also similar between the groups. CONCLUSIONS: Although the high-score group had signifi-cantly more early postoperative complications, the two groups had comparable hospital mortality and similar satisfactory rates of graft survival and patient overall survival. Therefore, a high MELD score should not be a contraindication to right-lobe LDLT if donor risk and recipient benefit are taken into full account.展开更多
To explore the potential capacity of dual-fight-turn lanes at signalized intersections under mixed traffic conditions, we defined two conflict zones between right turn vehicles and through bicycle corresponding to dif...To explore the potential capacity of dual-fight-turn lanes at signalized intersections under mixed traffic conditions, we defined two conflict zones between right turn vehicles and through bicycle corresponding to different right turn flows from dual-right-turn lanes. Relationships between the arrival rate of bicycle group at each conflict zone and the saturation flow rate of right turn movement were investigated. A model based on gap acceptance theory was adopted to estimate the capacity of dual-right-turn lanes under mixed traffic conditions. An analysis was carried out using the collected data from three four-leg signalized intersections in Beijing, China, where the dual-right-turn lanes were used. In addition, we also discussed the patterns of bicycle lane in the urban area of Beijing, and classified it based on its characteristics in use. It is concluded that the two lanes of dual-fight-turn lanes produce different capacities under mixed traffic conditions, and the analysis on scenarios of dual-right-turn movement traversing bicycle traffic plays a key role in explaining the different capacity performance of the two right turn lanes. Error analysis of the model indicated that the model was rational.展开更多
Complex function method and multi-polar coordinate transformation technology are used here to study scattering of circular cavity in right-angle planar space to SH-wave with out-of-plane loading on the horizontal stra...Complex function method and multi-polar coordinate transformation technology are used here to study scattering of circular cavity in right-angle planar space to SH-wave with out-of-plane loading on the horizontal straight boundary. At first, Green function of right-angle planar space which has no circular cavity is constructed; then the scattering solution which satisfies the free stress conditions of the two right-angle boundaries with the circular cavity existing in the space is formulated. Therefore, the total displacement field can be constructed using overlapping principle. An infinite algebraic equations of unknown coefficients existing in the scattering solution field can be gained using multi-polar coordinate and the free stress condition at the boundary of the circular cavity. It can be solved by using limit items in the infinite series which can give a high computation precision. An example is given to illustrate the variations of the tangential stress at the boundary of the circular cavity due to different dimensionless wave numbers, the location of the circular cavity, the loading center and the distributing range of the out-of-plane loading. The results show the efficiency and effectiveness of the mothod introduced here.展开更多
Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure fo...Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized.展开更多
BACKGROUND:Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture,a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis,...BACKGROUND:Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture,a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis,after failed endoscopic treatment.The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of endto-side hepaticojejunostomy.METHODS:Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed.Diagnosis of biliary anastomotic stricture was made based on clinical,biochemical,histological and radiological results.Endoscopic treatment was the first-line treatment of biliary anastomotic stricture.RESULTS:Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients,so they underwent conversion hepaticojejunostomy.Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy.In the end-to-side group,two patients sustained hepatic artery injury requiring repeated microvascular anastomosis,two developed restenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation,and two required revision hepaticojejunostomy.In the side-to-side group,one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation.No re-operation was needed in this group.Otherwise,outcomes in the two groups were similar in terms of liver function and graft survival.CONCLUSIONS:Despite the similar outcomes,side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops.However,more large-scale studies are warranted to validate the results.展开更多
