BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidec...BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.展开更多
The photoacoustic imaging of lipid is intrinsically constrained by the feeble nature of endogenous lipid signals,posing a persistent sensitivity challenge that demands innovative solutions.Although adopting high-effic...The photoacoustic imaging of lipid is intrinsically constrained by the feeble nature of endogenous lipid signals,posing a persistent sensitivity challenge that demands innovative solutions.Although adopting high-efficiency excitation and detection elements may improve the imaging sensitivity to a certain extent,the application of the elements is inevitably subject to various limitations in practical applications,particularly during in vivo imaging and endoscopic imaging.In this study,we propose a multi-combinatorial approach to enhance the sensitivity of lipid photoacoustic imaging.The approach involves wavelet transform processing of one-dimensional A-line signals,gradient-based denoising of two-dimensional B-scan images,and finally,threedimensional spatial weighted averaging of the data processed by the previous two steps.This method not only significantly improves the signal-to-noise ratio(SNR)in distinguished feature regions of the image by around 10 dB,but also efficiently extracts weak signals with no distinct features in the original image.After processing with this method,the images acquired under single scanning were compared with those obtained under multiple scanning.The results showed highly consistent image features,with the structural similarity index increasing from 0.2 to 0.8,confirming the accuracy and reliability of the multi-combinatorial approach.展开更多
With the rapid development of intelligent navigation technology,efficient and safe path planning for mobile robots has become a core requirement.To address the challenges of complex dynamic environments,this paper pro...With the rapid development of intelligent navigation technology,efficient and safe path planning for mobile robots has become a core requirement.To address the challenges of complex dynamic environments,this paper proposes an intelligent path planning framework based on grid map modeling.First,an improved Safe and Smooth A*(SSA*)algorithm is employed for global path planning.By incorporating obstacle expansion and cornerpoint optimization,the proposed SSA*enhances the safety and smoothness of the planned path.Then,a Partitioned Dynamic Window Approach(PDWA)is integrated for local planning,which is triggered when dynamic or sudden static obstacles appear,enabling real-time obstacle avoidance and path adjustment.A unified objective function is constructed,considering path length,safety,and smoothness comprehensively.Multiple simulation experiments are conducted on typical port grid maps.The results demonstrate that the improved SSA*significantly reduces the number of expanded nodes and computation time in static environmentswhile generating smoother and safer paths.Meanwhile,the PDWA exhibits strong real-time performance and robustness in dynamic scenarios,achieving shorter paths and lower planning times compared to other graph search algorithms.The proposedmethodmaintains stable performance across maps of different scales and various port scenarios,verifying its practicality and potential for wider application.展开更多
The 17 Sustainable Development Goals(SDGs)for 2030,adopted by all United Nations member states in 2015,are facing a range of challenges.Factors such as climate change,regional conflicts and economic recession are havi...The 17 Sustainable Development Goals(SDGs)for 2030,adopted by all United Nations member states in 2015,are facing a range of challenges.Factors such as climate change,regional conflicts and economic recession are having a significant impact,particularly on global poverty governance.As a platform for dialogue,exchange and technical cooperation,the 2025 International Seminar on Global Poverty Reduction Partnerships was held in Beijing on 10 December 2025.展开更多
The rapid identification of γ-emitting radionuclides with low activity levels in public areas is crucial for nuclear safety.However,classical methods rely on full-energy peaks in the integral spectrum,requiring suffi...The rapid identification of γ-emitting radionuclides with low activity levels in public areas is crucial for nuclear safety.However,classical methods rely on full-energy peaks in the integral spectrum,requiring sufficient count accumulation for evaluation,thereby limiting response time.The sequential Bayesian approach,which utilizes prior information and considers both photon energies and interarrival times,can significantly enhance the performance of radionuclides identification.This study proposes a theoretical optimization method for the traditional sequential Bayesian approach.Each photon is processed sequentially,and the corresponding posterior probability is updated in real time using a noninformative prior from the Bayesian theory.By comparing the posterior probabilities of the background and radionuclides based on the energy variance and time interval,the type of γ-rays can be identified(background characteristic γ-rays,Compton plateaus γ-rays,or radionuclide-specific characteristic γ-rays).By integrating the information from these multiple characteristic γ-rays,the presence and type of radionuclides were determined based on the final decision function and a set threshold.Based on theoretical research,verification experiments were conducted using a LaBr_(3)(Ce)detector in both low-and natural background radiation environments with typical radionuclides(^(137)Cs,^(60)Co,and ^(133)Ba).The results show that this approach can identify ^(137)Cs in 7.9 s and 8.5 s(source dose rate contribution:approximately 6.5×10^(−3)μGy/h),^(60)Co in 8.1 s and 9.8 s(approximately 4.8×10^(−2)μGy/h),and ^(133)Ba in 4.05 s and 5.99 s(approximately 3.4×10^(−2)μGy/h)under low and natural background radiation,respectively,with a miss rate below 0.01%.This demonstrates the effectiveness of the proposed approach for fast radionuclides identification,even at low activity levels and highlights its potential for enhancing public safety in diverse radiation environments.展开更多
