BACKGROUND Endoscopic submucosal dissection(ESD)is a standardized therapeutic approach for early carcinoma of the digestive tracts.In this regard,the process of histopathological diagnosis requires standardization.How...BACKGROUND Endoscopic submucosal dissection(ESD)is a standardized therapeutic approach for early carcinoma of the digestive tracts.In this regard,the process of histopathological diagnosis requires standardization.However,the uneven development of healthcare in China,especially in eastern and western China,creates challenges for sharing a standardized diagnostic process.AIM To optimize the process of ESD specimen sampling,embedding and slide production,and to provide complete and accurate pathological reports.METHODS We established a practical process of specimen sampling,created standardized reporting templates,and trained pathologists from neighboring hospitals and those in the western region.A training effectiveness survey was conducted,and the collected data were assessed by the corresponding percentages.RESULTS A total of 111 valid feedback forms have been received,among which 58%of the participants obtained photographs during specimen collection,whereas the percentage increased to 79%after training.Only 58%and 62%of the respondents ensured the mucosal tissue strips were flat and their order remained unchanged;after training,these two proportions increased to 95%and 92%,respectively.Approximately half the participants measured the depth of the submucosal infiltration,which significantly increased to 95%after training.The percentage of pathologists who did not evaluate lymphovascular invasion effectively reduced.Only 22%of the participants had fixed clinic-pathological meetings before training,which increased to 49%after training.The number of participants who had a thorough understanding of endoscopic diagnosis also significantly increased.CONCLUSION There have been significant improvements in the process of specimen collection,section quality,and pathology reporting in trained hospitals.Therefore,our study provides valuable insights for others facing similar challenges.展开更多
The paper designs a novel material-level specimen and its dedicated fixture suitable for applying Combined high-and low-Cycle Fatigue(CCF)loads.Unlike full-scale or simulation specimens,the CCF specimen eliminates geo...The paper designs a novel material-level specimen and its dedicated fixture suitable for applying Combined high-and low-Cycle Fatigue(CCF)loads.Unlike full-scale or simulation specimens,the CCF specimen eliminates geometrically induced stress gradients in the test region.Experimental data on CCF life and strain responses of ZSGH4169 alloy are acquired under different CCF loads.The Maximum Strain within Each(MSE)CCF cycle is demonstrated to be independent of the Low-Cycle Fatigue(LCF)loads and High-Cycle Fatigue(HCF)stress amplitudes,but exhibits a correlation with the Cycle Ratio of HCF/LCF(Rf).The growth law of MSE changes from linear to logarithmic as Rfdecreases.Strain amplitudes in the dwell stage,observed unaffected by Rf,are quantified as a function of LCF nominal stresses and HCF stress amplitudes.However,under a defined CCF load,strain amplitudes in the dwell stage remain constant.Strain peaks in the dwell stage in a single CCF cycle decrease in a power function with increasing HCF cycles.展开更多
Biological specimens are fundamental for taxonomy and flora/fauna research.More importantly,they also play crucial roles in recording environmental impacts on morphology and behavior,which is vital for biodiversity re...Biological specimens are fundamental for taxonomy and flora/fauna research.More importantly,they also play crucial roles in recording environmental impacts on morphology and behavior,which is vital for biodiversity research and conservation.However,there are few systematic studies on the patterns and drivers of bird specimen number at regional scales.This study is the first attempt to examine the relationships between bird specimen number and species traits as well as climate niche breadth in China,aiming to answer two questions:1)how do species’temperature niche breadth and precipitation niche breadth influence specimen number?2)which trait is most associated with bird specimen number?The associations between bird specimen number and explanatory variables were examined using ordinary least squares,generalized linear models,phylogenetic generalized linear mixed models,and multiple comparisons.The results showed that Muscicapidae was the family with the highest specimen number,and Passeriformes was the order with the highest specimen number.Bird specimen number significantly increased with larger temperature niche breadth and precipitation niche breadth.Specimen number was also positively associated with geographic range size,habitat specificity,hunting vulnerability and clutch size,but negatively associated with body size.These findings suggest that future bird specimen collection should pay more attention to birds with limited ecological niches,large body sizes,and small clutch sizes.This research enhances the use of bird specimen data to study and preserve biodiversity.展开更多
The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency di...The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency disturbance dynamic uniaxial compression tests on coal specimens using a self-developed dynamic-static load coupling electro-hydraulic servo system,and studied the strength evolutions,surface deformations,acoustic emission(AE)characteristic parameters,and the failure modes of coal specimens with different static preloading levels were studied.The disturbance damage is positively correlated with the coal specimen static preload level.Specifically,the cumulative AE count rates of the initial accelerated damage stage for the coal specimens with static preloading level of 60%and 70%of the uniaxial compressive strength(UCS)were 2.66 and 3.19 times that of the 50%UCS specimens,respectively.Macroscopically,this behaviour manifested as a decrease in the compressive strength,and the mean strengths of the disturbance-damaged coal specimens with 60%and 70%of UCS static preloading decreased by 8.53%and 9.32%,respectively,compared to those of the specimens under pure static loading.The crack sources,such as the primary fissures,strongly control the dynamic response of the coal specimen.The difference between the dynamic responses of the coal specimens and that of dense rocks is significant.展开更多
Many different factors,such as species traits,socio-economic factors,geographical and environmental factors,can lead to specimen collection preference.This study aims to determine whether grassland specimen collection...Many different factors,such as species traits,socio-economic factors,geographical and environmental factors,can lead to specimen collection preference.This study aims to determine whether grassland specimen collection in China is preferred by species traits(i.e.,plant height,flowering and fruiting period),environmental range(i.e.,the temperature and precipitation range)and geographical range(i.e.,distribution range and altitudinal range).Ordinary least squares models and phylogenetic generalized linear mixed models were used to analyze the relationships between specimen number and the explanatory variables.Random Forest models were then used to find the most parsimonious multivariate model.The results showed that interannual variation in specimen number between 1900 and 2020 was considerable.Specimen number of these species in southeast China was notably lower than that in northwest China.Environmental range and geographical range of species had significant positive correlations with specimen number.In addition,there were relatively weak but significant associations between specimen number and species trait(i.e.,plant height and flowering and fruiting period).Random Forest models indicated that distribution range was the most important variable,followed by flowering and fruiting period,and altitudinal range.These findings suggest that future floristic surveys should pay more attention to species with small geographical range,narrow environmental range,short plant height,and short flowering and fruiting period.The correction of specimen collection preference will also make the results of species distribution model,species evolution and other works based on specimen data more accurate.展开更多
