BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segme...BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates.CASE SUMMARY We report a newborn baby with gut malrotation associated with jejuno-ileal atresia,congenital SBS and jejunal volvulus.Hematemesis and abdominal distention were noted.At laparotomy,malrotation associated with jejuno-ileal atresia,congenital SBS and jenunal volvulus was confirmed.The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm,including 18 cm necrotic segment below the Treitz’s ligament and 20 cm severe ischemic segment.The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter.Ladd’s procedure,necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed.The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure.Three months later,to restore the continuity of the isolated gut segment,end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed.The entire functional small bowel length increased to 80 cm.Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively.Twelve months later,her body weight was 9.5 kg.CONCLUSION Isolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.展开更多
AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE und...AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×80.The magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s classification.Then,a 0.5%solution of methylene blue(MB)was sprayed over columnar mucosa.The patterns of the magnified image and MB staining were analyzed.Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.RESULTS:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.展开更多
The size and shape of the effective test area are crucial to consider when short-crested waves are created by segmented wavemakers. The range of the effective test area of short-crested waves simulated by two-sided se...The size and shape of the effective test area are crucial to consider when short-crested waves are created by segmented wavemakers. The range of the effective test area of short-crested waves simulated by two-sided segmented wavemakers is analyzed in this paper. The experimental investigation on the wave field distribution of short-crested waves generated by two-sided segmented wavemakers is conducted by using an array of wave gauges. Wave spectra and directional spreading function are analyzed and the results show that when the main direction is at a certain angle with the normal line of wave generators, the wave field of 3D short-crested waves generated by two-sided segmented wavemakers has good spatial uniformity within the model test area. The effective test area can provide good wave environments for seakeeping model tests of various ocean engineering structures in the deep ocean engineering basin.展开更多
Multi-components sinusoidal engineering signals who are non-stationary signals were considered in this study since their separation and segmentations are of great interests in many engineering fields. In most cases, t...Multi-components sinusoidal engineering signals who are non-stationary signals were considered in this study since their separation and segmentations are of great interests in many engineering fields. In most cases, the segmentation of non-stationary or multi-component signals is conducted in time domain. In this paper, we explore the advantages of applying joint time-frequency (TF) distribution of the multi-component signals to identify their segments. The Spectrogram that is known as Short-Time Fourier Transform (STFT) will be used for obtaining the time-frequency kernel. Time marginal of the computed kernel is optimally used for the signal segmentation. In order to obtain the desirable segmentation, it requires first to improve time marginal of the kernel by using two-dimensional Wiener mask filter applied to the TF kernel to mitigate and suppress non-stationary noise or interference. Additionally, a proper choice of the sliding window and its overlaying has enhanced our scheme to capture the discontinuities corresponding to the boundaries of the candidate segments.展开更多
文摘BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates.CASE SUMMARY We report a newborn baby with gut malrotation associated with jejuno-ileal atresia,congenital SBS and jejunal volvulus.Hematemesis and abdominal distention were noted.At laparotomy,malrotation associated with jejuno-ileal atresia,congenital SBS and jenunal volvulus was confirmed.The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm,including 18 cm necrotic segment below the Treitz’s ligament and 20 cm severe ischemic segment.The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter.Ladd’s procedure,necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed.The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure.Three months later,to restore the continuity of the isolated gut segment,end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed.The entire functional small bowel length increased to 80 cm.Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively.Twelve months later,her body weight was 9.5 kg.CONCLUSION Isolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.
文摘AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×80.The magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s classification.Then,a 0.5%solution of methylene blue(MB)was sprayed over columnar mucosa.The patterns of the magnified image and MB staining were analyzed.Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.RESULTS:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.
基金financially supported by the National Natural Science Foundation of China(Grant No.51239007)
文摘The size and shape of the effective test area are crucial to consider when short-crested waves are created by segmented wavemakers. The range of the effective test area of short-crested waves simulated by two-sided segmented wavemakers is analyzed in this paper. The experimental investigation on the wave field distribution of short-crested waves generated by two-sided segmented wavemakers is conducted by using an array of wave gauges. Wave spectra and directional spreading function are analyzed and the results show that when the main direction is at a certain angle with the normal line of wave generators, the wave field of 3D short-crested waves generated by two-sided segmented wavemakers has good spatial uniformity within the model test area. The effective test area can provide good wave environments for seakeeping model tests of various ocean engineering structures in the deep ocean engineering basin.
文摘Multi-components sinusoidal engineering signals who are non-stationary signals were considered in this study since their separation and segmentations are of great interests in many engineering fields. In most cases, the segmentation of non-stationary or multi-component signals is conducted in time domain. In this paper, we explore the advantages of applying joint time-frequency (TF) distribution of the multi-component signals to identify their segments. The Spectrogram that is known as Short-Time Fourier Transform (STFT) will be used for obtaining the time-frequency kernel. Time marginal of the computed kernel is optimally used for the signal segmentation. In order to obtain the desirable segmentation, it requires first to improve time marginal of the kernel by using two-dimensional Wiener mask filter applied to the TF kernel to mitigate and suppress non-stationary noise or interference. Additionally, a proper choice of the sliding window and its overlaying has enhanced our scheme to capture the discontinuities corresponding to the boundaries of the candidate segments.