West Java in the western part of the Sunda Arc has a relatively high seismicity due to subduction activity and faults.In this study,double-difference tomography was used to obtain the 3D velocity tomograms of P and S ...West Java in the western part of the Sunda Arc has a relatively high seismicity due to subduction activity and faults.In this study,double-difference tomography was used to obtain the 3D velocity tomograms of P and S waves beneath the western part of Java.To infer the geometry of the structure beneath the study area,precise earthquake hypo・center determination was first performed before tomographic imaging.For this,earthquake waveform data were extracted from the regional Meteorological,Climatological,Geophysical Agency(BMKG)network of Indonesia from South Sumatra to Central Java.The P and S arrival times for about 1,000 events in the period April 2009 to July 2016 were selected,the key features being events of magnitude>3,azimuthal gap<210°and number of phases>8.A nonlinear method using the oct-tree sampling algorithm from the NonLinLoc program was employed to determine the earthquake hypocenters.The hypocenter locations were then relocated using double-difference tomography(tomoDD).A significant reduction of travel-time(root mean square basis)and a better clustering of earthquakes were achieved which correlated well with the geological structure in West Java.Double-difference tomography was found to give a clear velocity structure,especially beneath the volcanic arc area,i.e.,under Mt Anak Krakatau,Mt Salak and the mountains complex in the southern part of West Java.Low velocity anomalies for the P and S waves as well as the vp/vs ratio below the volcanoes indicated possible partial melting of the upper mantle which ascended from the subducted slab beneath the volcanic arc.展开更多
In this paper,we use the double difference location method based on waveform crosscorrelation algorithm for precise positioning of the Three Gorges Reservoir( TGR)earthquakes and analysis of seismic activity. First,we...In this paper,we use the double difference location method based on waveform crosscorrelation algorithm for precise positioning of the Three Gorges Reservoir( TGR)earthquakes and analysis of seismic activity. First,we use the bi-spectrum cross-correlation method to analyze the seismic waveform data of TGR encrypted networks from March,2009 to December,2010,and evaluate the quality of waveform cross-correlation analysis.Combined with the waveform cross-correlation of data obtained, we use the double difference method to relocate the earthquake position. The results show that location precision using bi-spectrum verified waveform cross-correlation data is higher than that by using other types of data,and the mean 2 sig-error in EW,NS and UD are 3.2 m,3.9 m and 6.2 m,respectively. For the relocation of the Three Gorges Reservoir earthquakes,the results show that the micro-earthquakes along the Shenlongxi river in the Badong reservoir area obviously show the characteristics of three linear zones with nearly east-west direction,which is in accordance with the small faults and carbonate strata line of the neotectonic period,revealing the reservoir water main along the underground rivers or caves permeated and induced seismic activity. The stronger earthquakes may have resulted from small earthquakes through the active layers.展开更多
We applied double-difference tomography to relocate seismic events and determine the lithospheric velocity structure beneath the New Britain Island arc and the South Bismarck Sea Basin,based on the local P wave arriva...We applied double-difference tomography to relocate seismic events and determine the lithospheric velocity structure beneath the New Britain Island arc and the South Bismarck Sea Basin,based on the local P wave arrival time dataset collected by the International Seismological Centre.Results of the seismic relocation and velocity inversion show that the subduction of Solomon Sea Plate along the New Britain Trench is spatially different above 150 km,and the subduction angle of the slab on the west side is higher than that on the east side.The relocated earthquakes also show that there are double seismic zones at the depths of about 30–90km beneath the New Britain Island Arc.The velocity structure shows that the dehydration of the subducting slab caused the low-velocity anomalies in mantle wedge above the slab,which are associated with the magmatic activities around the New Guinea-New Britain Island arc.Moreover,it shows that there is another low-velocity anomaly zone beneath the Bismarck mid-oceanic ridge with spatial variation.Beneath the west of the Bismarck mid-oceanic ridge,the low-velocity anomaly is weakly connected to the subducted Solomon Sea slab.Conversely,the low-velocity anomaly beneath the Manus Sea Basin is highly intertwined to the subducting slab and its mantle wedge,indicating that the subduction of the Solomon Sea Plate might be a key deep dynamic factor that drives the spreading of the Manus Sea Basin and the separation of the Bismarck Plate.展开更多
The locations of about 400 earthquakes in Yangjiang, Guangdong Province are determined using the double, difference earthquake location algorithm （DDA）. The seismicity pattern becomes concentrated from discrete grid...The locations of about 400 earthquakes in Yangjiang, Guangdong Province are determined using the double, difference earthquake location algorithm （DDA）. The seismicity pattern becomes concentrated from discrete grids. The rupture characteristics of the Yangjiang earthquake sequence show a conjugated distribution in NW and NE directions. The major distribution trends NE and dips NE with an angle of 30^o and a length of 30km,and the minor distribution trends NW and dips SE with an angle of 30^o and a length of 20km. The focal depth is 5km - 15km. The distribution of the Enping earthquake sequence,which is not far from Yangjiang,is NW-trending. The relationship between hypocenter distribution and geological structure is discussed.展开更多
Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponi...Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.展开更多
For large-scale heterogeneous multi-agent systems(MASs)with characteristics of dense-sparse mixed distribution,this paper investigates the practical finite-time deployment problem by establishing a novel crossspecies ...For large-scale heterogeneous multi-agent systems(MASs)with characteristics of dense-sparse mixed distribution,this paper investigates the practical finite-time deployment problem by establishing a novel crossspecies bionic analytical framework based on the partial differential equation-ordinary differential equation(PDE-ODE)approach.Specifically,by designing a specialized network communication protocol and employing the spatial continuum method for densely distributed agents,this paper models the tracking errors of densely distributed agents as a PDE equivalent to a human disease transmission model,and that of sparsely distributed agents as several ODEs equivalent to the predator population models.The coupling relationship between the PDE and ODE models is established through boundary conditions of the PDE,thereby forming a PDE-ODE-based tracking error model for the considered MASs.Furthermore,by integrating adaptive neural control scheme with the aforementioned biological models,a“Flexible Neural Network”endowed with adaptive and self-stabilized capabilities is constructed,which acts upon the considered MASs,enabling their practical finite-time deployment.Finally,effectiveness of the developed approach is illustrated through a numerical example.展开更多