Rxol cloned from maize is a non-host gene resistant to bacterial leaf streak of rice. pCAMBIA1305-1 with Rxo1 was digested with Sca I and NgoM IV and the double right-border binary vector pMNDRBBin6 was digested with ...Rxol cloned from maize is a non-host gene resistant to bacterial leaf streak of rice. pCAMBIA1305-1 with Rxo1 was digested with Sca I and NgoM IV and the double right-border binary vector pMNDRBBin6 was digested with Hpa I and Xma I. pMNDRBBin6 carrying the gene Rxo1 was acquired by ligation of blunt-end and cohesive end. The results of PCR, restriction enzyme analysis and sequencing indicated that the Rxo1 gene had been cloned into pMNDRBBin6. This double right-border binary vector, named as pMNDRBBin6-Rxol, will play a role in breeding marker-free plants resistant to bacterial leaf streak of rice by genetic transformation.展开更多
Wlpp semigroups are generalizations of lpp semigroups and regular semigroups. In this paper, we consider some kinds of wlpp semigroups, namely right-e wlpp semigroups. It is proved that such a semigroup S, if and only...Wlpp semigroups are generalizations of lpp semigroups and regular semigroups. In this paper, we consider some kinds of wlpp semigroups, namely right-e wlpp semigroups. It is proved that such a semigroup S, if and only if S is the strong semilattice of L-right cancellative planks; also if and only if S is a spined product of a right-e wlpp semigroup and a left normal band.展开更多
Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwen...Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwent laparoscopic radical resection of right-sided colon cancer between January 2018 and August 2019 were retrospectively analysed. The surgical method was selected by the patients. The patients were divided into two groups according to the surgeons’ positioning habits and trocar placements. The group with the lead surgeon standing between the patient’s legs had 35 patients, and the group with the lead surgeon standing at the left side of the patient had 43 patients. The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups. Results: All patients underwent the laparoscopic radical resection of right-sided colon cancer, none converting to laparotomy. No significant difference (P > 0.05) in intraoperative blood loss (57.6 ± 21.3 ml vs 60.2 ± 35.3 ml), postoperative anal gas evacuation time (3.5 ± 1.1 d vs 3.8 ± 1.3 d), postoperative urinary catheter indwelling time (2.6 ± 1.3 d vs 2.4 ± 1.2 d), postoperative hospital stay (7.1 ± 1.8 d vs 7.5 ± 2.1 d), or CRP level on the first day after surgery (54.7 ± 9.6 mg/L vs 53.9 ± 8.2 mg/L) was detected between the two groups. The operation time was shorter in the group with the lead surgeon standing between the patient’s legs (185.2 ± 25.6 min vs 196.2 ±19.7 min) (P < 0.05). The two groups did not differ significantly in the tumour length (4.2 ± 1.3 cm vs 3.9 ± 1.5 cm), number of dissected lymph nodes (27.5 ± 11.6 vs 25.1 ± 15.4), pathological type, or postoperative pathological tumour-node-metastasis stage (P > 0.05). No patients died or had anastomotic fistula during their postoperative hospital stay, and the incidence of postoperative complications did not differ between the two groups (22.9% (8/35) vs 23.3% (10/42);P > 0.05). Conclusion: Under the principle of radical resection, the surgeon should adopt the most suitable standing position and trocar placement according to the specific situation. If the surgeon stands between the patient’s legs, this might shorten the operation time and promote a smoother surgery.展开更多
The epitaxial material, device structure, and corresponding equivalent large signal circuit model of GaAs planar Schottky varactor diode are successfully developed to design and fabricate a monolithic phase shifter, w...The epitaxial material, device structure, and corresponding equivalent large signal circuit model of GaAs planar Schottky varactor diode are successfully developed to design and fabricate a monolithic phase shifter, which is based on right-handed nonlinear transmission lines and consists of a coplanar waveguide transmission line and periodically distributed GaAs planar Schottky varactor diode. The distributed-Schottky transmission-line-type phase shifter at a bias voltage greater than 1.5 V presents a continuous 0°–360° differential phase shift over a frequency range from 0 to 33 GHz. It is demonstrated that the minimum insertion loss is about 0.5 dB and that the return loss is less than-10 dB over the frequency band of 0–33 GHz at a reverse bias voltage less than 4.5 V. These excellent characteristics, such as broad differential phase shift, low insertion loss, and return loss, indicate that the proposed phase shifter can entirely be integrated into a phased array radar circuit.展开更多