BACKGROUND Natural orifice specimen extraction surgery(NOSES)has emerged as a promising alternative compared to conventional laparoscopic-assisted total gastrectomy(LATG)for treating gastric cancer(GC).However,evidenc...BACKGROUND Natural orifice specimen extraction surgery(NOSES)has emerged as a promising alternative compared to conventional laparoscopic-assisted total gastrectomy(LATG)for treating gastric cancer(GC).However,evidence regarding the efficacy and safety of NOSES for GC surgery is limited.This study aimed to compare the safety and feasibility,in addition to postoperative complications of NOSES and LATG.METHODS Dual circular staplers were used in Roux-en-Y digestive tract reconstruction for transvaginal specimen extraction LATG,and its outcomes were compared with LATG in a cohort of 51 GC patients with tumor size≤5 cm.The study was conducted from May 2018 to September 2020,and patients were categorized into the NOSES group(n=22)and LATG group(n=29).Perioperative parameters were compared and analyzed,including patient and tumor characteristics,postoperative outcomes,and anastomosis-related complications,postoperative hospital stay,the length of abdominal incision,difference in tumor type,postoperative complications,and postoperative survival.RESULTS Postoperative exhaust time,operation duration,mean postoperative hospital stay,length of abdominal incision,number of specific staplers used,and Brief Illness Perception Questionnaire score were significant in both groups(P<0.01).In the NOSES group,the postoperative time to first flatus,mean postoperative hospital stay,and length of abdominal incision were significantly shorter than those in the LATG group.Patients in the NOSES group had faster postoperative recovery,and achieved abdominal minimally invasive incision that met aesthetic requirements.There were no significant differences in gender,age,tumor type,postoperative complications,and postoperative survival between the two groups.CONCLUSION The application of dual circular staplers in Roux-en-Y digestive tract reconstruction combined with NOSES gastrectomy is safe and convenient.This approach offers better short-term outcomes compared to LATG,while long-term survival rates are comparable to those of conventional laparoscopic surgery.展开更多
To compare finite element analysis(FEA)predictions and stereovision digital image correlation(StereoDIC)strain measurements at the same spatial positions throughout a region of interest,a field comparison procedure is...To compare finite element analysis(FEA)predictions and stereovision digital image correlation(StereoDIC)strain measurements at the same spatial positions throughout a region of interest,a field comparison procedure is developed.The procedure includes(a)conversion of the finite element data into a triangular mesh,(b)selection of a common coordinate system,(c)determination of the rigid body transformation to place both measurements and FEA data in the same system and(d)interpolation of the FEA nodal information to the same spatial locations as the StereoDIC measurements using barycentric coordinates.For an aluminum Al-6061 double edge notched tensile specimen,FEA results are obtained using both the von Mises isotropic yield criterion and Hill’s quadratic anisotropic yield criterion,with the unknown Hill model parameters determined using full-field specimen strain measurements for the nominally plane stress specimen.Using Hill’s quadratic anisotropic yield criterion,the point-by-point comparison of experimentally based full-field strains and stresses to finite element predictions are shown to be in excellent agreement,confirming the effectiveness of the field comparison process.展开更多
The naming of rock hand specimens is usually conducted by geological workers based on observed mineral composition,texture characteristics,etc.,combined with their own knowledge reserves.The accuracy of identification...The naming of rock hand specimens is usually conducted by geological workers based on observed mineral composition,texture characteristics,etc.,combined with their own knowledge reserves.The accuracy of identification results is limited by the experience,research interests,and identification level of the identifier,as well as the complexity of the rock composition.To improve the efficiency of rock hand specimen identification,this paper proposes a method for rock image recognition and classification based on deep learning and the Inception-v3 model.It encompasses the preprocessing of collected photographs of typical intrusive rock hand specimens,along with augmenting the sample size through data augmentation methods,culminating in a comprehensive dataset comprising 12501 samples.Experimental results show that the model has good learning ability when there is sufficient data.Through iterative training of the Inception-v3 model on the rock dataset,the accuracy of rock image recognition reaches 92.83%,with a loss of only 0.2156.Currently,several common types of intrusive rocks can be identified:gabbro,granite,diorite,peridotite,granodiorite,diabase,and granite porphyry.Software is developed for open use by geological workers to improve work efficiency.展开更多
Using a scanning electron microscope (SEM) in the back-scattered electron (BSE) mode the composition of multi-element specimens may be determined based on the strong dependence of emission coefficient η on the averag...Using a scanning electron microscope (SEM) in the back-scattered electron (BSE) mode the composition of multi-element specimens may be determined based on the strong dependence of emission coefficient η on the average atomic number of elements Z. The output video signal of the usual BSE detectors is produced from their sensors, and the larger proportion of high-energy electrons with modified spectrum is added. Since η = is/ip (is and ip currents of specimen and probe), better accuracy must be achieved by direct measurements those currents on the specimen surface. Here, an experimental model of a current detector for a presented specimen is described. The cage is mounted on the carousel of the moving specimen stage. The input of the preamplifier is connected to the specimen holder in the form of a disk, the diameter of which is 12 mm. When the probe along its surface scanned, the input potential begins to pulsate with a negative polarity. The output of this preamplifier is connected to a small light-emitting diode, which creates intensity-modulated radiation in the chamber. Thus created the light video signal will be picked up by the photomultiplier of the E-T detector. The modes of true SE and BSE are set by applying tens bias volts of various polarities to the specimens or the cage itself.展开更多