The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed patho...The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed pathogenesis accounting for dopaminergic neuron degeneration in Parkinson's disease is still unclear,the advancement of stem cell approaches has shown promise for Parkinson's disease research and therapy.The induced pluripotent stem cells have been commonly used to generate dopaminergic neurons,which has provided valuable insights to improve our understanding of Parkinson's disease pathogenesis and contributed to anti-Parkinson's disease therapies.The current review discusses the practical approaches and potential applications of induced pluripotent stem cell techniques for generating and differentiating dopaminergic neurons from induced pluripotent stem cells.The benefits of induced pluripotent stem cell-based research are highlighted.Various dopaminergic neuron differentiation protocols from induced pluripotent stem cells are compared.The emerging three-dimension-based brain organoid models compared with conventional two-dimensional cell culture are evaluated.Finally,limitations,challenges,and future directions of induced pluripotent stem cell–based approaches are analyzed and proposed,which will be significant to the future application of induced pluripotent stem cell-related techniques for Parkinson's disease.展开更多
Deep learning algorithms have been rapidly incorporated into many different applications due to the increase in computational power and the availability of massive amounts of data.Recently,both deep learning and ensem...Deep learning algorithms have been rapidly incorporated into many different applications due to the increase in computational power and the availability of massive amounts of data.Recently,both deep learning and ensemble learning have been used to recognize underlying structures and patterns from high-level features to make predictions/decisions.With the growth in popularity of deep learning and ensemble learning algorithms,they have received significant attention from both scientists and the industrial community due to their superior ability to learn features from big data.Ensemble deep learning has exhibited significant performance in enhancing learning generalization through the use of multiple deep learning algorithms.Although ensemble deep learning has large quantities of training parameters,which results in time and space overheads,it performs much better than traditional ensemble learning.Ensemble deep learning has been successfully used in several areas,such as bioinformatics,finance,and health care.In this paper,we review and investigate recent ensemble deep learning algorithms and techniques in health care domains,medical imaging,health care data analytics,genomics,diagnosis,disease prevention,and drug discovery.We cover several widely used deep learning algorithms along with their architectures,including deep neural networks(DNNs),convolutional neural networks(CNNs),recurrent neural networks(RNNs),and generative adversarial networks(GANs).Common healthcare tasks,such as medical imaging,electronic health records,and genomics,are also demonstrated.Furthermore,in this review,the challenges inherent in reducing the burden on the healthcare system are discussed and explored.Finally,future directions and opportunities for enhancing healthcare model performance are discussed.展开更多
This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal disease...This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.展开更多
Microwave-assisted rock-breaking technology,as a novel hybrid approach,is anticipated to facilitate the efficient excavation of complex rock formations.It is therefore crucial to understand the damage and failure mech...Microwave-assisted rock-breaking technology,as a novel hybrid approach,is anticipated to facilitate the efficient excavation of complex rock formations.It is therefore crucial to understand the damage and failure mechanisms of rocks that have been subjected to irradiation.In this study,uniaxial compression experiments were conducted on granite specimens after 1.4 kW microwave irradiation for varying durations.Furthermore,a numerical method was proposed to solve electromagnetic-thermal-mechanical coupling problems by integrating finite and discrete elements.The results demonstrated a differential temperature distribution(high temperature in the middle and low-temperature areas at the ends)in the granite specimens under microwave irradiation,which resulted in a notable reduction in their physical and mechanical properties.As the duration of irradiation increased,the rate of heating and the extent of strength reduction both diminished,while the morphology and distribution of cracks at ultimate failure became increasingly complex.The numerical method effectively addresses the simulation challenges associated with the electromagnetic selective heating of granite containing multiple polar minerals under microwave irradiation.This approach accounted for the non-uniform thermal expansion of the minerals and provided a comprehensive model of damage progression under compression.展开更多
Objective: To explore the effect of Health Action Process Approach (HAPA) theory in patients with type D personality psoriasis. Methods: A total of 66 patients with type D personality psoriasis admitted to the dermato...Objective: To explore the effect of Health Action Process Approach (HAPA) theory in patients with type D personality psoriasis. Methods: A total of 66 patients with type D personality psoriasis admitted to the dermatology department of a top-three hospital in Jingzhou City from November 2022 to July 2023 were selected and divided into control group and test group with 33 cases in each group by random number table method. The control group received routine health education, and the experimental group received health education based on the HAPA theory. Chronic disease self-efficacy scale, hospital anxiety and depression scale and skin disease quality of life scale were used to evaluate the effect of intervention. Results: After 3 months of intervention, the scores of self-efficacy in experimental group were higher than those in control group (P P Conclusion: Health education based on the theory of HAPA can enhance the self-efficacy of patients with type D personality psoriasis, relieve negative emotions and improve their quality of life.展开更多