This paper summarizes the results of investigations carried out in the northern section of the Tommot-Yakutsk Railroad in eastern Siberia, underlain by ice-rich permafrost. The ongoing permafrost and geotechnical rese...This paper summarizes the results of investigations carried out in the northern section of the Tommot-Yakutsk Railroad in eastern Siberia, underlain by ice-rich permafrost. The ongoing permafrost and geotechnical research program in support of railroad construction includes assessment of the ground thermal state on the right-of-way and adjacent areas based on long-term field observations using the method of terrain thermal physics. These studies focus on the upper permafrost within the depth of annual temperature variation. In undisturbed areas, inter-annual variability of the ground thermal state shows little response to recent climatic variations. However, forest clearing and surface disturbance during right-of-way construction cause an increase in permafrost temperature, deepening of the active layer, thaw settlement, and water accumulation along the embankment. The active layer is thickest along the sun-exposed left berm and is thinnest along the more shaded right berm. Measures to prevent thaw-related embankment problems are recommended.展开更多
Numerical methods for Differential-Algebraic systems with discontinuous right-hand sides is discussed. A class of continuous Rosenbrock methods are constructed, and numerical experiments show that the continuous Rosen...Numerical methods for Differential-Algebraic systems with discontinuous right-hand sides is discussed. A class of continuous Rosenbrock methods are constructed, and numerical experiments show that the continuous Rosenbrock methods are effective. Applying the methods, a fast and high-precision numerical algorithm is given to deal with typical discontinuous parts, which occur frequently in differential-algebraic systems(DAS).展开更多
Right-sided ligamentum teres(RSLT) is a congenital anomaly in which the right umbilical ligament becomes dominant and anomalous ramifications of the hepatic vessels and biliary system are present. A male patient in hi...Right-sided ligamentum teres(RSLT) is a congenital anomaly in which the right umbilical ligament becomes dominant and anomalous ramifications of the hepatic vessels and biliary system are present. A male patient in his 70 s was diagnosed with advanced gallbladder cancer directly infiltrating the right hepatic duct(RHD), together with RSLT. Preoperative three-dimensional simulation of the liver based on multiple detector computed tomography images after cholangiography revealed ramifications of all segmental portal veins from the portal trunk and discordance of the arterial and biliary branching patterns of segment 8. Fusion analysis of the biliary architecture and segmental volumetry showed that the RHD drained segments 1 r, 5, 6, and 7. We successfully performed a modified right-sided hepatectomy sparing segment 8(i.e., resection of the RHD drainage territory), with negative surgical margins. This report is the first to describe major hepatectomy for advanced gallbladder cancer with RSLT.展开更多
We present a case of Staphylococcus aurous tricuspid valve endocarditis without any risk factors (intravenous drug users, with pacemaker or central venous lines and with congenital heart disease). Transthoracic echoca...We present a case of Staphylococcus aurous tricuspid valve endocarditis without any risk factors (intravenous drug users, with pacemaker or central venous lines and with congenital heart disease). Transthoracic echocardiography, as first line examination, showed the vegetations on tricuspid valve. In our case, the diagnosis and treatment of right-sided infective endocarditis without any inducement were extremely difficult. Therefore, once a patient comes out with fever, the blood culture remains positive for gram-positive bacterium, and the infectious location still unknown, then the infective endocarditis should be considered. In addition, surgical measure is also an important therapy for right-sided infective endocarditis.展开更多
文摘Field observations illustrated that, right-turn vehicles stopped at various positions when proceeding within the right-turn lanes, while some of them trespassed on the crosswalks with multiple stops. In this case, pedestrians and bikes (ped/bike) are encountered unsmooth and hazardous crossings when right-turn vehicles encroaching their lanes. Meanwhile, this also causes conflicts between right-turn and through vehicles at the crossing street. To better protect ped/bike at crossings with right-turn vehicles, this paper proposes a concept of “right-turn vehicle box” (RTVB) as a supplemental treatment within right-turn lanes. Sight distance, geometric conditions, and behaviors of vehicles and ped/bike are key factors to consider so as to set up the criteria and to design the suitable treatment. A case study was conducted at an intersection pair in Houston, USA to shape the idea of RTVB, together with driving simulator tests under relevant scenarios. The preliminary crosscheck examination shows that the right-turn vehicle box could possibly provide ped/ bike with smoother and safer crossings. In the interim, the safety and efficiency of right-turn operations were also improved. To further validate the effects, implementation studies should be conducted before the RTVB can make its debut in practice. Future works will focus on the complete warrants and design details of this treatment. Moreover, the concept of “vehicle box” could also be transplanted to other places where turning movement(s) needs assistance or improvements.