Objective:To analyze the application effect of feedforward control in outpatient blood specimen management.Methods:1,200 patients who had their venous blood collected in outpatient phlebotomy room of our hospital'...Objective:To analyze the application effect of feedforward control in outpatient blood specimen management.Methods:1,200 patients who had their venous blood collected in outpatient phlebotomy room of our hospital's outpatient clinic from January 2021 to April 2021 were selected as study subjects and divided into 600 cases in the control group and 600 cases in the observation group.The two groups of patients were compared in terms of their satisfaction with the staff,the efficiency of the nurses and the quality of nursing care,turnaround time before specimen analysis,the rejection rate of the blood specimens,and the time of result reporting.Results:After the implementation of feedforward control,patients'satisfaction with staff,nurses work efficiency and quality of care,turnaround time before specimen analysis,specimen rejection rate,and result reporting time in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:The application of feedforward control in the management of outpatient blood specimens has significant effect,which effectively improves patients'satisfaction,enhances the efficiency of nurses and the quality of nursing care,shortens the turnaround time of specimens before analysis and the reporting time of results,and reduces the rejection rate of specimens.展开更多
Objective: To explore the value of hand-sewn anastomosis in totally laparoscopic radical resection of colorectal cancr with transanal specimen extraction. Methods: A retrospective descriptive study was conducted. Clin...Objective: To explore the value of hand-sewn anastomosis in totally laparoscopic radical resection of colorectal cancr with transanal specimen extraction. Methods: A retrospective descriptive study was conducted. Clinical data of 54 patients with colorectal cancer who underwent totally laparoscopic transrectal specimen extraction surgery between January 2019 and December 2023 at the Department of Gastrointestinal Surgery, Bayannur City Hospital, were collected. All patients underwent digestive tract reconstruction using hand-sewn end-to-end colonic or rectal anastomosis. Intraoperative and postoperative general conditions, pathological results, complications, and follow-up data were analyzed. Results: Among the 54 cases, 37 were male, and 17 were female. The cases included 26 sigmoid colon cancers, 27 high rectal cancers, and 1 descending colon cancer. All patients underwent totally laparoscopic radical resection of colorectal cancer with transrectal specimen extraction. The average surgical duration was 187.87 ± 61.36 minutes, with 16 (14-19) minutes required for hand-sewn anastomosis. Intraoperative blood loss was 16 (10-200) mL, with no conversions to open surgery or blood transfusions. Postoperative outcomes included first flatus time of 1 (1-3) day, liquid diet resumption on 2 (2-3) days, postoperative Visual Analog Scale (VAS) pain score of 2 (2-3), and hospital stay duration of 8 (7-9) days. The total hospitalization cost was 41,011 (25,655-148,589) Chinese yuan, with an average cost of 42,558.81 ± 8,599.30 Chinese yuan after excluding three cases with complications. Pathological examination revealed all cases to be adenocarcinomas: 20 well-differentiated, 32 moderately differentiated, and 2 poorly differentiated. All resection margins were negative. An average of 16.85 ± 7.97 lymph nodes were dissected. Pathological staging included 18 stage I, 17 stage II, and 19 stage III cases. Postoperative complications included 2 cases of anastomotic leakage (3.7%), 1 case of anastomotic stricture (1.8%), and 1 case of pulmonary infection (1.8%). No unplanned readmissions or postoperative deaths occurred during the 30-day follow-up period. Conclusion: Hand-sewn anastomosis in totally laparoscopic radical resection of colorectal cancer with transanal specimen extraction is safe and feasible.展开更多
Over the last 20 years, laparoscopic colorectal surgery has shown equal efficacy for benign and malignant colorectal diseases when compared to open surgery. However, a laparoscopic approach reduces postoperative morbi...Over the last 20 years, laparoscopic colorectal surgery has shown equal efficacy for benign and malignant colorectal diseases when compared to open surgery. However, a laparoscopic approach reduces postoperative morbidity and shortens hospital stay. In the quest to optimize outcomes after laparoscopic colorectal surgery, reduction of access trauma could be a way to improve recovery. To date, one method to reduce access trauma is natural orifice specimen extraction(NOSE). NOSE aims to reduce access trauma in laparoscopic colorectal surgery. The specimen is delivered via a natural orifice and the anastomosis is created intracorporeally. Different methods are used to extract the specimen and to create a bowel anastomosis. Currently, specimens are delivered transcolonically, transrectally, transanally, or transvaginally. Each of these NOSEprocedures raises specific issues with regard to operative technique and application. The presumed benefits of NOSE-procedures are less pain, lower analgesia requirements, faster recovery, shorter hospital stay, better cosmetic results, and lower incisional hernia rates. Avoidance of extraction site laparotomy is the most important characteristic of NOSE. Concerns associated with the NOSE-technique include bacterial contamination of the peritoneal cavity, inflammatory response, and postoperative outcomes, including postoperative pain and the functional and oncologic outcomes. These issues need to be studied in prospective randomized controlled trials. The aim of this systematic review is to describe the role of NOSE in minimally invasive colorectal surgery.展开更多
AIM: To investigate whether transanal natural orifice specimen extraction (NOSE) is a better technique for rectal cancer resection.METHODS: A prospectively designed database of a consecutive series of patients undergo...AIM: To investigate whether transanal natural orifice specimen extraction (NOSE) is a better technique for rectal cancer resection.METHODS: A prospectively designed database of a consecutive series of patients undergoing laparoscopic low anterior resection for rectal cancer with various tumor-node-metastasis classi?cations from March 2011 to February 2012 at the First Affiliated Hospital of Sun Yat-Sen University was analyzed. Patient selection for transanal specimen extraction and intracorporeal anastomosis was made on the basis of tumor size and distance of rectal lesions from the anal verge. Demographic data, operative parameters, and postoperative outcomes were assessed.RESULTS: None of the patients was converted to laparotomy. Respectively, there were 16 cases in the low anastomosis and five in the ultralow anastomosis groups. Mean age of the patients was 45.4 years, and mean body mass index was 23.1 kg/m2. Mean distance of the lower edge of the lesion from the anal verge was 8.3 cm. Mean operating time was 132 min, and mean intraoperative blood loss was 84 mL. According to the principle of rectal cancer surgery, we performed D2 lymph node dissection in 13 cases and D3 in eight. Mean lymph nodes harvest was 17.8, and the number of positive lymph nodes was 3.4. Median hospital stay was 6.7 d. No serious postoperative complication occurred except for one anastomotic leakage. All patients remained disease free. Mean Wexner score was 3.7 at 11 mo after the operation.CONCLUSION: Transanal NOSE for total laparoscopic low/ultralow anterior resection is feasible, safe and oncologically sound. Further studies with long-term outcomes are needed to explore its potential advantages.展开更多
AIM: To investigate how complete laparoscopic anterior resection with natural orifice specimen extraction (NOSE), as a novel minimally invasive surgery, compares to conventional laparoscopic surgery.