Background:Social anxiety is prevalent among adolescents and severely impacts their mental health and social functioning.This study aims to explore the underlying mechanisms and subgroup differences in adolescent soci...Background:Social anxiety is prevalent among adolescents and severely impacts their mental health and social functioning.This study aims to explore the underlying mechanisms and subgroup differences in adolescent social anxiety to provide a theoretical basis for targeted interventions.Methods:3025 Chinese adolescents(Meanage=13.91±1.60 years;47%male)completed self-report measures of physical activity,core self-evaluation,and social anxiety.Variable-centered analyses employed PROCESS Model 4 with 5000 bootstrap samples;covariates were gender,grade,and place of residence.Person-centered analyses used latent profile analysis in Mplus 8.3 to identify subgroups based on social anxiety item profiles.Results:Variable-centered analyses showed that physical activity had a significant negative association with social anxiety(β=−0.224,p<0.001)and a significant positive association with core self-evaluation(β=0.471,p<0.001);core self-evaluation partially mediated this relationship,accounting for 30%of the total effect.Person-centered analyses revealed an optimal two-profile solution:a low social anxiety profile(89.6%)and a high social anxiety profile(10.4%).The high social anxiety profile reported significantly lower physical activity and lower core self-evaluation than the low social anxiety profile.Conclusions:This study integrates variable-centered and person-centered evidence,identifies physical activity and core self-evaluation as key modifiable factors in reducing social anxiety,providing a theoretical basis for targeted and differentiated interventions.展开更多
BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of ...BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.展开更多
BACKGROUND Laparoscopic hepatectomy has been widely accepted for the treatment of liver tumors.Compared with open surgery,it provides a reduced hospital stay,less intraoperative blood loss,less trauma,and fewer incisi...BACKGROUND Laparoscopic hepatectomy has been widely accepted for the treatment of liver tumors.Compared with open surgery,it provides a reduced hospital stay,less intraoperative blood loss,less trauma,and fewer incisional infections,without affecting tumor outcomes.However,lesions in the right lobe of the liver are deep and obstructed by the ribs,making exposure difficult and increasing the degree of surgical difficulty;thus,liver tumors in the deep right lobe pose technical challenges in standard laparoscopic surgery.AIM To investigate the safety and efficacy of laparoscopic retroperitoneal partial hepatectomy for liver tumors.METHODS The clinical data of 72 patients who underwent laparoscopic retroperitoneal partial hepatectomy for liver tumors between January 2018 and December 2024 at the First People’s Hospital of Yunnan Province were analyzed.Of the 72 patients included,34 were male and 38 were female,with ages ranging from 34 years to 72 years(median age,45 years).The tumors were all located in the right lobe of the liver,with 30 cases in segment S6,27 cases in segment S7,and 15 cases in segment S8;the mean tumor diameter was 7.5±3.4 cm.The postoperative tumor indices,liver function,and postoperative complications were analyzed to evaluate the clinical efficacy of laparoscopic partial hepatectomy via the retroperitoneal approach.RESULTS The surgeries were successfully completed in all patients,and conversion to open surgery was required in 10 patients.The mean operative time,blood loss,drain retention time,and length of postoperative hospital stay were 140±30 minutes,150±46 mL,3.8±1.2 days,and 8.3±5.3 days,respectively.Liver function tests returned to normal in all patients within two weeks of surgery.Fifteen patients developed atelectasis and pleural effusion and were managed with incision and drainage and antibiotics.Two patients developed uncomplicated minimal ascites,and the remaining patients had no perioperative complications,such as abdominal hemorrhage,infection,liver failure,bile leakage,and other adverse events.All patients were successfully treated.CONCLUSION Laparoscopic retroperitoneal partial hepatectomy is a safe and effective approach for right hepatic space-occupying lesions,particularly in segments S6,S7,and S8,with fewer postoperative complications,less trauma,and faster recovery times.This procedure provides a new surgical access for resection of deep tumors in the right lobe of the liver and has clear clinical implications.展开更多
In response to the common problems in college English writing teaching,such as the separation of learning and application,students’low interest in writing,and difficulties in expression,this paper,based on the theore...In response to the common problems in college English writing teaching,such as the separation of learning and application,students’low interest in writing,and difficulties in expression,this paper,based on the theoretical framework of the production-oriented approach(POA)proposed by Professor Wen Qiufang,designed and implemented a set of IELTS writing teaching plan.This plan takes“motivating,enabling,and assessing”as the core teaching process,and selects typical IELTS argumentative essay topics(such as food diversity)to create real communication scenarios.In the motivating stage,diverse inputs are used to stimulate students’interest and expose their language weaknesses;in the enabling stage,language knowledge,viewpoint generation,and text structure are focused on for targeted input and training;in the assessing stage,a combination of teacher-student cooperation and peer evaluation is adopted to guide students to identify and correct deficiencies in language use.The research results show that the POA model can effectively enhance students’writing interest,active learning awareness,and writing ability,particularly in overcoming vocabulary poverty and material shortages,as well as improving language accuracy and expression richness.This provides an operational theoretical basis and practical path for improving the teaching effect of IELTS writing.展开更多
文摘BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.