文摘AIM To assess the usefulness of en bloc right hemicolectomy with pancreaticoduodenectomy(RHCPD) for locally advanced right-sided colon cancer(LARCC).METHODS We retrospectively reviewed the database of Saitama Medical Center, Jichi Medical University, between January 2009 and December 2016. During this time, 299 patients underwent radical right hemicolectomy for right-sided colon cancer. Among them, 5 underwent RHCPD for LARCC with tumor infiltration to adjacent organs. Preoperative computed tomography(CT) was routinely performed to evaluate local tumor infiltration into adjacent organs. During the operation, we evaluated the resectability and the amount of infiltration into the adjacent organs without dissecting the adherent organs from the cancer. When we confirmed that radical resection was feasible and could lead to R0 resection, we performed RHCPD. The clinical data were carefully reviewed, and the demographic variables, intraoperative data, and postoperative parameters were recorded.RESULTS The median age of the 5 patients who underwent RHCPD for LARCC was 70 years. The tumors were located in the ascending colon(three patients) and transverse colon(two patients). Preoperative CT revealed infiltration of the tumor into the duodenum in all patients, the pancreas in four patients, the superior mesenteric vein(SMV) in two patients, and tumor thrombosis in the SMV in one patient. We performed RHCPD plus SMV resection in three patients. Major postoperative complications occurred in 3 patients(60%) as pancreatic fistula(grade B and grade C, according to International Study Group on Pancreatic Fistula Definition) and delayed gastric empty. None of the patients died during their hospital stay. A histological examination confirmed malignant infiltration into the duodenum and/or pancreas in 4 patients(80%), and no patients showed any malignant infiltration into the SMV. Two patients were histologically confirmed to have tumor thrombosis in the SMV. All of the tumors had clear resection margins(R0). The median follow-up time was 77 mo. During this period, two patients with tumor thrombosis died from liver metastasis. The overall survival rates were 80% at 1 year and 60% at 5 years. All patients with node-negative status(n = 2) survived for more than seven years.CONCLUSION This study showed that the long-term survival is possible for patients with LARCC if RHCPD is performed successfully, particularly in those with node-negative status.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 60977068,61178015 and 11102100)the Youth Foundation of Sanming University,China (Grant No. B201008/Q)
文摘Based on the ABCD matrix formalism,the propagation property of an Airy beam from right-handed material（RHM） to left-handed material（LHM） is investigated.The result shows that when the Airy beam propagates in the LHM,the intensity self-bending due to its propagation in the RHM can be compensated.In particular,if the propagation distance in the RHM is equal to that in the LHM and the refractive index of the LHM is n L =-1,the transverse intensity distribution of the Airy beam can return to its original state.
基金Supported by the Scientific Research Foundation of Traditional Chinese Medicine of the Shanghai Health Bureau,No.2014LZ079Athe Scientific Research Plan Project of the Shanghai Science and Technology Committee,No.14401930800the Program of Shanghai Municipal Technology and Education Commission,No.16401970500
文摘AIM To explore the differences in the responses of left-sided colorectal cancer(LSCRC) and right-sided colon cancer(RSCC) to traditional Chinese medicine(TCM).METHODS Patients with postoperative stage I-III colorectal cancer(CRC) were enrolled and divided into the LSCRC with or without TCM and RSCC with or without TCM groups depending on the primary tumor side and TCM administration. Patients in the TCM group were given TCM for at least 6 mo. Our research adopted diseasefree survival(DFS) as the primary endpoint. We applied a Cox proportional hazards regression model for the multivariate factor analysis using Stata 12.0 and SPSS 22.0 software for data analysis.RESULTS Of the 817 patients included in our study, 617 had LSCRC(TCM group, n = 404; Non-TCM group, n = 213), and 200 had RSCC(TCM group, n = 132; NonTCM group, n = 68). The 6-year DFS for patients with LSCRC was 56.95% in the TCM group and 41.50% in the Non-TCM group(P = 0.000). For patients with RSCC, the 6-year DFS was 52.92% in the TCM group and 37.19% in the Non-TCM group(P = 0.003). Differences between LSCRC and RSCC were not statistically significant regardless of TCM ingestion.CONCLUSION Patients with either LSCRC or RSCC and who took TCM experienced longer DFS; furthermore, patients with RSCC benefited more from TCM in DFS.