Objective:The transanal approach to specimen collection,combined with the prolapsing technique,is a wellestablished and minimally invasive surgery for treating rectal cancer.However,reports on outcomes for this approa...Objective:The transanal approach to specimen collection,combined with the prolapsing technique,is a wellestablished and minimally invasive surgery for treating rectal cancer.However,reports on outcomes for this approach are sparse.We compared short-and long-term outcomes of conventional laparoscopic surgery(CLS)vs.transanal natural orifice specimen extraction(NOSE)using the prolapsing technique for patients with middle-to low-rectal cancer.Methods:From January 2013 to December 2017,we enrolled consecutive patients with middle-to low-rectal cancer undergoing laparoscopic anterior resection.Totally,50 patients who underwent transanal NOSE using the prolapsing technique were matched with 50 patients who received CLS.Clinical parameters and survival outcomes between the two groups were compared.Results:Estimated blood loss(29.70±29.28 vs.52.80±45.09 mL,P=0.003),time to first flatus(2.50±0.79 vs.2.86±0.76,P=0.022),time to liquid diet(3.62±0.64 vs.4.20±0.76 d,P<0.001),and the need for analgesics(22%vs.48%,P=0.006)were significantly lower for the NOSE group compared to the CLS group.The incidences of overall complications and fecal incontinence were comparable in both groups.After a median follow-up of 44.52 months,the overall local recurrence rate(6%vs.5%,P=0.670),3-year disease-free survival(86.7%vs.88.0%,P=0.945)and 3-year overall survival(95.6%vs.96.0%,P=0.708),were not significantly different.Conclusions:For total laparoscopic rectal resection,transanal NOSE using the prolapsing technique is effective and safe,and associated with less trauma and pain,a faster recovery,and similar survival outcomes compared to CLS.展开更多
BACKGROUND Robotic resection using the natural orifice specimen extraction surgery I-type F method(R-NOSES I-F)is a novel minimally invasive surgical strategy for the treatment of lower rectal cancer.However,the curre...BACKGROUND Robotic resection using the natural orifice specimen extraction surgery I-type F method(R-NOSES I-F)is a novel minimally invasive surgical strategy for the treatment of lower rectal cancer.However,the current literature on this method is limited to case reports,and further investigation into its safety and feasibility is warranted.AIM To evaluate the safety and feasibility of R-NOSES I-F for the treatment of low rectal cancer.METHODS From September 2018 to February 2022,206 patients diagnosed with low rectal cancer at First Affiliated Hospital of Nanchang University were included in this retrospective analysis.Of these patients,22 underwent R-NOSES I-F surgery(RNOSES I-F group)and 76 underwent conventional robotic-assisted low rectal cancer resection(RLRC group).Clinicopathological data of all patients were collected and analyzed.Postoperative outcomes and prognoses were compared between the two groups.Statistical analysis was performed using SPSS software.RESULTS Patients in the R-NOSES I-F group had a significantly lower visual analog score for pain on postoperative day 1(1.7±0.7 vs 2.2±0.6,P=0.003)and shorter postoperative anal venting time(2.7±0.6 vs 3.5±0.7,P<0.001)than those in the RLRC group.There were no significant differences between the two groups in terms of sex,age,body mass index,tumor size,TNM stage,operative time,intrao-perative bleeding,postoperative complications,or inflammatory response(P>0.05).Postoperative anal and urinary functions,as assessed by Wexner,low anterior resection syndrome,and International Prostate Symptom Scale scores,were similar in both groups(P>0.05).Long-term follow-up revealed no significant differences in the rates of local recurrence and distant metastasis between the two groups(P>0.05).CONCLUSION R-NOSES I-F is a safe and effective minimally invasive procedure for the treatment of lower rectal cancer.It improves pain relief,promotes gastrointestinal function recovery,and helps avoid incision-related complications.展开更多
Although hydraulic fracturing is the most commonly used method for fracturing of shale-gas-bearing rock,there are some problems with this method.As plasma blasting can fracture rock without these problems,laboratory-s...Although hydraulic fracturing is the most commonly used method for fracturing of shale-gas-bearing rock,there are some problems with this method.As plasma blasting can fracture rock without these problems,laboratory-scale fracturing of cement and rock specimens by plasma blasting was performed to investigate the possibility of using this method in shale gas development.展开更多
Objective The causal agent for SARS is considered as a novel coronavirus that has never been described both in human and animals previously. The stability of SARS coronavirus in human specimens and in environments was...Objective The causal agent for SARS is considered as a novel coronavirus that has never been described both in human and animals previously. The stability of SARS coronavirus in human specimens and in environments was studied. Methods Using a SARS coronavirus strain CoV-P9, which was isolated from pharyngeal swab of a probable SARS case in Beijing, its stability in mimic human specimens and in mimic environment including surfaces of commonly used materials or in household conditions, as well as its resistances to temperature and UV irradiation were analyzed. A total of 106 TCID50 viruses were placed in each tested condition, and changes of the viral infectivity in samples after treatments were measured by evaluating cytopathic effect (CPE) in cell line Vero-E6 at 48 h after infectionn. Results The results showed that SARS coronavirus in the testing condition could survive in serum, 1:20 diluted sputum and feces for at least 96 h, whereas it could remain alive in urine for at least 72 h with a low level of infectivity. The survival abilities on the surfaces of eight different materials and in water were quite comparable, revealing reduction of infectivity after 72 to 96 h exposure. Viruses stayed stable at 4℃, at room temperature (20℃) and at 37℃ for at least 2 h without remarkable change in the infectious ability in cells, but were converted to be non-infectious after 90-, 60- and 30-min exposure at 56℃, at 67℃ and at 75℃, respectively. Irradiation of UV for 60 min on the virus in culture medium resulted in the destruction of viral infectivity at an undetectable level. Conclusion The survival ability of SARS coronavirus in human specimens and in environments seems to be relatively strong. Heating and UV irradiation can efficiently eliminate the viral infectivity.展开更多
AIM:To introduce transvaginal or transanal specimen extraction in laparoscopic total mesorectal excision surgery to avoid an abdominal incision. METHODS:Between January 2009 and December 2011,21 patients with rectal c...AIM:To introduce transvaginal or transanal specimen extraction in laparoscopic total mesorectal excision surgery to avoid an abdominal incision. METHODS:Between January 2009 and December 2011,21 patients with rectal cancer underwent laparoscopic radical resection and the specimen was retrieved by two different ways:transvaginal or transanal rectal removal.Transvaginal specimen extraction approach was strictly limited to elderly post-menopausal women who need hysterectomy.Patients aged between 30 and 80 years,with a body mass index of less than 30 kg/m2, underwent elective surgery.The surgical technique and the outcomes related to the specimen extraction,such as duration of surgery,length of hospital stay,and the complications were retrospectively reviewed. RESULTS:Laparoscopic resection using a natural orifice removal approach was successful in all of the 21 patients.Median operating time was 185 min(range,122-260 min)and the estimated blood loss was 48 mL. The mean length of hospital stay was 7.5 d(range,2-11 d).One patient developed postoperative ileus and had an extended hospital stay.The patient complained of minimal pain.There were no postoperative complications or surgery-associated death.The mean size of the lesion was 2.8 cm(range,1.8-6.0 cm),and the mean number of lymph nodes harvested was 18.7(range, 8-27).At a mean follow-up of 20.6 mo(range,10-37 mo),there were no functional disorders associated with the transvaginal and transanal specimen extraction. CONCLUSION:Transvaginal or transanal extraction in L-TME is a safe and effective procedure.Natural orifice specimen extraction can avoid the abdominal wall incision and its potential complications.展开更多
AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction(TVSE) for gastric cancer patients.METHODS: Between July and November 2014, eight female patients who were diagnose...AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction(TVSE) for gastric cancer patients.METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE.RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3(range, 42-69) years, and the mean body mass index was 23.2(range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224(range, 200-298) min and 62.5(range, 50-150) m L, respectively. The mean postoperative hospital stay was 3.6(range, 3-5) d. The mean number of lymph nodes resected was 23.6(range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected.CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients.展开更多
基金Supported by the Medical Education Research Project from Nanjing Drum Tower Hospital,No.2021-7the Clinical Trials Fund from Nanjing Drum Tower Hospital,No.2022-YXZX-XH-04National Natural Science Foundation of China,No.82203063.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)is a standardized therapeutic approach for early carcinoma of the digestive tracts.In this regard,the process of histopathological diagnosis requires standardization.However,the uneven development of healthcare in China,especially in eastern and western China,creates challenges for sharing a standardized diagnostic process.AIM To optimize the process of ESD specimen sampling,embedding and slide production,and to provide complete and accurate pathological reports.METHODS We established a practical process of specimen sampling,created standardized reporting templates,and trained pathologists from neighboring hospitals and those in the western region.A training effectiveness survey was conducted,and the collected data were assessed by the corresponding percentages.RESULTS A total of 111 valid feedback forms have been received,among which 58%of the participants obtained photographs during specimen collection,whereas the percentage increased to 79%after training.Only 58%and 62%of the respondents ensured the mucosal tissue strips were flat and their order remained unchanged;after training,these two proportions increased to 95%and 92%,respectively.Approximately half the participants measured the depth of the submucosal infiltration,which significantly increased to 95%after training.The percentage of pathologists who did not evaluate lymphovascular invasion effectively reduced.Only 22%of the participants had fixed clinic-pathological meetings before training,which increased to 49%after training.The number of participants who had a thorough understanding of endoscopic diagnosis also significantly increased.CONCLUSION There have been significant improvements in the process of specimen collection,section quality,and pathology reporting in trained hospitals.Therefore,our study provides valuable insights for others facing similar challenges.