基金supported by the National Key Research and Development Program of China(2022YFC2402400)the National Natural Science Foundation of China(82027803,62275062)+7 种基金the Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology(2020B121201010)the Shenzhen Science and Technology Innovation Committee under Grant(JCYJ20220818101417039)the Shenzhen Key Laboratory for Molecular lmaging(ZDSY20130401165820357)the Shenzhen Medical Research Fund(D2404002)the Project of Shandong Innovation and Startup Community of High-end Medical Apparatus and Instruments(2023-SGTTXM-002 and 2024-SGTTXM-005)the Shandong Province Technology Innovation Guidance Plan(Central Leading Local Science and Technology Development Fund)(YDZX2023115)the Taishan Scholar Special Funding Project of Shandong Provinceand the Shandong Laboratory of Advanced Biomaterials and Medical Devices in Weihai(ZL202402).
文摘The photoacoustic imaging of lipid is intrinsically constrained by the feeble nature of endogenous lipid signals,posing a persistent sensitivity challenge that demands innovative solutions.Although adopting high-efficiency excitation and detection elements may improve the imaging sensitivity to a certain extent,the application of the elements is inevitably subject to various limitations in practical applications,particularly during in vivo imaging and endoscopic imaging.In this study,we propose a multi-combinatorial approach to enhance the sensitivity of lipid photoacoustic imaging.The approach involves wavelet transform processing of one-dimensional A-line signals,gradient-based denoising of two-dimensional B-scan images,and finally,threedimensional spatial weighted averaging of the data processed by the previous two steps.This method not only significantly improves the signal-to-noise ratio(SNR)in distinguished feature regions of the image by around 10 dB,but also efficiently extracts weak signals with no distinct features in the original image.After processing with this method,the images acquired under single scanning were compared with those obtained under multiple scanning.The results showed highly consistent image features,with the structural similarity index increasing from 0.2 to 0.8,confirming the accuracy and reliability of the multi-combinatorial approach.
文摘With the rapid development of intelligent navigation technology,efficient and safe path planning for mobile robots has become a core requirement.To address the challenges of complex dynamic environments,this paper proposes an intelligent path planning framework based on grid map modeling.First,an improved Safe and Smooth A*(SSA*)algorithm is employed for global path planning.By incorporating obstacle expansion and cornerpoint optimization,the proposed SSA*enhances the safety and smoothness of the planned path.Then,a Partitioned Dynamic Window Approach(PDWA)is integrated for local planning,which is triggered when dynamic or sudden static obstacles appear,enabling real-time obstacle avoidance and path adjustment.A unified objective function is constructed,considering path length,safety,and smoothness comprehensively.Multiple simulation experiments are conducted on typical port grid maps.The results demonstrate that the improved SSA*significantly reduces the number of expanded nodes and computation time in static environmentswhile generating smoother and safer paths.Meanwhile,the PDWA exhibits strong real-time performance and robustness in dynamic scenarios,achieving shorter paths and lower planning times compared to other graph search algorithms.The proposedmethodmaintains stable performance across maps of different scales and various port scenarios,verifying its practicality and potential for wider application.
文摘The 17 Sustainable Development Goals(SDGs)for 2030,adopted by all United Nations member states in 2015,are facing a range of challenges.Factors such as climate change,regional conflicts and economic recession are having a significant impact,particularly on global poverty governance.As a platform for dialogue,exchange and technical cooperation,the 2025 International Seminar on Global Poverty Reduction Partnerships was held in Beijing on 10 December 2025.
基金supported by the Program for NIM-Basic Research Business Expenses Key Field Program,China(No.AKYCX2315).
文摘The rapid identification of γ-emitting radionuclides with low activity levels in public areas is crucial for nuclear safety.However,classical methods rely on full-energy peaks in the integral spectrum,requiring sufficient count accumulation for evaluation,thereby limiting response time.The sequential Bayesian approach,which utilizes prior information and considers both photon energies and interarrival times,can significantly enhance the performance of radionuclides identification.This study proposes a theoretical optimization method for the traditional sequential Bayesian approach.Each photon is processed sequentially,and the corresponding posterior probability is updated in real time using a noninformative prior from the Bayesian theory.By comparing the posterior probabilities of the background and radionuclides based on the energy variance and time interval,the type of γ-rays can be identified(background characteristic γ-rays,Compton plateaus γ-rays,or radionuclide-specific characteristic γ-rays).By integrating the information from these multiple characteristic γ-rays,the presence and type of radionuclides were determined based on the final decision function and a set threshold.Based on theoretical research,verification experiments were conducted using a LaBr_(3)(Ce)detector in both low-and natural background radiation environments with typical radionuclides(^(137)Cs,^(60)Co,and ^(133)Ba).The results show that this approach can identify ^(137)Cs in 7.9 s and 8.5 s(source dose rate contribution:approximately 6.5×10^(−3)μGy/h),^(60)Co in 8.1 s and 9.8 s(approximately 4.8×10^(−2)μGy/h),and ^(133)Ba in 4.05 s and 5.99 s(approximately 3.4×10^(−2)μGy/h)under low and natural background radiation,respectively,with a miss rate below 0.01%.This demonstrates the effectiveness of the proposed approach for fast radionuclides identification,even at low activity levels and highlights its potential for enhancing public safety in diverse radiation environments.