文摘BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain unclear.AIM To determine the appropriate management approach for right-sided malignant colonic obstruction.METHODS Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the study.We compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents(SEMS). The primary outcome was the overall survival duration(OS) and the secondary endpoints were the diseasefree survival(DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat basis.RESULTS There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group(5-year OS rate; decompression tube 79.5%,SEMS 32%, P = 0.043). Multivariate analysis revealed that the bridge to surgery using a decompression tube was significantly associated with the OS(hazard ratio, 17.41; P = 0.004). The 3-year DFS rate was significantly higher in thedecompression tube group than in the SEMS group(68.9% vs 45.9%; log-rank test,P = 0.032). A propensity score–adjusted analysis also demonstrated that the prognosis was significantly better in the decompression tube group than in the SEMS group.CONCLUSION The bridge to surgery using trans-nasal and trans-anal decompression tubes for right-sided malignant colonic obstruction is safe and may improve long-term outcomes.
文摘BACKGROUND: Controversy exists over whether living donor liver transplantation (LDLT) should be offered to patients with high Model for End-stage Liver Disease (MELD) scores. This study tried to determine whether a high MELD score would result in inferior outcomes of right-lobe LDLT. METHODS: Among 411 consecutive patients who received right-lobe LDLT at our center, 143 were included in this study. The patients were divided into two groups according to their MELD scores: a high-score group (MELD score ≥25; n=75) and a low-score group (MELD score 【25; n=68). Their demographic data and perioperative conditions were compared. Univariable and multivariable analyses were performed to identify risk factors affecting patient survival. RESULTS: In the high-score group, more patients required preoperative intensive care unit admission (49.3% vs 2.9%; P【0.001), mechanical ventilation (21.3% vs 0%; P【0.001), or hemodialysis (13.3% vs 0%; P=0.005); the waiting time before LDLT was shorter (4 vs 66 days; P【0.001); more blood was transfused during operation (7 vs 2 units; P【0.001); patients stayed longer in the intensive care unit (6 vs 3 days; P【0.001) and hospital (21 vs 15 days; P=0.015) after transplantation;more patients developed early postoperative complications (69.3% vs 50.0%; P=0.018); and values of postoperative peak blood parameters were higher. However, the two groups had comparable hospital mortality. Graft survival and patient overall survival at one year (94.7% vs 95.6%; 95.9% vs 96.9%), three years (91.9% vs 92.6%; 93.2% vs 95.3%), and five years (90.2% vs 90.2%; 93.2% vs 95.3%) were also similar between the groups. CONCLUSIONS: Although the high-score group had signifi-cantly more early postoperative complications, the two groups had comparable hospital mortality and similar satisfactory rates of graft survival and patient overall survival. Therefore, a high MELD score should not be a contraindication to right-lobe LDLT if donor risk and recipient benefit are taken into full account.
文摘To explore the potential capacity of dual-fight-turn lanes at signalized intersections under mixed traffic conditions, we defined two conflict zones between right turn vehicles and through bicycle corresponding to different right turn flows from dual-right-turn lanes. Relationships between the arrival rate of bicycle group at each conflict zone and the saturation flow rate of right turn movement were investigated. A model based on gap acceptance theory was adopted to estimate the capacity of dual-right-turn lanes under mixed traffic conditions. An analysis was carried out using the collected data from three four-leg signalized intersections in Beijing, China, where the dual-right-turn lanes were used. In addition, we also discussed the patterns of bicycle lane in the urban area of Beijing, and classified it based on its characteristics in use. It is concluded that the two lanes of dual-fight-turn lanes produce different capacities under mixed traffic conditions, and the analysis on scenarios of dual-right-turn movement traversing bicycle traffic plays a key role in explaining the different capacity performance of the two right turn lanes. Error analysis of the model indicated that the model was rational.