基金co-supported by the National Natural Science Foundation of China(51805017)National Science and Technology Project(J2017-IV-0012-0049)+1 种基金National Science and Technology Project,China(J2019-IV-0007-0075)the Fundamental Research Funds for the Central Universities,China(JKF-20240036).
文摘The paper designs a novel material-level specimen and its dedicated fixture suitable for applying Combined high-and low-Cycle Fatigue(CCF)loads.Unlike full-scale or simulation specimens,the CCF specimen eliminates geometrically induced stress gradients in the test region.Experimental data on CCF life and strain responses of ZSGH4169 alloy are acquired under different CCF loads.The Maximum Strain within Each(MSE)CCF cycle is demonstrated to be independent of the Low-Cycle Fatigue(LCF)loads and High-Cycle Fatigue(HCF)stress amplitudes,but exhibits a correlation with the Cycle Ratio of HCF/LCF(Rf).The growth law of MSE changes from linear to logarithmic as Rfdecreases.Strain amplitudes in the dwell stage,observed unaffected by Rf,are quantified as a function of LCF nominal stresses and HCF stress amplitudes.However,under a defined CCF load,strain amplitudes in the dwell stage remain constant.Strain peaks in the dwell stage in a single CCF cycle decrease in a power function with increasing HCF cycles.
基金supported by the Natural Science Foundation of Inner Mongolia,China(2023JQ01)the National Key R&D Program of China(2019YFA0607103)+2 种基金the Central Government Guides Local Science and Technology Development Fund Projects(2022ZY0224)the Open Project Program of’Ministry of Education Key Laboratory of Ecology and Resources Use of the Mongolian Plateau(KF2023003)’the Major Science and Technology Project of Inner Mongolia Autonomous Region:Monitoring,Assessment and Early Warning Technology Research of Biodiversity in Inner Mongolia(2021ZD0011)。
文摘Biological specimens are fundamental for taxonomy and flora/fauna research.More importantly,they also play crucial roles in recording environmental impacts on morphology and behavior,which is vital for biodiversity research and conservation.However,there are few systematic studies on the patterns and drivers of bird specimen number at regional scales.This study is the first attempt to examine the relationships between bird specimen number and species traits as well as climate niche breadth in China,aiming to answer two questions:1)how do species’temperature niche breadth and precipitation niche breadth influence specimen number?2)which trait is most associated with bird specimen number?The associations between bird specimen number and explanatory variables were examined using ordinary least squares,generalized linear models,phylogenetic generalized linear mixed models,and multiple comparisons.The results showed that Muscicapidae was the family with the highest specimen number,and Passeriformes was the order with the highest specimen number.Bird specimen number significantly increased with larger temperature niche breadth and precipitation niche breadth.Specimen number was also positively associated with geographic range size,habitat specificity,hunting vulnerability and clutch size,but negatively associated with body size.These findings suggest that future bird specimen collection should pay more attention to birds with limited ecological niches,large body sizes,and small clutch sizes.This research enhances the use of bird specimen data to study and preserve biodiversity.
基金Projects(51925402,52334005,52304094)supported by the National Natural Science Foundation of ChinaProject(20201102004)supported by the Shanxi Science and Technology Major Project,China。
文摘The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency disturbance dynamic uniaxial compression tests on coal specimens using a self-developed dynamic-static load coupling electro-hydraulic servo system,and studied the strength evolutions,surface deformations,acoustic emission(AE)characteristic parameters,and the failure modes of coal specimens with different static preloading levels were studied.The disturbance damage is positively correlated with the coal specimen static preload level.Specifically,the cumulative AE count rates of the initial accelerated damage stage for the coal specimens with static preloading level of 60%and 70%of the uniaxial compressive strength(UCS)were 2.66 and 3.19 times that of the 50%UCS specimens,respectively.Macroscopically,this behaviour manifested as a decrease in the compressive strength,and the mean strengths of the disturbance-damaged coal specimens with 60%and 70%of UCS static preloading decreased by 8.53%and 9.32%,respectively,compared to those of the specimens under pure static loading.The crack sources,such as the primary fissures,strongly control the dynamic response of the coal specimen.The difference between the dynamic responses of the coal specimens and that of dense rocks is significant.
基金the Natural Science Foundation of Inner Mongolia,China(2023JQ01)the National Key R&D Program of China(2019YFA0607103)+2 种基金the Central Government Guides Local Science and Technology Development Fund Projects(2022ZY0224)the Open Project Program of Ministry of Education Key Laboratory of Ecology and Resources Use of the Mongolian Plateau,Hohhot,Inner Mongolia,China(KF2023003)Major Science and Technology Project of Inner Mongolia Autonomous Region:Monitoring,Assessment and Early Warning Technology Research of Biodiversity in Inner Mongolia(2021ZD0011)for financial support.