基金the Directorate General of Resources for Science Technologythe Higher Education of the Republic of Indonesia for granting a PMDSU scholarship to SR
文摘West Java in the western part of the Sunda Arc has a relatively high seismicity due to subduction activity and faults.In this study,double-difference tomography was used to obtain the 3D velocity tomograms of P and S waves beneath the western part of Java.To infer the geometry of the structure beneath the study area,precise earthquake hypo・center determination was first performed before tomographic imaging.For this,earthquake waveform data were extracted from the regional Meteorological,Climatological,Geophysical Agency(BMKG)network of Indonesia from South Sumatra to Central Java.The P and S arrival times for about 1,000 events in the period April 2009 to July 2016 were selected,the key features being events of magnitude>3,azimuthal gap<210°and number of phases>8.A nonlinear method using the oct-tree sampling algorithm from the NonLinLoc program was employed to determine the earthquake hypocenters.The hypocenter locations were then relocated using double-difference tomography(tomoDD).A significant reduction of travel-time(root mean square basis)and a better clustering of earthquakes were achieved which correlated well with the geological structure in West Java.Double-difference tomography was found to give a clear velocity structure,especially beneath the volcanic arc area,i.e.,under Mt Anak Krakatau,Mt Salak and the mountains complex in the southern part of West Java.Low velocity anomalies for the P and S waves as well as the vp/vs ratio below the volcanoes indicated possible partial melting of the upper mantle which ascended from the subducted slab beneath the volcanic arc.
基金funded by the National Science and Technology Pillar Program(2008BAC38B04)the Special Research Fund for Seismology(16A44ZX282)
文摘In this paper,we use the double difference location method based on waveform crosscorrelation algorithm for precise positioning of the Three Gorges Reservoir( TGR)earthquakes and analysis of seismic activity. First,we use the bi-spectrum cross-correlation method to analyze the seismic waveform data of TGR encrypted networks from March,2009 to December,2010,and evaluate the quality of waveform cross-correlation analysis.Combined with the waveform cross-correlation of data obtained, we use the double difference method to relocate the earthquake position. The results show that location precision using bi-spectrum verified waveform cross-correlation data is higher than that by using other types of data,and the mean 2 sig-error in EW,NS and UD are 3.2 m,3.9 m and 6.2 m,respectively. For the relocation of the Three Gorges Reservoir earthquakes,the results show that the micro-earthquakes along the Shenlongxi river in the Badong reservoir area obviously show the characteristics of three linear zones with nearly east-west direction,which is in accordance with the small faults and carbonate strata line of the neotectonic period,revealing the reservoir water main along the underground rivers or caves permeated and induced seismic activity. The stronger earthquakes may have resulted from small earthquakes through the active layers.
基金supported by the National Natural Science Foundation of China(Nos.41906048 and 91858215).
文摘We applied double-difference tomography to relocate seismic events and determine the lithospheric velocity structure beneath the New Britain Island arc and the South Bismarck Sea Basin,based on the local P wave arrival time dataset collected by the International Seismological Centre.Results of the seismic relocation and velocity inversion show that the subduction of Solomon Sea Plate along the New Britain Trench is spatially different above 150 km,and the subduction angle of the slab on the west side is higher than that on the east side.The relocated earthquakes also show that there are double seismic zones at the depths of about 30–90km beneath the New Britain Island Arc.The velocity structure shows that the dehydration of the subducting slab caused the low-velocity anomalies in mantle wedge above the slab,which are associated with the magmatic activities around the New Guinea-New Britain Island arc.Moreover,it shows that there is another low-velocity anomaly zone beneath the Bismarck mid-oceanic ridge with spatial variation.Beneath the west of the Bismarck mid-oceanic ridge,the low-velocity anomaly is weakly connected to the subducted Solomon Sea slab.Conversely,the low-velocity anomaly beneath the Manus Sea Basin is highly intertwined to the subducting slab and its mantle wedge,indicating that the subduction of the Solomon Sea Plate might be a key deep dynamic factor that drives the spreading of the Manus Sea Basin and the separation of the Bismarck Plate.
基金The research was sponsored by the Key Science and Technology R&D Program of Guangdong Province(Grant No. 2005B32601003)
文摘The locations of about 400 earthquakes in Yangjiang, Guangdong Province are determined using the double, difference earthquake location algorithm （DDA）. The seismicity pattern becomes concentrated from discrete grids. The rupture characteristics of the Yangjiang earthquake sequence show a conjugated distribution in NW and NE directions. The major distribution trends NE and dips NE with an angle of 30^o and a length of 30km,and the minor distribution trends NW and dips SE with an angle of 30^o and a length of 20km. The focal depth is 5km - 15km. The distribution of the Enping earthquake sequence,which is not far from Yangjiang,is NW-trending. The relationship between hypocenter distribution and geological structure is discussed.
文摘Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.
基金The National Key R&D Program of China(2021ZD0201300)the National Natural Science Foundation of China(624B2058,U1913602 and 61936004)+1 种基金the Innovation Group Project of the National Natural Science Foundation of China(61821003)the 111 Project on Computational Intelligence and Intelligent Control(B18024).