文摘Complex function method and multi-polar coordinate transformation technology are used here to study scattering of circular cavity in right-angle planar space to SH-wave with out-of-plane loading on the horizontal straight boundary. At first, Green function of right-angle planar space which has no circular cavity is constructed; then the scattering solution which satisfies the free stress conditions of the two right-angle boundaries with the circular cavity existing in the space is formulated. Therefore, the total displacement field can be constructed using overlapping principle. An infinite algebraic equations of unknown coefficients existing in the scattering solution field can be gained using multi-polar coordinate and the free stress condition at the boundary of the circular cavity. It can be solved by using limit items in the infinite series which can give a high computation precision. An example is given to illustrate the variations of the tangential stress at the boundary of the circular cavity due to different dimensionless wave numbers, the location of the circular cavity, the loading center and the distributing range of the out-of-plane loading. The results show the efficiency and effectiveness of the mothod introduced here.
文摘Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized.
文摘BACKGROUND:Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture,a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis,after failed endoscopic treatment.The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of endto-side hepaticojejunostomy.METHODS:Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed.Diagnosis of biliary anastomotic stricture was made based on clinical,biochemical,histological and radiological results.Endoscopic treatment was the first-line treatment of biliary anastomotic stricture.RESULTS:Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients,so they underwent conversion hepaticojejunostomy.Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy.In the end-to-side group,two patients sustained hepatic artery injury requiring repeated microvascular anastomosis,two developed restenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation,and two required revision hepaticojejunostomy.In the side-to-side group,one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation.No re-operation was needed in this group.Otherwise,outcomes in the two groups were similar in terms of liver function and graft survival.CONCLUSIONS:Despite the similar outcomes,side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops.However,more large-scale studies are warranted to validate the results.
文摘Rxol cloned from maize is a non-host gene resistant to bacterial leaf streak of rice. pCAMBIA1305-1 with Rxo1 was digested with Sca I and NgoM IV and the double right-border binary vector pMNDRBBin6 was digested with Hpa I and Xma I. pMNDRBBin6 carrying the gene Rxo1 was acquired by ligation of blunt-end and cohesive end. The results of PCR, restriction enzyme analysis and sequencing indicated that the Rxo1 gene had been cloned into pMNDRBBin6. This double right-border binary vector, named as pMNDRBBin6-Rxol, will play a role in breeding marker-free plants resistant to bacterial leaf streak of rice by genetic transformation.
基金The NSF(11471255)of Chinathe Scientific Research Project(15JK1411)of Education Department of Shaanxi Provincial Governmentthe Scientific Research Project(17KY02)of College
文摘Wlpp semigroups are generalizations of lpp semigroups and regular semigroups. In this paper, we consider some kinds of wlpp semigroups, namely right-e wlpp semigroups. It is proved that such a semigroup S, if and only if S is the strong semilattice of L-right cancellative planks; also if and only if S is a spined product of a right-e wlpp semigroup and a left normal band.
文摘Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwent laparoscopic radical resection of right-sided colon cancer between January 2018 and August 2019 were retrospectively analysed. The surgical method was selected by the patients. The patients were divided into two groups according to the surgeons’ positioning habits and trocar placements. The group with the lead surgeon standing between the patient’s legs had 35 patients, and the group with the lead surgeon standing at the left side of the patient had 43 patients. The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups. Results: All patients underwent the laparoscopic radical resection of right-sided colon cancer, none converting to laparotomy. No significant difference (P > 0.05) in intraoperative blood loss (57.6 ± 21.3 ml vs 60.2 ± 35.3 ml), postoperative anal gas evacuation time (3.5 ± 1.1 d vs 3.8 ± 1.3 d), postoperative urinary catheter indwelling time (2.6 ± 1.3 d vs 2.4 ± 1.2 d), postoperative hospital stay (7.1 ± 1.8 d vs 7.5 ± 2.1 d), or CRP level on the first day after surgery (54.7 ± 9.6 mg/L vs 53.9 ± 8.2 mg/L) was detected between the two groups. The operation time was shorter in the group with the lead surgeon standing between the patient’s legs (185.2 ± 25.6 min vs 196.2 ±19.7 min) (P < 0.05). The two groups did not differ significantly in the tumour length (4.2 ± 1.3 cm vs 3.9 ± 1.5 cm), number of dissected lymph nodes (27.5 ± 11.6 vs 25.1 ± 15.4), pathological type, or postoperative pathological tumour-node-metastasis stage (P > 0.05). No patients died or had anastomotic fistula during their postoperative hospital stay, and the incidence of postoperative complications did not differ between the two groups (22.9% (8/35) vs 23.3% (10/42);P > 0.05). Conclusion: Under the principle of radical resection, the surgeon should adopt the most suitable standing position and trocar placement according to the specific situation. If the surgeon stands between the patient’s legs, this might shorten the operation time and promote a smoother surgery.