文摘Many different factors,such as species traits,socio-economic factors,geographical and environmental factors,can lead to specimen collection preference.This study aims to determine whether grassland specimen collection in China is preferred by species traits(i.e.,plant height,flowering and fruiting period),environmental range(i.e.,the temperature and precipitation range)and geographical range(i.e.,distribution range and altitudinal range).Ordinary least squares models and phylogenetic generalized linear mixed models were used to analyze the relationships between specimen number and the explanatory variables.Random Forest models were then used to find the most parsimonious multivariate model.The results showed that interannual variation in specimen number between 1900 and 2020 was considerable.Specimen number of these species in southeast China was notably lower than that in northwest China.Environmental range and geographical range of species had significant positive correlations with specimen number.In addition,there were relatively weak but significant associations between specimen number and species trait(i.e.,plant height and flowering and fruiting period).Random Forest models indicated that distribution range was the most important variable,followed by flowering and fruiting period,and altitudinal range.These findings suggest that future floristic surveys should pay more attention to species with small geographical range,narrow environmental range,short plant height,and short flowering and fruiting period.The correction of specimen collection preference will also make the results of species distribution model,species evolution and other works based on specimen data more accurate.
文摘BACKGROUND Natural orifice specimen extraction surgery(NOSES)has emerged as a promising alternative compared to conventional laparoscopic-assisted total gastrectomy(LATG)for treating gastric cancer(GC).However,evidence regarding the efficacy and safety of NOSES for GC surgery is limited.This study aimed to compare the safety and feasibility,in addition to postoperative complications of NOSES and LATG.METHODS Dual circular staplers were used in Roux-en-Y digestive tract reconstruction for transvaginal specimen extraction LATG,and its outcomes were compared with LATG in a cohort of 51 GC patients with tumor size≤5 cm.The study was conducted from May 2018 to September 2020,and patients were categorized into the NOSES group(n=22)and LATG group(n=29).Perioperative parameters were compared and analyzed,including patient and tumor characteristics,postoperative outcomes,and anastomosis-related complications,postoperative hospital stay,the length of abdominal incision,difference in tumor type,postoperative complications,and postoperative survival.RESULTS Postoperative exhaust time,operation duration,mean postoperative hospital stay,length of abdominal incision,number of specific staplers used,and Brief Illness Perception Questionnaire score were significant in both groups(P<0.01).In the NOSES group,the postoperative time to first flatus,mean postoperative hospital stay,and length of abdominal incision were significantly shorter than those in the LATG group.Patients in the NOSES group had faster postoperative recovery,and achieved abdominal minimally invasive incision that met aesthetic requirements.There were no significant differences in gender,age,tumor type,postoperative complications,and postoperative survival between the two groups.CONCLUSION The application of dual circular staplers in Roux-en-Y digestive tract reconstruction combined with NOSES gastrectomy is safe and convenient.This approach offers better short-term outcomes compared to LATG,while long-term survival rates are comparable to those of conventional laparoscopic surgery.
基金Financial support provided by Correlated Solutions Incorporated to perform StereoDIC experimentsthe Department of Mechanical Engineering at the University of South Carolina for simulation studies is deeply appreciated.
文摘To compare finite element analysis(FEA)predictions and stereovision digital image correlation(StereoDIC)strain measurements at the same spatial positions throughout a region of interest,a field comparison procedure is developed.The procedure includes(a)conversion of the finite element data into a triangular mesh,(b)selection of a common coordinate system,(c)determination of the rigid body transformation to place both measurements and FEA data in the same system and(d)interpolation of the FEA nodal information to the same spatial locations as the StereoDIC measurements using barycentric coordinates.For an aluminum Al-6061 double edge notched tensile specimen,FEA results are obtained using both the von Mises isotropic yield criterion and Hill’s quadratic anisotropic yield criterion,with the unknown Hill model parameters determined using full-field specimen strain measurements for the nominally plane stress specimen.Using Hill’s quadratic anisotropic yield criterion,the point-by-point comparison of experimentally based full-field strains and stresses to finite element predictions are shown to be in excellent agreement,confirming the effectiveness of the field comparison process.
基金Supported by the Qinghai Province Geological Exploration Fund Project(2023085029ky004)Natural Science Foundation of Jilin Provinc(20220101161JC)Open Project Plan of Shandong Province Deep Gold Exploration in Big Data Application and Development Engineering Laboratory(SDK202203).
文摘The naming of rock hand specimens is usually conducted by geological workers based on observed mineral composition,texture characteristics,etc.,combined with their own knowledge reserves.The accuracy of identification results is limited by the experience,research interests,and identification level of the identifier,as well as the complexity of the rock composition.To improve the efficiency of rock hand specimen identification,this paper proposes a method for rock image recognition and classification based on deep learning and the Inception-v3 model.It encompasses the preprocessing of collected photographs of typical intrusive rock hand specimens,along with augmenting the sample size through data augmentation methods,culminating in a comprehensive dataset comprising 12501 samples.Experimental results show that the model has good learning ability when there is sufficient data.Through iterative training of the Inception-v3 model on the rock dataset,the accuracy of rock image recognition reaches 92.83%,with a loss of only 0.2156.Currently,several common types of intrusive rocks can be identified:gabbro,granite,diorite,peridotite,granodiorite,diabase,and granite porphyry.Software is developed for open use by geological workers to improve work efficiency.
文摘Using a scanning electron microscope (SEM) in the back-scattered electron (BSE) mode the composition of multi-element specimens may be determined based on the strong dependence of emission coefficient η on the average atomic number of elements Z. The output video signal of the usual BSE detectors is produced from their sensors, and the larger proportion of high-energy electrons with modified spectrum is added. Since η = is/ip (is and ip currents of specimen and probe), better accuracy must be achieved by direct measurements those currents on the specimen surface. Here, an experimental model of a current detector for a presented specimen is described. The cage is mounted on the carousel of the moving specimen stage. The input of the preamplifier is connected to the specimen holder in the form of a disk, the diameter of which is 12 mm. When the probe along its surface scanned, the input potential begins to pulsate with a negative polarity. The output of this preamplifier is connected to a small light-emitting diode, which creates intensity-modulated radiation in the chamber. Thus created the light video signal will be picked up by the photomultiplier of the E-T detector. The modes of true SE and BSE are set by applying tens bias volts of various polarities to the specimens or the cage itself.
文摘Objective:To analyze the application effect of feedforward control in outpatient blood specimen management.Methods:1,200 patients who had their venous blood collected in outpatient phlebotomy room of our hospital's outpatient clinic from January 2021 to April 2021 were selected as study subjects and divided into 600 cases in the control group and 600 cases in the observation group.The two groups of patients were compared in terms of their satisfaction with the staff,the efficiency of the nurses and the quality of nursing care,turnaround time before specimen analysis,the rejection rate of the blood specimens,and the time of result reporting.Results:After the implementation of feedforward control,patients'satisfaction with staff,nurses work efficiency and quality of care,turnaround time before specimen analysis,specimen rejection rate,and result reporting time in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:The application of feedforward control in the management of outpatient blood specimens has significant effect,which effectively improves patients'satisfaction,enhances the efficiency of nurses and the quality of nursing care,shortens the turnaround time of specimens before analysis and the reporting time of results,and reduces the rejection rate of specimens.