文摘For large-scale heterogeneous multi-agent systems(MASs)with characteristics of dense-sparse mixed distribution,this paper investigates the practical finite-time deployment problem by establishing a novel crossspecies bionic analytical framework based on the partial differential equation-ordinary differential equation(PDE-ODE)approach.Specifically,by designing a specialized network communication protocol and employing the spatial continuum method for densely distributed agents,this paper models the tracking errors of densely distributed agents as a PDE equivalent to a human disease transmission model,and that of sparsely distributed agents as several ODEs equivalent to the predator population models.The coupling relationship between the PDE and ODE models is established through boundary conditions of the PDE,thereby forming a PDE-ODE-based tracking error model for the considered MASs.Furthermore,by integrating adaptive neural control scheme with the aforementioned biological models,a“Flexible Neural Network”endowed with adaptive and self-stabilized capabilities is constructed,which acts upon the considered MASs,enabling their practical finite-time deployment.Finally,effectiveness of the developed approach is illustrated through a numerical example.
基金supported by Singapore National Medical Research Council(NMRC)grants,including CS-IRG,HLCA2022(to ZDZ),STaR,OF LCG 000207(to EKT)a Clinical Translational Research Programme in Parkinson's DiseaseDuke-Duke-NUS collaboration pilot grant(to ZDZ)。
文摘The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed pathogenesis accounting for dopaminergic neuron degeneration in Parkinson's disease is still unclear,the advancement of stem cell approaches has shown promise for Parkinson's disease research and therapy.The induced pluripotent stem cells have been commonly used to generate dopaminergic neurons,which has provided valuable insights to improve our understanding of Parkinson's disease pathogenesis and contributed to anti-Parkinson's disease therapies.The current review discusses the practical approaches and potential applications of induced pluripotent stem cell techniques for generating and differentiating dopaminergic neurons from induced pluripotent stem cells.The benefits of induced pluripotent stem cell-based research are highlighted.Various dopaminergic neuron differentiation protocols from induced pluripotent stem cells are compared.The emerging three-dimension-based brain organoid models compared with conventional two-dimensional cell culture are evaluated.Finally,limitations,challenges,and future directions of induced pluripotent stem cell–based approaches are analyzed and proposed,which will be significant to the future application of induced pluripotent stem cell-related techniques for Parkinson's disease.
基金funded by Taif University,Saudi Arabia,project No.(TU-DSPP-2024-263).
文摘Deep learning algorithms have been rapidly incorporated into many different applications due to the increase in computational power and the availability of massive amounts of data.Recently,both deep learning and ensemble learning have been used to recognize underlying structures and patterns from high-level features to make predictions/decisions.With the growth in popularity of deep learning and ensemble learning algorithms,they have received significant attention from both scientists and the industrial community due to their superior ability to learn features from big data.Ensemble deep learning has exhibited significant performance in enhancing learning generalization through the use of multiple deep learning algorithms.Although ensemble deep learning has large quantities of training parameters,which results in time and space overheads,it performs much better than traditional ensemble learning.Ensemble deep learning has been successfully used in several areas,such as bioinformatics,finance,and health care.In this paper,we review and investigate recent ensemble deep learning algorithms and techniques in health care domains,medical imaging,health care data analytics,genomics,diagnosis,disease prevention,and drug discovery.We cover several widely used deep learning algorithms along with their architectures,including deep neural networks(DNNs),convolutional neural networks(CNNs),recurrent neural networks(RNNs),and generative adversarial networks(GANs).Common healthcare tasks,such as medical imaging,electronic health records,and genomics,are also demonstrated.Furthermore,in this review,the challenges inherent in reducing the burden on the healthcare system are discussed and explored.Finally,future directions and opportunities for enhancing healthcare model performance are discussed.
基金Supported by National Research Foundation of Korea,No.NRF-2021S1A5A8062526.
文摘This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.
基金funded by the Postgraduate Research and Practice Innovation Program of Jiangsu Province(Grant No.KYCX23_2744)the Fundamental Research Funds for the Central Universities(Grant No.2023XSCX051)the Graduate Innovation Program of China University of Mining and Technology(Grant No.2023WLKXJ182).
文摘Microwave-assisted rock-breaking technology,as a novel hybrid approach,is anticipated to facilitate the efficient excavation of complex rock formations.It is therefore crucial to understand the damage and failure mechanisms of rocks that have been subjected to irradiation.In this study,uniaxial compression experiments were conducted on granite specimens after 1.4 kW microwave irradiation for varying durations.Furthermore,a numerical method was proposed to solve electromagnetic-thermal-mechanical coupling problems by integrating finite and discrete elements.The results demonstrated a differential temperature distribution(high temperature in the middle and low-temperature areas at the ends)in the granite specimens under microwave irradiation,which resulted in a notable reduction in their physical and mechanical properties.As the duration of irradiation increased,the rate of heating and the extent of strength reduction both diminished,while the morphology and distribution of cracks at ultimate failure became increasingly complex.The numerical method effectively addresses the simulation challenges associated with the electromagnetic selective heating of granite containing multiple polar minerals under microwave irradiation.This approach accounted for the non-uniform thermal expansion of the minerals and provided a comprehensive model of damage progression under compression.