基金Project supported by the Fundamental Research Funds for Central Universities,China(Grant No.XDJK2013B004)the Research Fund for the Doctoral Program of Southwest University,China(Grant No.SWU111030)the State Key Laboratory for Millimeter Waves of Southeast University,China(Grant No.K201312)
文摘The epitaxial material, device structure, and corresponding equivalent large signal circuit model of GaAs planar Schottky varactor diode are successfully developed to design and fabricate a monolithic phase shifter, which is based on right-handed nonlinear transmission lines and consists of a coplanar waveguide transmission line and periodically distributed GaAs planar Schottky varactor diode. The distributed-Schottky transmission-line-type phase shifter at a bias voltage greater than 1.5 V presents a continuous 0°–360° differential phase shift over a frequency range from 0 to 33 GHz. It is demonstrated that the minimum insertion loss is about 0.5 dB and that the return loss is less than-10 dB over the frequency band of 0–33 GHz at a reverse bias voltage less than 4.5 V. These excellent characteristics, such as broad differential phase shift, low insertion loss, and return loss, indicate that the proposed phase shifter can entirely be integrated into a phased array radar circuit.
基金the Republic of Sakha (Yakutia) Government for financial support of field work during the period from 2005 to 2013 under Public Contracts 251, 588, and 1090
文摘This paper summarizes the results of investigations carried out in the northern section of the Tommot-Yakutsk Railroad in eastern Siberia, underlain by ice-rich permafrost. The ongoing permafrost and geotechnical research program in support of railroad construction includes assessment of the ground thermal state on the right-of-way and adjacent areas based on long-term field observations using the method of terrain thermal physics. These studies focus on the upper permafrost within the depth of annual temperature variation. In undisturbed areas, inter-annual variability of the ground thermal state shows little response to recent climatic variations. However, forest clearing and surface disturbance during right-of-way construction cause an increase in permafrost temperature, deepening of the active layer, thaw settlement, and water accumulation along the embankment. The active layer is thickest along the sun-exposed left berm and is thinnest along the more shaded right berm. Measures to prevent thaw-related embankment problems are recommended.
文摘Numerical methods for Differential-Algebraic systems with discontinuous right-hand sides is discussed. A class of continuous Rosenbrock methods are constructed, and numerical experiments show that the continuous Rosenbrock methods are effective. Applying the methods, a fast and high-precision numerical algorithm is given to deal with typical discontinuous parts, which occur frequently in differential-algebraic systems(DAS).
文摘Right-sided ligamentum teres(RSLT) is a congenital anomaly in which the right umbilical ligament becomes dominant and anomalous ramifications of the hepatic vessels and biliary system are present. A male patient in his 70 s was diagnosed with advanced gallbladder cancer directly infiltrating the right hepatic duct(RHD), together with RSLT. Preoperative three-dimensional simulation of the liver based on multiple detector computed tomography images after cholangiography revealed ramifications of all segmental portal veins from the portal trunk and discordance of the arterial and biliary branching patterns of segment 8. Fusion analysis of the biliary architecture and segmental volumetry showed that the RHD drained segments 1 r, 5, 6, and 7. We successfully performed a modified right-sided hepatectomy sparing segment 8(i.e., resection of the RHD drainage territory), with negative surgical margins. This report is the first to describe major hepatectomy for advanced gallbladder cancer with RSLT.
文摘We present a case of Staphylococcus aurous tricuspid valve endocarditis without any risk factors (intravenous drug users, with pacemaker or central venous lines and with congenital heart disease). Transthoracic echocardiography, as first line examination, showed the vegetations on tricuspid valve. In our case, the diagnosis and treatment of right-sided infective endocarditis without any inducement were extremely difficult. Therefore, once a patient comes out with fever, the blood culture remains positive for gram-positive bacterium, and the infectious location still unknown, then the infective endocarditis should be considered. In addition, surgical measure is also an important therapy for right-sided infective endocarditis.