基金Medical and Health Science and Technology Plan of Inner Mongolia Autonomous Region(No.202202405)Clinical Key Specialty Construction Project of Inner Mongolia Autonomous Region(2023)+1 种基金Bayannur City Science and Technology Innovation Driving Project(No.K202029,SFK2020LH05)Internal Research Project of Bayannur City Hospital(No.2019022)。
文摘Objective: To explore the value of hand-sewn anastomosis in totally laparoscopic radical resection of colorectal cancr with transanal specimen extraction. Methods: A retrospective descriptive study was conducted. Clinical data of 54 patients with colorectal cancer who underwent totally laparoscopic transrectal specimen extraction surgery between January 2019 and December 2023 at the Department of Gastrointestinal Surgery, Bayannur City Hospital, were collected. All patients underwent digestive tract reconstruction using hand-sewn end-to-end colonic or rectal anastomosis. Intraoperative and postoperative general conditions, pathological results, complications, and follow-up data were analyzed. Results: Among the 54 cases, 37 were male, and 17 were female. The cases included 26 sigmoid colon cancers, 27 high rectal cancers, and 1 descending colon cancer. All patients underwent totally laparoscopic radical resection of colorectal cancer with transrectal specimen extraction. The average surgical duration was 187.87 ± 61.36 minutes, with 16 (14-19) minutes required for hand-sewn anastomosis. Intraoperative blood loss was 16 (10-200) mL, with no conversions to open surgery or blood transfusions. Postoperative outcomes included first flatus time of 1 (1-3) day, liquid diet resumption on 2 (2-3) days, postoperative Visual Analog Scale (VAS) pain score of 2 (2-3), and hospital stay duration of 8 (7-9) days. The total hospitalization cost was 41,011 (25,655-148,589) Chinese yuan, with an average cost of 42,558.81 ± 8,599.30 Chinese yuan after excluding three cases with complications. Pathological examination revealed all cases to be adenocarcinomas: 20 well-differentiated, 32 moderately differentiated, and 2 poorly differentiated. All resection margins were negative. An average of 16.85 ± 7.97 lymph nodes were dissected. Pathological staging included 18 stage I, 17 stage II, and 19 stage III cases. Postoperative complications included 2 cases of anastomotic leakage (3.7%), 1 case of anastomotic stricture (1.8%), and 1 case of pulmonary infection (1.8%). No unplanned readmissions or postoperative deaths occurred during the 30-day follow-up period. Conclusion: Hand-sewn anastomosis in totally laparoscopic radical resection of colorectal cancer with transanal specimen extraction is safe and feasible.
文摘Over the last 20 years, laparoscopic colorectal surgery has shown equal efficacy for benign and malignant colorectal diseases when compared to open surgery. However, a laparoscopic approach reduces postoperative morbidity and shortens hospital stay. In the quest to optimize outcomes after laparoscopic colorectal surgery, reduction of access trauma could be a way to improve recovery. To date, one method to reduce access trauma is natural orifice specimen extraction(NOSE). NOSE aims to reduce access trauma in laparoscopic colorectal surgery. The specimen is delivered via a natural orifice and the anastomosis is created intracorporeally. Different methods are used to extract the specimen and to create a bowel anastomosis. Currently, specimens are delivered transcolonically, transrectally, transanally, or transvaginally. Each of these NOSEprocedures raises specific issues with regard to operative technique and application. The presumed benefits of NOSE-procedures are less pain, lower analgesia requirements, faster recovery, shorter hospital stay, better cosmetic results, and lower incisional hernia rates. Avoidance of extraction site laparotomy is the most important characteristic of NOSE. Concerns associated with the NOSE-technique include bacterial contamination of the peritoneal cavity, inflammatory response, and postoperative outcomes, including postoperative pain and the functional and oncologic outcomes. These issues need to be studied in prospective randomized controlled trials. The aim of this systematic review is to describe the role of NOSE in minimally invasive colorectal surgery.
文摘AIM: To investigate whether transanal natural orifice specimen extraction (NOSE) is a better technique for rectal cancer resection.METHODS: A prospectively designed database of a consecutive series of patients undergoing laparoscopic low anterior resection for rectal cancer with various tumor-node-metastasis classi?cations from March 2011 to February 2012 at the First Affiliated Hospital of Sun Yat-Sen University was analyzed. Patient selection for transanal specimen extraction and intracorporeal anastomosis was made on the basis of tumor size and distance of rectal lesions from the anal verge. Demographic data, operative parameters, and postoperative outcomes were assessed.RESULTS: None of the patients was converted to laparotomy. Respectively, there were 16 cases in the low anastomosis and five in the ultralow anastomosis groups. Mean age of the patients was 45.4 years, and mean body mass index was 23.1 kg/m2. Mean distance of the lower edge of the lesion from the anal verge was 8.3 cm. Mean operating time was 132 min, and mean intraoperative blood loss was 84 mL. According to the principle of rectal cancer surgery, we performed D2 lymph node dissection in 13 cases and D3 in eight. Mean lymph nodes harvest was 17.8, and the number of positive lymph nodes was 3.4. Median hospital stay was 6.7 d. No serious postoperative complication occurred except for one anastomotic leakage. All patients remained disease free. Mean Wexner score was 3.7 at 11 mo after the operation.CONCLUSION: Transanal NOSE for total laparoscopic low/ultralow anterior resection is feasible, safe and oncologically sound. Further studies with long-term outcomes are needed to explore its potential advantages.
文摘AIM: To investigate how complete laparoscopic anterior resection with natural orifice specimen extraction (NOSE), as a novel minimally invasive surgery, compares to conventional laparoscopic surgery.