文摘Objective: To explore the effect of Health Action Process Approach (HAPA) theory in patients with type D personality psoriasis. Methods: A total of 66 patients with type D personality psoriasis admitted to the dermatology department of a top-three hospital in Jingzhou City from November 2022 to July 2023 were selected and divided into control group and test group with 33 cases in each group by random number table method. The control group received routine health education, and the experimental group received health education based on the HAPA theory. Chronic disease self-efficacy scale, hospital anxiety and depression scale and skin disease quality of life scale were used to evaluate the effect of intervention. Results: After 3 months of intervention, the scores of self-efficacy in experimental group were higher than those in control group (P P Conclusion: Health education based on the theory of HAPA can enhance the self-efficacy of patients with type D personality psoriasis, relieve negative emotions and improve their quality of life.
基金The Ministry of Education of China supported this work under the Humanities and Social Sciences Research Project for Young Scholars(Grant No.20YJC890020).
文摘Background:Social anxiety is prevalent among adolescents and severely impacts their mental health and social functioning.This study aims to explore the underlying mechanisms and subgroup differences in adolescent social anxiety to provide a theoretical basis for targeted interventions.Methods:3025 Chinese adolescents(Meanage=13.91±1.60 years;47%male)completed self-report measures of physical activity,core self-evaluation,and social anxiety.Variable-centered analyses employed PROCESS Model 4 with 5000 bootstrap samples;covariates were gender,grade,and place of residence.Person-centered analyses used latent profile analysis in Mplus 8.3 to identify subgroups based on social anxiety item profiles.Results:Variable-centered analyses showed that physical activity had a significant negative association with social anxiety(β=−0.224,p<0.001)and a significant positive association with core self-evaluation(β=0.471,p<0.001);core self-evaluation partially mediated this relationship,accounting for 30%of the total effect.Person-centered analyses revealed an optimal two-profile solution:a low social anxiety profile(89.6%)and a high social anxiety profile(10.4%).The high social anxiety profile reported significantly lower physical activity and lower core self-evaluation than the low social anxiety profile.Conclusions:This study integrates variable-centered and person-centered evidence,identifies physical activity and core self-evaluation as key modifiable factors in reducing social anxiety,providing a theoretical basis for targeted and differentiated interventions.
文摘BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.
基金Supported by Yunnan Provincial Clinical Medicine Center for Digestive System Diseases,No.2024YNLCYXZX0132.
文摘BACKGROUND Laparoscopic hepatectomy has been widely accepted for the treatment of liver tumors.Compared with open surgery,it provides a reduced hospital stay,less intraoperative blood loss,less trauma,and fewer incisional infections,without affecting tumor outcomes.However,lesions in the right lobe of the liver are deep and obstructed by the ribs,making exposure difficult and increasing the degree of surgical difficulty;thus,liver tumors in the deep right lobe pose technical challenges in standard laparoscopic surgery.AIM To investigate the safety and efficacy of laparoscopic retroperitoneal partial hepatectomy for liver tumors.METHODS The clinical data of 72 patients who underwent laparoscopic retroperitoneal partial hepatectomy for liver tumors between January 2018 and December 2024 at the First People’s Hospital of Yunnan Province were analyzed.Of the 72 patients included,34 were male and 38 were female,with ages ranging from 34 years to 72 years(median age,45 years).The tumors were all located in the right lobe of the liver,with 30 cases in segment S6,27 cases in segment S7,and 15 cases in segment S8;the mean tumor diameter was 7.5±3.4 cm.The postoperative tumor indices,liver function,and postoperative complications were analyzed to evaluate the clinical efficacy of laparoscopic partial hepatectomy via the retroperitoneal approach.RESULTS The surgeries were successfully completed in all patients,and conversion to open surgery was required in 10 patients.The mean operative time,blood loss,drain retention time,and length of postoperative hospital stay were 140±30 minutes,150±46 mL,3.8±1.2 days,and 8.3±5.3 days,respectively.Liver function tests returned to normal in all patients within two weeks of surgery.Fifteen patients developed atelectasis and pleural effusion and were managed with incision and drainage and antibiotics.Two patients developed uncomplicated minimal ascites,and the remaining patients had no perioperative complications,such as abdominal hemorrhage,infection,liver failure,bile leakage,and other adverse events.All patients were successfully treated.CONCLUSION Laparoscopic retroperitoneal partial hepatectomy is a safe and effective approach for right hepatic space-occupying lesions,particularly in segments S6,S7,and S8,with fewer postoperative complications,less trauma,and faster recovery times.This procedure provides a new surgical access for resection of deep tumors in the right lobe of the liver and has clear clinical implications.
文摘In response to the common problems in college English writing teaching,such as the separation of learning and application,students’low interest in writing,and difficulties in expression,this paper,based on the theoretical framework of the production-oriented approach(POA)proposed by Professor Wen Qiufang,designed and implemented a set of IELTS writing teaching plan.This plan takes“motivating,enabling,and assessing”as the core teaching process,and selects typical IELTS argumentative essay topics(such as food diversity)to create real communication scenarios.In the motivating stage,diverse inputs are used to stimulate students’interest and expose their language weaknesses;in the enabling stage,language knowledge,viewpoint generation,and text structure are focused on for targeted input and training;in the assessing stage,a combination of teacher-student cooperation and peer evaluation is adopted to guide students to identify and correct deficiencies in language use.The research results show that the POA model can effectively enhance students’writing interest,active learning awareness,and writing ability,particularly in overcoming vocabulary poverty and material shortages,as well as improving language accuracy and expression richness.This provides an operational theoretical basis and practical path for improving the teaching effect of IELTS writing.