基金supported by National Key R&D Program of China(No.2017YFC0908203)Chinese Academy of Medical Sciences Initiative for Innovative Medicine(No.2017-I2M-2-003 and 2016-I2M-1-001)+2 种基金Science and Technology Project of Chaoyang District,Beijing(No.CYSF-1931)Beijing Science and Technology Program(No.D17110002617004)Beijing Gold-Bridge Funds(No.ZZ19055)。
文摘Objective:The transanal approach to specimen collection,combined with the prolapsing technique,is a wellestablished and minimally invasive surgery for treating rectal cancer.However,reports on outcomes for this approach are sparse.We compared short-and long-term outcomes of conventional laparoscopic surgery(CLS)vs.transanal natural orifice specimen extraction(NOSE)using the prolapsing technique for patients with middle-to low-rectal cancer.Methods:From January 2013 to December 2017,we enrolled consecutive patients with middle-to low-rectal cancer undergoing laparoscopic anterior resection.Totally,50 patients who underwent transanal NOSE using the prolapsing technique were matched with 50 patients who received CLS.Clinical parameters and survival outcomes between the two groups were compared.Results:Estimated blood loss(29.70±29.28 vs.52.80±45.09 mL,P=0.003),time to first flatus(2.50±0.79 vs.2.86±0.76,P=0.022),time to liquid diet(3.62±0.64 vs.4.20±0.76 d,P<0.001),and the need for analgesics(22%vs.48%,P=0.006)were significantly lower for the NOSE group compared to the CLS group.The incidences of overall complications and fecal incontinence were comparable in both groups.After a median follow-up of 44.52 months,the overall local recurrence rate(6%vs.5%,P=0.670),3-year disease-free survival(86.7%vs.88.0%,P=0.945)and 3-year overall survival(95.6%vs.96.0%,P=0.708),were not significantly different.Conclusions:For total laparoscopic rectal resection,transanal NOSE using the prolapsing technique is effective and safe,and associated with less trauma and pain,a faster recovery,and similar survival outcomes compared to CLS.
基金National Natural Science Foundation of China,No.81860519.
文摘BACKGROUND Robotic resection using the natural orifice specimen extraction surgery I-type F method(R-NOSES I-F)is a novel minimally invasive surgical strategy for the treatment of lower rectal cancer.However,the current literature on this method is limited to case reports,and further investigation into its safety and feasibility is warranted.AIM To evaluate the safety and feasibility of R-NOSES I-F for the treatment of low rectal cancer.METHODS From September 2018 to February 2022,206 patients diagnosed with low rectal cancer at First Affiliated Hospital of Nanchang University were included in this retrospective analysis.Of these patients,22 underwent R-NOSES I-F surgery(RNOSES I-F group)and 76 underwent conventional robotic-assisted low rectal cancer resection(RLRC group).Clinicopathological data of all patients were collected and analyzed.Postoperative outcomes and prognoses were compared between the two groups.Statistical analysis was performed using SPSS software.RESULTS Patients in the R-NOSES I-F group had a significantly lower visual analog score for pain on postoperative day 1(1.7±0.7 vs 2.2±0.6,P=0.003)and shorter postoperative anal venting time(2.7±0.6 vs 3.5±0.7,P<0.001)than those in the RLRC group.There were no significant differences between the two groups in terms of sex,age,body mass index,tumor size,TNM stage,operative time,intrao-perative bleeding,postoperative complications,or inflammatory response(P>0.05).Postoperative anal and urinary functions,as assessed by Wexner,low anterior resection syndrome,and International Prostate Symptom Scale scores,were similar in both groups(P>0.05).Long-term follow-up revealed no significant differences in the rates of local recurrence and distant metastasis between the two groups(P>0.05).CONCLUSION R-NOSES I-F is a safe and effective minimally invasive procedure for the treatment of lower rectal cancer.It improves pain relief,promotes gastrointestinal function recovery,and helps avoid incision-related complications.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(2019R1A6A1A03033167).
文摘Although hydraulic fracturing is the most commonly used method for fracturing of shale-gas-bearing rock,there are some problems with this method.As plasma blasting can fracture rock without these problems,laboratory-scale fracturing of cement and rock specimens by plasma blasting was performed to investigate the possibility of using this method in shale gas development.
基金This work was supported by the National High-Technology Research and Development Program of China (863 Program) 2003AA208402.
文摘Objective The causal agent for SARS is considered as a novel coronavirus that has never been described both in human and animals previously. The stability of SARS coronavirus in human specimens and in environments was studied. Methods Using a SARS coronavirus strain CoV-P9, which was isolated from pharyngeal swab of a probable SARS case in Beijing, its stability in mimic human specimens and in mimic environment including surfaces of commonly used materials or in household conditions, as well as its resistances to temperature and UV irradiation were analyzed. A total of 106 TCID50 viruses were placed in each tested condition, and changes of the viral infectivity in samples after treatments were measured by evaluating cytopathic effect (CPE) in cell line Vero-E6 at 48 h after infectionn. Results The results showed that SARS coronavirus in the testing condition could survive in serum, 1:20 diluted sputum and feces for at least 96 h, whereas it could remain alive in urine for at least 72 h with a low level of infectivity. The survival abilities on the surfaces of eight different materials and in water were quite comparable, revealing reduction of infectivity after 72 to 96 h exposure. Viruses stayed stable at 4℃, at room temperature (20℃) and at 37℃ for at least 2 h without remarkable change in the infectious ability in cells, but were converted to be non-infectious after 90-, 60- and 30-min exposure at 56℃, at 67℃ and at 75℃, respectively. Irradiation of UV for 60 min on the virus in culture medium resulted in the destruction of viral infectivity at an undetectable level. Conclusion The survival ability of SARS coronavirus in human specimens and in environments seems to be relatively strong. Heating and UV irradiation can efficiently eliminate the viral infectivity.
基金Supported by Jilin University,China,No.3R211P163428
文摘AIM:To introduce transvaginal or transanal specimen extraction in laparoscopic total mesorectal excision surgery to avoid an abdominal incision. METHODS:Between January 2009 and December 2011,21 patients with rectal cancer underwent laparoscopic radical resection and the specimen was retrieved by two different ways:transvaginal or transanal rectal removal.Transvaginal specimen extraction approach was strictly limited to elderly post-menopausal women who need hysterectomy.Patients aged between 30 and 80 years,with a body mass index of less than 30 kg/m2, underwent elective surgery.The surgical technique and the outcomes related to the specimen extraction,such as duration of surgery,length of hospital stay,and the complications were retrospectively reviewed. RESULTS:Laparoscopic resection using a natural orifice removal approach was successful in all of the 21 patients.Median operating time was 185 min(range,122-260 min)and the estimated blood loss was 48 mL. The mean length of hospital stay was 7.5 d(range,2-11 d).One patient developed postoperative ileus and had an extended hospital stay.The patient complained of minimal pain.There were no postoperative complications or surgery-associated death.The mean size of the lesion was 2.8 cm(range,1.8-6.0 cm),and the mean number of lymph nodes harvested was 18.7(range, 8-27).At a mean follow-up of 20.6 mo(range,10-37 mo),there were no functional disorders associated with the transvaginal and transanal specimen extraction. CONCLUSION:Transvaginal or transanal extraction in L-TME is a safe and effective procedure.Natural orifice specimen extraction can avoid the abdominal wall incision and its potential complications.
文摘AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction(TVSE) for gastric cancer patients.METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE.RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3(range, 42-69) years, and the mean body mass index was 23.2(range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224(range, 200-298) min and 62.5(range, 50-150) m L, respectively. The mean postoperative hospital stay was 3.6(range, 3-5) d. The mean number of lymph nodes resected was 23.6(range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected.CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients.
